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Session Title: Corneal Femtosecond
Session Date/Time: Monday 07/10/2013 | 14:30-16:30
Paper Time: 16:14
Venue: Elicium 1 (First Floor)
First Author: : C.Kiss, MBA AUSTRIA
Co Author(s): : A. Kuchar S. Kaminski
To investigate the optical coherence tomography (OCT) characteristics of femtosecond laser-assisted corneal incisions for cataract surgery.
Private eye care center, specialized on laser and cataract refractive surgery ("Auge & 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.
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 ?m (mean 24.5±14.5 ?m), after 1 month the inner wound gape ranged from 0 to 29 ?m (mean 20.9±10.9 ?m). In two cases a gape of the outer lip measuring 5 and 25 ?m 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 ?m.
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.
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