Good versus Bad Corneal Phaco Incisions with OCT

The phaco incision is critical to the success of the cataract surgery. It gives us controlled access to the cataract, assists in maintaining fluidic balance, induces minimal astigmatic changes, and seals securely. A well-constructed incision makes the surgery safer and the recovery quicker. In addition, it is your signature because, along with the capsulorhexis, it is what other ophthalmologists will see when they examine the eye in the future.

Previous articles here on have taught the basics of excellent incisions:

In the video shown here, we are comparing two cataract surgery cases which were done on the same day by the same resident surgeon in training. This is a great learning video because we can compare and contrast a good incision with a poorly-made one.

This case has a good incision with excellent balance between the roof and the floor and it has appropriate architecture. It seals well and securely with minimal astigmatic effect.
In this surgery, the incision has too long of a tunnel length. It starts out very shallow with a thin roof and then the surgeon abruptly changes angle to enter the anterior chamber. The result is a bad incision with too thin of a roof and too thick of a floor which does not seal well.

Click below for the video comparing good versus bad phaco incisions:

Leave a Reply