Comparative Analysis of Morphologic Features Of Clear Corneal Incisions Created With the Femtosecond Cataract Laser and a Manual Keratome Using Anterior Segment Optical Coherence Tomography

Wound construction using clear corneal incisions is an integral component of modern cataract surgery. The recently introduced Femtosecond laser for cataract surgery has stated advantages of increased accuracy, predictability and improved wound integrity. The creation of more square clear corneal incisions and accurately creating a true multiplanar corneal wound configuration are also thought to be advantages of the Femtosecond laser. This study aims to compare the morphology of clear corneal incisions and their wound architecture using Spectral-Domain Anterior Segment Optical Coherence Tomography (AS-OCT) in human cadaver eyes randomized to undergo wound creation with a standard 2.65 mm keratome by an experienced cataract surgeon or femtosecond laser–generated corneal incisions (Catalys, OptiMedica). The cadaver eye corneas will then be imaged using AS-OCT and software (Review Software and Image J) will be used for measurement and quantification of the following architectural features: gaping of the wound at the epithelial side, gaping of the wound at the endothelial side, approximation of the two wound surfaces, alignment of the roof and floor of the incision at the endothelial side and local Descemet’s membrane detachment. In addition the intended and the actually achieved wound parameters will be compared between the two groups. The results of this cadaver eye study will provide data to establish the predictability of corneal incisions generated using the femtosecond laser and illustrate the difference in incision architecture between a laser and the keratome. This data may be helpful to determine optimal femtosecond laser corneal wound construction parameters in-vivo.