Swab Pressing vs Stromal Hydration to Prevent Incision Leakage and Transient Collapse of Anterior Chamber in Phacoemulsification

The article discusses the use of a new technique called swab pressing to seal incisions in phacoemulsification for age-related cataract, as compared to the current practice of stromal hydration.

The study conducted a randomized controlled clinical trial with 126 participants to determine the efficacy of swab pressing. The main outcome measured was the proportion of closed clear corneal incisions evaluated using intraoperative optical coherence tomography.

In the pressing group, a cotton swab was used to applygentle pressure on the incision downward for 30 seconds im-mediately after the withdrawal of irrigation and aspiration (I/A)handpiece tip. In the stromal hydration group, a balanced saltsolution was injected toward the anterolateral walls of the in-cision until visible whitening of the corneal stroma was noted.

The results showed that swab pressing was noninferior to stromal hydration in sealing the incisions, with a proportion of closed incisions of 96.8% in the swab pressing group and 93.7% in the stromal hydration group. The rate of anterior chamber collapse was also lower in the swab pressing group.

The study suggests that swab pressing is a feasible technique, but further investigations are needed to determine its effects on the collapse of the anterior chamber and visual acuity outcomes.

Liu, Zitian, et al. “Swab Pressing vs Stromal Hydration to Prevent Incision Leakage and Transient Collapse of Anterior Chamber in Phacoemulsification: A Randomized Clinical Trial.” JAMA Ophthalmology, vol. 141, no. 6, 1 June 2023, pp. 574-81, doi:10.1001/jamaophthalmol.2023.1491.

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Retina Ward of Farabi Eye Hospital