I congratulate Calladine et al. on conducting a very useful and informative study. With an increasing number of cataract surgeons making smaller clear corneal incisions, it is important to know whether stromal hydration improves wound integrity and reduces the risk for wound leakage.
In the discussion, the authors mention that the mean IOP was 5.1 mm Hg higher in the stromal hydration group than in the no-hydration group; they suggest this might be due to an increased amount of fluid going into the anterior chamber or to less leakage in the early postoperative period. They also mention that slightly elevated IOP was associated with less risk for loss of coaptation, hence a more secure wound and less risk for endophthalmitis.
I wonder whether the authors can comment on the possibility of transient central corneal edema due to stromal hydration of the incisions. Was the central corneal thickness before and after cataract surgery measured, and did stromal hydration change the central corneal thickness? If wound hydration changed the corneal thickness, was it significant enough to affect the IOP measurements?© 2010 by Lippincott Williams & Wilkins, Inc.