Corneal lip tunnel incision.

To evaluate whether the corneal lip tunnel incision or the sutureless closure causes any refractive problems, we performed a retrospective study on 387 cataract surgery patients who were divided into four groups based on type of wound closure and whether the corneal lip was made. The four groups consisted of patients who received an X-stitch closure without the corneal lip, a horizontal mattress stitch without the lip, a horizontal mattress stitch with the lip, and a sutureless closure with the lip. All patients had phacoemulsification in situ; implantation of a foldable silicone lens was performed through a scleral tunnel incision. Clinical evaluations included preoperative characteristics and postoperative Snellen visual acuity, intraocular pressure, and vector analysis of cylinder. In all four groups, a 4.0 mm wide incision was used. Entrance into the clear cornea during the corneal lip tunnel incision did not induce additional cylinder, and the sutureless closure did not decrease induced cylinder or increase the against-the-rule shift. The results of this study indicate that the combination of a 4.0 mm incision with 1.5 mm corneal lip, phacoemulsification in situ, foldable lens implantation, and sutureless closure is a safe and effective procedure for cataract surgery.