Comparison of morphologic features of clear corneal incisions created with a femtosecond laser or a keratome.


Journal Article

PURPOSE: To compare the morphology of clear corneal incisions (CCIs) created with a femtosecond laser (Catalys) or a keratome (2.65 mm steel) during phacoemulsification using anterior segment optical coherence tomography (AS-OCT) and analyze the intended versus the achieved morphologic characteristics of femtosecond laser-generated CCIs. SETTING: Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. DESIGN: Comparative case series. METHODS: Eyes with femtosecond CCIs and age-matched eyes with the keratome CCIs underwent AS-OCT of the incisions 1 month after phacoemulsification. ImageJ software was used to evaluate AS-OCT images for CCI length, endothelial gaping, endothelial misalignment, and Descemet membrane detachment. RESULTS: In the femtosecond group (20 eyes) and keratome group (16 eyes), the mean values were CCI length, 1.99 mm±0.07 (SEM) versus 2.04±0.23 mm (P=.39); endothelial gaping, 0.14±0.03 mm versus 0.19±0.09 mm (P=.03); endothelial misalignment, 0.04±0.03 mm versus 0.08±0.06 mm (P=.022). No eye in the femtosecond group and 3 eyes in the keratome group had a Descemet membrane detachment (P=.04). Six femtosecond eyes and 11 keratome eyes had posterior wound retraction (P=.02). The mean CCI length was 94.9% of the intended 2.1 mm, the posterior plane depth was 93.3% of the intended 70%, and the posterior side-cut angle was 91.7% of the intended 45 degrees. CONCLUSION: Femtosecond laser-generated CCIs had significantly lower endothelial gaping, endothelial misalignment, Descemet membrane detachment, and posterior wound retraction than keratome-created CCIs and were within 10% of the intended length, depth, and angle measurements. FINANCIAL DISCLOSURE: Neither author has a financial or proprietary interest in any material or method mentioned.

Full Text

Duke Authors

Cited Authors

  • Grewal, DS; Basti, S

Published Date

  • April 2014

Published In

Volume / Issue

  • 40 / 4

Start / End Page

  • 521 - 530

PubMed ID

  • 24568722

Pubmed Central ID

  • 24568722

Electronic International Standard Serial Number (EISSN)

  • 1873-4502

Digital Object Identifier (DOI)

  • 10.1016/j.jcrs.2013.11.028


  • eng

Conference Location

  • United States