Ultrasound-induced corneal incision contracture survey in the United States and Canada.

PURPOSE: To ascertain factors associated with corneal incision contracture (wound burn) secondary to phacoemulsification in the United States and Canada.

SETTING

John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA, and University of Toronto, Toronto, Ontario, Canada.

DESIGN

Cross-sectional study.

METHODS

Through state and provincial societies, members were queried as to cataract surgery practices during the previous 3 years as well as the specifics associated with each case of wound burn, if any, encountered during that period.

RESULTS

Eight hundred forty-two cataract surgeons reported on 920,095 surgeries and 341 wound burns (raw incidence 0.037%). After a multivariate analysis, the wound burn incidence was significantly inversely associated with the surgeon's surgical volume (45% decrease per doubling of volume; 95% confidence interval, 38%-55%; P<.001), the surgical approach (P<.001), and the ophthalmic viscosurgical device (OVD) used (P=.004). Machine or ultrasound modality used, region of the U.S. or Canada, and incision size were not related to wound burn.

CONCLUSION

Phacoemulsification-induced wound burn can be reduced by experience, by the approach used in nucleus disassembly, by choice of OVD, and most important, by not using ultrasound when the anterior chamber is filled with OVD.