Duration 5min, Q&A 3min
Femtosecond Laser-Assisted Corneal Incisions in Cataract Surgery - An Optical Coherence Tomography Study
To investigate the optical coherence tomography (OCT) characteristics of femtosecond laser-assisted corneal incisions for cataract surgery.
Thirty eyes of 21 patients underwent femtosecond-laser-assisted cataract surgery using the Alcon LenSx Laser.
Thirty eyes of 21 patients underwent cataract surgery using the Alcon LenSx Femtosecond Cataract Laser. OCT cross sections of the primary incision (tunnel) were performed using the Heidelberg Spectralis OCT with the anterior segment imaging module. The scans were done at one week, one month and 3 months after surgery. The primary incision was tri-planar, the length and width was varied in order to improve wound stability.
Results and Conclusion
On OCT, a wound gape of the inner wound lip could be observed in 30 of 30 cases on week 1 and 18 of 30 cases on month 1. At one week this gape ranged from 9 to 60 μm (mean 24.5±14.5 μm), after 1 month the inner wound gape ranged from 0 to 29 μm (mean 20.9±10.9 μm). In two cases a gape of the outer lip measuring 5 and 25 μm respectively, could be observed. At one week all cases showed medium to prominent edema of the inner cornea and two cases also showed swelling of the outer cornea. After 4 weeks, no outer cornea swelling could be observed, but in all but one case mild to moderate edema of the inner cornea was evident. At 3 months there were no signs of edema, but still wound gapes ranging from 0 to 17 μm.
Conclusions: There is clearly a learning curve associated with the design of the primary incision when using a femtosecond laser for cataract surgery. The advocated superiority of femtosecond laser assisted incisions over conventional blade incisions is not a method-inherent advantage but requires the adaptation of incision parameters to surgeon preferences and experiences regarding the wound stability and quality in terms of tightness.
[ Keyword ]
Femtosecond Laser / Cataract / Optical Coherence Tomography
[ Conflict of Interest ]