Abstract
To pursue the least corneal implication during cataract surgery, this study aimed to monitor corneal wound injury after cataract surgery with a novel method. The prospective cohort study involved thirty-two patients, who were assessed by a Scheimpflug tomography AxL® (Oculus GmbH, Wetzlar, Germany) via the following two kinds of indices: whole corneal optical density (COD) and corneal thickness (CT), two weeks before and one month after cataract surgery. The results of the COD revealed that corneal annuli 0.0–2.0 mm and 2.0–6.0 mm, and the average and maximal values at the incisional site significantly increased postoperatively. Also, the anterior and central stroma of 0.0–2.0 mm, and all three depths of 2.0–6.0 mm, increased remarkably after the operation. For the CT, all ranges of diameters plus incisional sites showed significant increases postoperatively. Furthermore, we analyzed the differences (delta) of COD and CT between pre- and post-operation, and found significant correlations between the delta of COD and the delta of CT, regarding annuli 0.0–2.0 mm, 2.0–6.0 mm, and 6.0–10.0 mm, but no correlation at the incisional site, with either average density or maximal density, was detected. We concluded that whole COD and CT, especially at the central zones of the cornea (annulus < 6 mm), are both valuable parameters in the assessment of corneal damage post-cataract surgery, and are independent indices at the incisional site.
Highlights
Cataract surgery is the most common ocular surgery in the world
Among the seventy-five patients who initially participated, forty subjects were excluded for analysis because they did not pass the automatic quality assessment of the examination by the Pentacam AxL® (Oculus GmbH, Wetzlar, Germany), pre- or postoperatively
Another three patients were excluded because their corneal optical density (COD) at the surgical site could not be detected
Summary
Cataract surgery is the most common ocular surgery in the world. During the outbreak of COVID-19 in the world, it is estimable that each month of lockdown caused a reduction of about 50,000 cataract operations in Italy, one of the most affected countries [2]. Cataract surgery has proven to be one of the most cost-effective healthcare interventions. Cataract-related visual impairment has effects on daily life activities, and on one’s psychological wellbeing [3]. Phacoemulsification with the clear corneal incision is the most well-performed surgery in recent decades, but has the risk of mechanical trauma and thermal damage [4]. Before the following modern technique comes out, we search for feasible, objective, and precise parameters to monitor corneal damage and recovery after cataract surgery in clinical practice
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