Impact of a pre‐cut on clear cornea incision architecture in cataract surgery

Abstract

PurposeTo assess the influence of a 600 μm corneal pre‐cut on incision architecture compared to a stab‐incision in cataract surgery.MethodsThis randomised bilateral study included patients scheduled for cataract surgery in both eyes without any other relevant ophthalmological co‐morbidities. Pre‐operatively, optical biometry and topography were performed (IOL Master 500 and the Atlas; both CZM AG). The first eye to be operated randomly received a corneal pre‐cut, or a single‐plane stab incision and the second eye received the other incision technique. In the pre‐cut group, a vertical cut was performed using a 600 μm guided blade. Incision size was 2.4 mm in both groups. Incision architecture was assessed intra‐operatively using a continuous intraoperative‐OCT device (ReScan 700, Carl Zeiss Meditec AG, Germany) after the incision, after I/A and after IOL implantation. Additionally, OCT measurements were assessed (Spectralis, Heidelberg Engineering, Germany) one hour, one week and one month post‐operatively. Additionally, autorefraction and subjective refraction were performed at the one‐month‐follow‐up.ResultsIn total, 40 eyes of 20 patients were included. The intra‐operative measurements were possible in all cases and details of the morphology of the incision was visible in nearly all cases. Intra‐operative findings of endothelial and epithelial gaping, as well as Descemet detachment correlated well with post‐operative findings at the 1 hour follow‐up. Correlations between wound architecture and residual astigmatism were found to be weak.ConclusionsIntra‐operative OCT measurements using spectral‐dmoain technology were found to be useful to observe and document the incision architecture during cataract surgery.