A properly constructed phaco incision will allow good access to the anterior chamber for cataract surgery and then will seal in a water-tight manner without inducing unwanted astigmatic effects. We have previously explained the concepts behind constructing the ideal corneal phaco incision, so now it’s time to review the technique for hydrating and sealing. The technique of using hydration of the corneal stroma works well for incisions of proper architecture, however poorly constructed incisions are best sealed with sutures.
The key is to aim the 27g blunt cannula into the corneal stroma while moving across the incision. While some surgeons like to hydrate just the left and right sides of the incision, this can leave the central incision leaky. In addition, large degrees of corneal stromal hydration will induce astigmatism which can take weeks to resolve.
The technique shown here is gentle and efficient, able to seal the incision completely in just a few seconds and with a minimal amount of balanced salt solution. The proof is on post-op day 1 where the astigmatic effect is near zero and the incision is completely water-tight.
Click below to learn this technique of corneal phaco incision hydration and sealing: