{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:14:41Z","timestamp":1760058881389,"version":"build-2065373602"},"reference-count":23,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Grant-in-Aid for Scientific Research (KAKENHI), Japan Society for the Promotion of Science (JSPS)","award":["24K12746"],"award-info":[{"award-number":["24K12746"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: This study evaluates the effect of limiting eyelid opening on wound closure time and surgical outcomes during cataract surgery. Methods: This retrospective study included 129 patients who had undergone cataract surgery between December 2023 and March 2024. The patients were divided into two groups based on the degree of eyelid opening: full eyelid opening group (n = 78) and 1 mm eyelid opening group (n = 51). Wound closure time, total operation time, postoperative intraocular pressure (IOP), uncorrected and best-corrected visual acuity (UCVA and BCVA, respectively), anterior chamber protein levels, and corneal endothelial cell loss were compared between the two groups. Results: The 1 mm eyelid opening group had a significantly shorter wound closure time (32.9 \u00b1 11.2 s) compared with the full eyelid opening group (57.0 \u00b1 21.3 s, p &lt; 0.001), as well as reduced total operation time (547.5 \u00b1 83.1 s vs. 606.9 \u00b1 144 s, p = 0.02). No significant differences were observed in the postoperative IOP, BCVA, UCVA, anterior chamber protein levels, or corneal endothelial cell loss between the groups. Conclusions: Limiting the eyelid opening to 1 mm from the corneal limbus during cataract surgery can reduce wound closure time and total operation time without compromising visual outcomes or corneal endothelial health. This simple adjustment may contribute to improved surgical efficiency.<\/jats:p>","DOI":"10.3390\/jcm14093163","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T11:35:13Z","timestamp":1746185713000},"page":"3163","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Eyelid Opener on Wound Closure Time in Cataract Surgery"],"prefix":"10.3390","volume":"14","author":[{"given":"Takato","family":"Sakono","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naohisa","family":"Mihara","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taiji","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroto","family":"Terasaki","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1016\/S0140-6736(17)30544-5","article-title":"Cataracts","volume":"390","author":"Liu","year":"2017","journal-title":"Lancet"},{"unstructured":"Lindstrom, R. (2025, April 23). Thoughts on Cataract Surgery: 2015. Review of Ophthalmology. Published online: 9 March 2015. Available online: https:\/\/www.reviewofophthalmology.com\/article\/thoughts-on--cataract-surgery-2015.","key":"ref_2"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1016\/S0886-3350(02)01432-3","article-title":"Practice styles and preferences of ASCRS members-survey 2001","volume":"28","author":"Leaming","year":"2002","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.jcrs.2006.02.014","article-title":"ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: Case for a European multicenter study","volume":"32","author":"Seal","year":"2006","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/S0002-9394(03)00202-2","article-title":"Case-control study of endophthalmitis after cataract surgery comparing scleral tunnel and clear corneal wounds","volume":"136","author":"Cooper","year":"2003","journal-title":"Am. J. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/S0886-3350(02)01483-9","article-title":"Bacterial endophthalmitis after small-incision cataract surgery. effect of incision placement and intraocular lens type","volume":"29","author":"Nagaki","year":"2003","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_7","first-page":"525","article-title":"Clinical features of endophthalmitis after cataract surgery evaluated by the presence of background factors","volume":"112","author":"Ninomiya","year":"2008","journal-title":"Nippon Ganka Gakkai Zasshi"},{"key":"ref_8","first-page":"e22003","article-title":"Postoperative endophthalmitis after cataract surgery: An update","volume":"14","author":"Althiabi","year":"2022","journal-title":"Cureus"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e71731","DOI":"10.1371\/journal.pone.0071731","article-title":"Risk factors for acute endophthalmitis following cataract surgery: A systematic review and meta-analysis","volume":"8","author":"Cao","year":"2013","journal-title":"PLoS ONE"},{"key":"ref_10","first-page":"921","article-title":"Cataract surgery and methods of wound closure: A review","volume":"9","author":"Matossian","year":"2015","journal-title":"Clin. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.ajo.2009.12.008","article-title":"Anterior segment optical coherence tomography evaluation of the integrity of clear corneal incisions: A comparison between 2.2-mm and 2.65-mm main incisions","volume":"149","author":"Chee","year":"2010","journal-title":"Am. J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.jcrs.2007.01.010","article-title":"Effect of stromal hydration of clear corneal incisions: Quantifying ingress of trypan blue into the anterior chamber after phacoemulsification","volume":"33","author":"Vasavada","year":"2007","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.jcrs.2006.09.016","article-title":"Profile of clear corneal cataract incisions demonstrated by ocular coherence tomography","volume":"33","author":"Fine","year":"2007","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s40123-021-00339-0","article-title":"A randomized study of the impact of a corneal pre-cut during cataract surgery on wound architecture and corneal astigmatism","volume":"10","author":"Doeller","year":"2021","journal-title":"Ophthalmol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.jcrs.2006.10.039","article-title":"Suture-related complications after congenital cataract surgery: Vicryl versus mersilene sutures","volume":"33","author":"Spierer","year":"2007","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1038\/bmt.2012.244","article-title":"Investigation of the freely available easy-to-use software \u201cEZR\u201d for medical statistics","volume":"48","author":"Kanda","year":"2013","journal-title":"Bone Marrow Transplant."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1007\/s10792-016-0201-z","article-title":"Prevalence of corneal astigmatism before cataract surgery","volume":"36","author":"Mohammadi","year":"2016","journal-title":"Int. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jcrs.2008.09.027","article-title":"Prevalence of corneal astigmatism before cataract surgery","volume":"35","year":"2009","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_19","first-page":"392","article-title":"Comparison of surgically induced astigmatism of temporal versus superior clear corneal incisions","volume":"108","author":"Marek","year":"2006","journal-title":"Klin. Oczna"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.jcrs.2005.12.104","article-title":"Surgically induced astigmatism after phacoemulsification in eyes with mild to moderate corneal astigmatism: Temporal versus on-axis clear corneal incisions","volume":"32","author":"Borasio","year":"2006","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1016\/j.jcrs.2006.04.010","article-title":"Corneal astigmatism correction with opposite clear corneal incisions or single clear corneal incision: Comparative analysis","volume":"32","author":"Khokhar","year":"2006","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S0886-3350(89)80145-2","article-title":"Induced astigmatism in small incision cataract surgery","volume":"15","author":"Shepherd","year":"1989","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.jcrs.2008.10.031","article-title":"Postoperative corneal shape changes: Microincision versus small-incision coaxial cataract surgery","volume":"35","author":"Hayashi","year":"2009","journal-title":"J. Cataract Refract. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/3163\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:26:32Z","timestamp":1760030792000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/3163"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,2]]},"references-count":23,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["jcm14093163"],"URL":"https:\/\/doi.org\/10.3390\/jcm14093163","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,5,2]]}}}