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Imaging analysis of intended and obtained clear cornea wound construction by femtosecond laser for cataract surgery

Session Details

Session Title: Femto-cataract

Session Date/Time: Monday 07/10/2013 | 08:00-10:00

Paper Time: 08:30

Venue: Forum (Ground Floor)

First Author: : J.De La Cruz USA

Co Author(s): :    M. Cortina   S. Jain   J. Hou   A. Prickett     

Abstract Details

Purpose:

To analyze by Scheimpflug Imaging and Anterior Segment Optical Coherence Tomography (ASOCT) femtosecond assisted clear cornea wound architecture for cataract surgery and to compare the intended design with the actual postoperative configuration.

Setting:

University of Illinois Eye and Ear Infirmary, Chicago Illinois USA

Methods:

Thirty eyes that underwent Femtosecond cataract surgery with LenSx System (Alcon, USA) were included in the study. All included eyes had one 2.4/2.6 mm trapezoid main triplanar clear cornea wound as well as two 1.2 mm clear paracentesis perfomed with the femtosecond laser. All wounds were analyzed by Sheimpflug imaging with Pentacam (Oculus, Denmark) or with high resolution ASOCT RTVue (Optovue,). Postoperative images were compared to intended wound architecture visualized in ASOCT overlay prior to delivery of femtosecond laser treatment. Also Intended depth and angle date was compared to postoperative result using ASOCT software for angle and depth measures. All postoperative images compared to intended wound architecture 1 week post op.

Results:

Thirty eyes analyzed and compared. All vertical entries into stroma from epithelium were consistent with femto second design. Vertical angle and final entry of clear cornea incision made by femto second laser by range of 5-15 degrees in posterior cornea entry. In case of the deviation posterior cornea folds were detected also by imaging intraop. All 30 cases had intended depths within 5-10 microns of its intended design plane. All 30 cases were within the 5-10 degrees variation of angle design. All clear cornea paracentesis reached intended depth. No clear cornea wound showed any signs of significant descemets detachment or epithelial defect or edema. Changes in posterior cornea due to Patient interface device applanation device were present in the clear cornea wounds that showed the highest variation of angle change in intended wound design. None of the corneal wounds shoed signs of gaping or widened wound entry one week post op.

Conclusions:

Wound architecture by Femto second laser demonstrated a variation in angle and entry when analyzed by imaging one week post op. These changes were more apparent when posterior corneal folds were present due to applanation of patient interface. None of these variations were significant to cause any wound architecture irregularities. All wounds achieved their overall triplanar structure or their intended paracentesis designs and none demonstrated posterior nor anterior surface irregularities when analyzed by Sheimpflug imaging or ASOCT.

Financial Interest:

NONE