Purpose: To examine the correlation between incision size and corneal shape changes in sutureless surgery using corneal topography.
Methods: Two hundred eyes undergoing sutureless cataract surgery were assigned randomly to three groups according to the incision size: group A, 3.2-mm incision; group B, 4.0-mm incision; and group C, 5.0-mm incision. All eyes were examined by corneal topography preoperatively as well as at 1 week and at 1, 3, and 6 months after surgery.
Results: In the average of difference maps of eyes in the 3.2-mm incision group, a wound-related flattening in the peripheral cornea occurred 1 week after surgery, but decreased rapidly thereafter. Subsequently, no significant changes were observed in the cornea after 1 month. In the 4.0-mm incision group, with a reduction of the wound-related peripheral flattening, an irregular steepening appeared in the lower central cornea 6 months after surgery. In the 5.0-mm incision group, a similar steepening in the lower cornea occurred just after surgery. This steepening persisted and even extended to the upper central cornea in its later postoperative periods.
Conclusion: The 3.2-mm incision hardly produced any irreversible corneal shape changes, whereas both the 4.0- and 5.0-mm incisions caused a persistent irregular steepening in the central cornea.