Prados-Carmona, Juan J (JJ);Arias-Alcalá, Manuel (M);Prados-Carmona, Álvaro (Á);Herrador-Montiel, M Ángeles (MÁ);Hernando-Molina, María (M);Giménez-Almenara-Amo, Javier (J);

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Int Ophthalmol.2025 May 05;45(1):171.doi:10.1007/s10792-025-03551-0

Abstract

PURPOSE: This review summarizes key aspects of corneal incision contracture (CIC), also known as wound burn. CIC is a rare complication of phacoemulsification, which can significantly compromise surgical outcomes, leading to delayed healing, suboptimal functional results, and patient dissatisfaction.

METHODS: A comprehensive literature review was conducted across multiple databases, encompassing full-length studies, case series, and reports. A total of 52 studies were selected, focusing either on the etiopathogenesis and risk factors of CIC or on different treatment strategies.

RESULTS: Although preventing CIC remains challenging, key risk factors include excessive ultrasound energy, the use of high-viscosity ophthalmic viscosurgical devices (OVDs), and narrower, longer incisions, particularly in shallow anterior chambers. Additionally, this review highlights therapeutic approaches for managing both the acute and chronic phases of CIC. A critical analysis of previous reports reveals a lack of consensus on management and limited attention to long-term rehabilitation, contributing to suboptimal visual outcomes in the majority of patients. Finally, we propose a novel treatment for the chronic phase of CIC: the implantation of intracorneal ring segments (ICRS), a technique not previously described. This method was successfully applied in a patient with severe CIC-induced astigmatism (> 23 diopters), achieving a plano spherical equivalent and a final visual acuity (VA) of 0.8 decimal (0.1 logMAR). This outcome surpasses those reported in previous literature.

CONCLUSION: This study highlights the significant challenges associated with CIC and introduces a promising therapeutic strategy using ICRS implantation, potentially improving outcomes for these complex cases.