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Surendra Basti, Dilraj Grewal; Analysis Of Early Postoperative Morphologic Features Of Clear Corneal Incisions Created With The Femtosecond Cataract Laser Using Anterior Segment Optical Coherence Tomography: Comparison Of Intended Versus Achieved Wound Parameters. Invest. Ophthalmol. Vis. Sci. 2013;54(15):563.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the morphology of clear corneal incisions (CCI) performed using a Femtosecond Cataract Laser (Catalys, Optimedica, Santa Clara, CA) in patients undergoing femtosecond laser-assisted cataract surgery using spectral domain anterior segment optical coherence tomography (AS-OCT).
Morphology of clear corneal incisions created with the Femtosecond cataract laser was studied with AS-OCT. An intended triplanar incision was programmed into the Catalys femtosecond laser software. The first plane was at 90 degree to the corneal surface and extended to 40% corneal depth, the second plane was an angled intrastromal plane and the third plane was at 45 degrees to the posterior corneal surface and reached the second plane at 70% depth. The intended incision width was 2.85 mm and length was 1.8 mm. AS-OCT was performed on the first postoperative day using the Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA). The clear corneal incision length, incision depth, angles of the tri-planar corneal incision, and wound gaping were measured using software calipers. The variability in wound length, depth and angle were calculated and compared to the programmed software settings. Five architectural features were used to describe the clear corneal incisions: gaping of the wound at the epithelial side, gaping of the wound at the endothelial side, within wound gape, misalignment of the roof and floor of the incision at the endothelial side and local Descemet’s membrane (DM) detachment. This study is ongoing and will include 30 eyes.
On analysis of first post-operative day AS-OCT images of the initial 3 eyes undergoing femtosecond cataract extraction, 2/3 eyes had endothelial side wound gape, 1/3 had epithelial wound gape, 2/3 eyes had a within wound gape and 3/3 eyes had a focal DM detachment. All three eyes had visible 3-plane profile on AS-OCT. The clear corneal incision length was within 100 microns of the intended length. The incision depth was within 8 percent of the intended depth.
Our initial results suggest that clear corneal incisions using the femtosecond cataract laser were close to the intended size and depth. A significant proportion of eyes had marginal and stromal wound gape and focal DM detachment.
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