The clear corneal tongue: a mechanism for wound incompetence after phacoemulsification.

PURPOSE: To describe a mechanism for wound incompetence after phacoemulsification with corneal incisions resulting in early postoperative wound leakage.

DESIGN

Observational case series.

METHODS

Three patients who had uneventful phacoemulsification through a clear corneal incision were identified because of a postoperative wound leak. A corneal tongue, consisting of an everted triangular flap of posterior corneal stroma, the Descemet membrane, and endothelium, was observed in the wounds of all cases.

RESULTS

One wound leak resolved after pressure patching. The other two necessitated wound revisions. None of the patients developed endophthalmitis.

CONCLUSIONS

In phacoemulsification with corneal incisions, an everted flap of posterior corneal tissue, a corneal tongue, may prevent normal anatomical apposition of the surgical wound edges leading to potential wound incompetence. This event may increase the risk of endophthalmitis after clear corneal phacoemulsification.