Variation in clear cornea incision size after phacoemulsification and foldable lens implantation

Purpose: To study the changes in clear cornea incision sire after phacoemulsification and implantation of a three-piece, silicone, foldable intraocular lens (IOL). Setting: Departamento de Oftalmologia, Clinica Universitaria de Navarra, Pamplona, Spain. Methods: In this prospective study, phacoemulsification with implantation of a foldable IOL (AMO SI-30NB) was performed in 133 eyes. Surgery was carried out by four surgeons who implanted the IOL with the same forceps. The external incision size was measured before and after phacoemulsification and irrigation/aspiration and before and after IOL implantation. Results: Before phacoemulsification, the mean incision size was 3.07 mm; after phacoemulsification and irrigation/aspiration, it enlarged to 3.09 mm (P = .001). The mean incision size before foldable IOL implantation was 3.16 mm, and after implantation it increased to 3.32 mm (P = .0001). When the IOL was less than 22.0 diopters (D), the final incision size was 3.31 mm +/- 0.11 (SD); when the IOL was 22.0 to 26.0 D, the final size was 3.32 +/- 9.01 mm; and when the IOL was 26.0 D or more, the final size was 3.39 +/- 0.08 mm (P = .01). Conclusions: Phacoemulsification and foldable IOL implantation enlarged the size of the clear cornea incision in this study. The IOL power may be a significant factor in determining the minimal incision size prior to IOL insertion and the final incision size.