Evaluation of corneal incision in femtosecond laser-assisted phacoemulsification

TL;DR

Femtosecond laser incisions in cataract surgery result in fewer corneal complications compared to manual incisions.

Contribution

Demonstrates that femtosecond laser incisions reduce Descemet membrane detachment and improve incision accuracy.

Findings

Femtosecond laser incisions had a significantly lower prevalence of Descemet membrane detachment (22.2%) compared to keratome incisions (63.2%).

Femtosecond laser incisions showed a statistically higher mean length and less endothelial misalignment and detachment.

No eyes with femtosecond laser incisions showed an endothelial gap after one to three months.

Abstract

•After cataract surgery, the prevalence rate of Descemet membrane Detachment was significantly higher in the group with keratome incisions (63.2 %) compared to that with femtolaser incisions (22.2 %).

After cataract surgery, the prevalence rate of Descemet membrane Detachment was significantly higher in the group with keratome incisions (63.2 %) compared to that with femtolaser incisions (22.2 %).

This study aimed to evaluate the accuracy and quality of healing of main corneal incisions in femtosecond laser procedures in cataract surgery.

It was a prospective, non-randomized, investigator-masked study. A total of 37 eyes of 37 patients with indication for cataract surgery were separated into two groups in this prospective, nonrandomized study: Femto group, with incisions automated by femtosecond laser (18 eyes), and Phaco group, with incisions made using a keratome (19 eyes). The planned incisions were 2.2 mm wide and 1.65 mm long. The length of the incision and prevalence of endothelial gap, endothelial misalignment, and localized Descemet Membrane Detachment (DMD) were compared.

The mean incision length was statistically higher in the Femto group in two examinations: 1.64 mm ± 0.16 vs. 1.43 mm ± 0.30 (p = 0.001) in Exam 1 (between 2 and 4 days) and 1.58 mm ± 0.22 vs. 1.27 mm ± 0.34 (p < 0.0001) in Exam 2 (between 1 and 3 months). No eye presented an endothelial gap in Exam 2. The endothelial gap was higher in the Femto group in Exam 1. In the two examinations, endothelial misalignment was lower in the Femto group, whereas the incidence of DMD was lower in the Femto group in the two examinations.

Automated incisions with femtolaser presented a higher mean length and lower DMD prevalence compared to manual incisions with a keratome.

Figures