Evaluation of Femtosecond Laser Versus Manual Clear Corneal Incisions in Cataract Surgery Using Spectral-Domain Optical Coherence Tomography.

PURPOSE: To investigate the wound healing changes of clear corneal incisions performed with a femtosecond laser or a steel bevel knife in cataract surgery using spectral-domain optical coherence tomography.

METHODS

Prospectively, consecutive patients undergoing either femtosecond laser-assisted cataract surgery (femtosecond laser group) using the LenSx laser (Alcon Laboratories, Inc., Fort Worth, TX) or traditional cataract surgery using steel blades (control group) were enrolled. The incidence of posterior wound gape, Descemet's membrane detachment, posterior wound retraction, and the inner and outer corneal incision thicknesses were assessed.

RESULTS

Compared to the control group, the femtosecond laser group had significantly lower incidences of posterior wound gape at 1 day (P = .012) and Descemet's membrane detachment at 1 week (P = .030), 1 month (P = .048), and 3 months (P = .048), and a significantly higher incidence of posterior wound retraction at 1 month (P < .001) and 3 months (P < .001) postoperatively. The inner and outer corneal incision thicknesses decreased over time in both groups.

CONCLUSIONS

The clear corneal incisions created by femtosecond laser demonstrated a lower incidence of posterior wound gape and Descemet's membrane detachment. However, the higher posterior wound retraction incidence, which indicated that there was wound remodeling, was apparent. [J Refract Surg. 2018;34(1):17-22.].