Architecture evaluation of the main clear corneal incisions in femtosecond laser-assisted cataract surgery by optical coherence tomography imaging

Abstract

Mario Augusto Pereira Dias Chaves,1–3 André Lins de Medeiros,1,2 César Martins Cortez Vilar,1,2,4 Klayne Rafaella Pereira Magalhães,2 Michelle Rodrigues Gonçalves,3 Patrick Frenzel de Moraes Tzelikis,1,2,5 Wilson Takashi Hida,1,2,5,6 Pedro Carlos Carricondo,2,5 Milton Ruiz Alves2,5 1Brasília Ophthalmologic Hospital (HOB), Department of Cataract, João Pessoa, Paraíba, Brazil; 2Renato Ambrosio Ophthalmologic Study Center (CEORA), Brasília, Federal District, Brazil; 3Provisão Paraíba Ophthalmologic Hospital, João Pessoa, Paraíba, Brazil; 4Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA; 5São Paulo University School of Medicine (FM-USP), Department of Ophthalmology, São Paulo, Brazil; 6São Paulo Federal University of School of Medicine (UNIFESP), Department of Ophthalmology, São Paulo, Brazil Purpose: To assess the stability and reliability of femtosecond laser-assisted cataract surgery (FLACS) incisions design and dimensions using anterior segment optical coherence tomography (AS-OCT) imaging.Setting: Renato Ambrósio Ophthalmologic Study Center from Hospital Oftalmológico de Brasília, Brasília, Brazil.Design: Prospective nonrandomized controlled case series.Methods: Eyes undergoing FLACS with triplanar main temporal clear corneal incision (CCI) were evaluated at the end of the case. Eyes that required any incision hydration, surgical complications or lacked follow-up were excluded. The AS-OCT was performed after femtosecond delivery; at the end of the case; at 1 day and at 30 days after surgery. Data of pachymetry, endothelial and epithelial gaps, Descemet detachment and CCI architecture were compared.Results: Eleven eyes from 11 patients completed follow-up. Corneal thickness was statistically different between after femtosecond delivery and the end of the case (P-value <0.05), but without difference compared to 30 days evaluation. There was an increase of Descemet detachments (P-value <0.05) and endothelial gaps (P-value =0.0133) at the end of the case compared to post-femtosecond delivery. As for the architecture of the CCI, significant difference was found between the parameters of entry angle and exit angle measured with AS-OCT and the programmed.Conclusion: The AS-OCT was capable of visualizing changes in the cornea at the CCI. Despite the stress caused by manipulation, results indicated good stability of incision and reproducibility of tunnel length.Synopsis: Difference of corneal thickness at the CCI between after femtosecond and after phacoemulsification measurements (P-value <0.05), with increase of endothelial gaps (P-value =0.0133) and Descemet detachments (P-value <0.05). Keywords: femtosecond, incisions, cataract, pachymetry, optical coherence tomography  

Keywords

• femtosecond incisions cataract surgery OCT cornea