A Randomized Study of the Impact of a Corneal Pre-Cut During Cataract Surgery on Wound Architecture and Corneal Astigmatism.

Abstract

IntroductionThe aim of the current study was to assess the effect of a 600-µm corneal pre-cut on wound architecture and its impact on surgically induced astigmatism. The images were acquired intraoperatively and postoperatively with high-resolution spectral-domain optical coherence tomography (SD-OCT).MethodsThis study included patients scheduled for cataract surgery. Preoperatively, optical biometry and corneal topography were performed (IOL Master 500 and Atlas 9000, both Carl Zeiss Meditec AG, Germany). The first eye randomly received a 600-µm corneal pre-cut during cataract surgery, or a single-plane stab-incision and the second eye received the other incision technique. Incision architecture was assessed intraoperatively using a continuous intraoperative optical coherence tomography (iOCT) device (ReScan 700, Carl Zeiss Meditec AG, Germany) at three time points: after the incision, after irrigation/aspiration and after intraocular lens (IOL) implantation. Additionally, OCT (Spectralis, Heidelberg Engineering, Germany) measurements were performed 1 h, 1 week and 1 month postoperatively.ResultsForty eight eyes of 24 patients were analysed. The pre-cut group and the stab-incision group had a significant decrease in wound thickness from the 1-h to the 1-week measurement (p = 0.022 and p = 0.001). Corneal astigmatism showed a vector difference from preoperatively to the 1-week measurement of 0.48 D (SD, ± 0.27) in the stab incision group and 0.49 D (SD, ± 0.24) in the stab incision group. No significant differences were found between the groups.ConclusionTo our knowledge, this was the first study which compared the wound alterations in pre-cut and stab-incision groups.Trial RegistrationNCT02155270.