Curved single-plane clear corneal incision made under anterior chamber collapse by aqueous humor aspiration prevents leakage after cataract surgery

Purpose To evaluate the self-sealing on curved single-plane clear corneal incisions (CCIs) after cataract surgery. The collapse of the anterior chamber was made by aspirating the aqueous humor in order to make curved single-plane CCI. Methods A retrospective study was conducted at Asai Hospital in Japan. There were 189 eyes of 132 patients scheduled from February to April 2017 for single-plane CCI. There were 175 eyes of 128 patients from February to April 2018 for curved single-plane CCI. Curved single-plane CCIs were made with aqueous humor aspiration via aqueous humor pipette, and single-plane CCIs were made without the aspiration. In case of leakage of aqueous humor from the CCI at the end of surgery, sutures were used. The main outcome measure was the proportion of sutures for CCI. Secondary outcomes included CCI length and surgically induced astigmatism (SIA) magnitude. Results The proportions of suture in single-plane CCI and in curved single-plane CCIs were 25.4% (48/189) and 0% (0/175), respectively ( p < 0.001). The length of curved single-plane CCI (2.06 ± 0.18 mm) was significantly greater than that of single-plane CCI (1.66 ± 0.12 mm; p < 0.001). The median postoperative SIAs of single-plane and curved single-plane CCIs were 0.64 D ( n = 89) and 0.73 D ( n = 85) for nasal incision, and 0.46 D ( n = 100) and 0.47 D ( n = 90) for temporal incision at examination 3 months after surgery, respectively, without significant change ( p = 0.12 for nasal incision and p = 0.37 for temporal incision). Conclusion The curved single-plane CCI achieved by only aqueous humor aspiration showed significant effectiveness in self-sealing. Trial registration UMIN clinical trials registry UMIN000032480, retrospectively registered on 6 May 2018.