Is there a difference in incision healing based on location?

Purpose: To determine whether there is a difference in the healing process between incisions that begin in avascular region and those that begin in vascular region. Setting: Wills Eye Hospital, Philadelphia, Pennsylvania, and Kresge Eye Institute, Detroit, Michigan, USA. Methods/Materials: Feline evaluations were conducted at two sites (one evaluation at each site). Eyes in both evaluations were grouped by incision location: avascular (clear corneal) incisions or vascular (limbal) incisions. A series of postoperative examinations were conducted in each group of both evaluations that included slitlamp examination, measurements of external pressure and incision stability, and histological analysis. Results: All limbal incisions were stable 7 days after surgery. Histological analyses in both evaluations showed a difference in tissue response between clear corneal and limbal incisions; the limbal incisions had an early fibroblastic response and the clear corneal, a delayed response. Conclusion: The predominant factors in incision healing and stability were incision geometry, architecture, and location. Endothelial pump action was effective in removing fluid but was not effective in incision stability. Histological analyses confirmed that starting incisions in the vascular region (limbus) resulted in a fibroblastic response that enhanced incision stability and allowed rapid incision healing within 7 days postoperatively compared with the 60 days healing time required for incisions started in the avascular region (cornea).