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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

Purpose:

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

Setting:

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

Methods:

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.

Results:

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.

Conclusions:

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:

NONE