The Stromal Hydration of Clear Corneal Incisions

D r. Vasavada regularly performs stromal hydration, at both the clear corneal temporal incision and paracentesis, as part of his strategy for sealing the wound after cataract surgery. Further, he has found stromal hydration to be a useful adjunct in clear corneal cataract surgery, because it allows the adequate approximation of the anterior and posterior aspects of the corneal tunnel. Today, surgeons perform stromal hydration to enhance the sealing of the wound and thus preclude the need for sutures. The stromal hydration of the incisions was advocated and popularized by Fine.1 In a recent study, he and his colleagues used anterior segment optical coherence tomography to evaluate the profiles of the clear corneal incision’s construction and architecture. They found persistent stromal swelling from stromal hydration, even on the first postoperative day.2 Furthermore, Wong found that stromal hydration assists in securing clear corneal incisions, thereby helping to prevent endophthalmitis.3 Some critics of clear corneal incisions maintain that stromal hydration is detrimental to structural integrity. This assertion presumes that the endothelial pump has no effect on stromal hydration. We decided to investigate whether hydrating the corneal stromal incision has any impact on the ingress of fluid from the ocular surface into the anterior chamber. This article summarizes our findings.