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Comparison of wound sealability of clear corneal incisions created with keratome or femtosceond laser

Poster Details

First Author: H.Uy PHILIPPINES

Co Author(s):                        

Abstract Details


To compare wound integrity and sealing properties of clear corneal incisions (CCI) created with a blade keratome or a femtosecond laser, among eyes undergoing refractive laser assisted cataract surgery (RELACS).


Ambulatory Surgical Center. Pacific Eye and Laser Institute, Makati, Philippines


Prospective randomized clinical trial of 62 eyes undergoing RELACS. The CCI was created using either a 2.2 mm keratome (n=31) or a femtosecond laser (Lensar, Orlando, FL) (n=31). Phacoemulsification was performed by a single surgeon. At the conclusion, after removal of the irrigation/aspiration probe, the eyes were graded as follows: Grade 1, flat anterior chamber (AC) needing CCI wound hydration (WH) and AC reformation via paracentesis wound; Grade 2, flat AC not needing WH but needing AC reformation.; Grade 3, formed AC not needing WH nor AC reformation. Main outcome measure: mean wound grade per incision type.


Both treatment groups were comparable in terms of patient age, nuclear density, cumulative dissipated energy, operative time. The mean (SD) wound seal grade for the keratome group was 1.32 (0.65) and for the laser group, 2.35 (0.84) (P < 0.0001). In the keratome group, the frequency of eyes with wound grade of 1, 2 and 3 was 77%, 13%, 10%, respectively; while in the laser group, 23%, 19%, 58%, respectively. None of the eyes developed significant postoperative wound-related complications.


Both methods created CCI that achieved adequate wound closure without suturing. The laser CCI wounds appear to demonstrate better wound closure reliability, greater ability to self-seal and lesser need for stromal hydration.

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