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Impact of incision size and architecture on surgically-induced astigmatism and corneal properties

Session Details

Session Title: Corneal Incisions and preloaded IOLs

Session Date/Time: Sunday 06/10/2013 | 08:00-09:30

Paper Time: 08:40

Venue: Elicium 2 (First Floor)

First Author: : M.Weber AUSTRIA

Co Author(s): :    S. Maedel   N. Hirnschall   J. Wiesinger   P. Draschl   C. Roberts   O. Findl

Abstract Details


To assess the influence of incision size on wound properties and surgically induced astigmatism.


Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital, Vienna


In a first sub-study, patients were randomly allocated to a micro incision (1.8 mm) or a small incision (2.5 mm) group and in a second sub-study, to a pre-cut or a non pre-cut group. Pre-cut was performed using a 300 µm guided blade. Wound architecture was assessed intra-operatively using continuous intraoperative-OCT (CI-OCT) and post-operative OCT (both Carl Zeiss Meditec AG, Germany) measurements were done. Pre-operatively, optical biometry was performed using the IOL Master 500 (Carl Zeiss Meditec AG). Surgically induced astigmatism was measured with Pentacam HR (Oculus, Germany) and subjective refraction 1 week and 3 months post-operatively. Corneal viscoelastic properties were assessed with the Ocular Response Analyzer (Reichert, Germany) 1 week, 1 month and 3 months post-operatively.


In total, 60 eyes of 60 patients were included in this prospective study, 40 eyes in substudy 1 and 20 eyes in substudy 2. In substudy 1, pre-operatively measured corneal astigmatism did not differ significantly between the micro incision and the small incision group (0.92±0.39D; 0.78±0.50D, p=0.524). Intra-operatively and 1 hour post-operatively, wound gaping was observed more often in the micro incision group compared to the small incision group (100% vs. 88% and 50% vs. 13%). Astigmatism difference vectors between pre-operative and 1 week and between pre-operative and 3 months measurements were 0.16D (p=0,90) and 0.05D (p=0.81), respectively. There was no significant difference in corneal hysteresis and corneal resistance factor at any time point between the 1.8 and the 2.5 mm incision. Results of substudy 2 will be presented.


Although wound properties differed between micro incisions and small incisions, there were no significant differences concerning surgically induced astigmatism and corneal viscoelastic properties.

Financial Interest:


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