The comparison of tunnel corneal incision performed with femtosecond laser and keratome

Cover Page

Abstract


Purpose. To compare and evaluate three-plane clear cornea incision (CCI) created with a femtosecond laser (Victus, B&L) and a metal keratome (2,2 mm steel). Materials and Mehtods. Sixty eyes of 60 patients were examined using anterior segment optical coherence tomography (AS-OCT) in early postoperative period (1 day, 1 week, 1 month) after phacoemulsification surgery. Images were used to measure incision length and incidence of epithelial or endothelial gaping, Descemet membrane detachment. Results. In the femtosecond group (34 eyes) the mean CCI length was 2.02 ± 0.05 mm versus keratome group (26 eyes) 2.04 ± 0.43mm. In laser group all incisions (100 %) were three-plane. In keratome group with manual incisions only 23 % were three-plane, 57.7 % were two-plane and 19.3 % were one-plane. Comparison of morphological features of femtosecond and keratome group: endothelial gaping 20.5 % versus 23 %, epithelial gaping 8.8 % versus 19 %. Descemet membrane detachment 17.6 % versus 34 %, respectively. Conclusion. All eyes in femtosecond group had three-plane profile visible on AS-OCT. Femtosecond CCIs showed better tunnel morphology compared to keratome group. Multiplane profile and minimal damaging of CCI will improve safety in the postoperative period.

Full Text

Restricted Access

About the authors

Yuriy V Takhtaev

North-Western State Medical University named after I.I Mechnikov

Email: Yurii.Takhtaev@spbmapo.ru
doctor of medical science, head of department. Ophthalmology department

Yulduz Sh Nizametdinova

City Multifield Hospital No 2

Email: Yulduzik55@gmail.com
MD, ophthalmologist

Sergey V Shukhaev

IR & TC “Eye Microsurgery” named after academician S.N. Fyodorov, Saint Petersburg Branch

Email: Shukhaevsv@gmail.com
MD, ophthalmologist

References

  1. Бойко К.В., Тахтаев Ю.В. Структурные изменения роговичного разреза при микрокоаксиальной факоэмульсификации // Вестник Российской военно-медицинской академии. - 2012. - Т. 37, № 1. - С. 92-97. [Boyko KV, Takhtaev YV. Strukturnye izmeneniya rogovichnogo razreza pri mikrokoaksial’noy fakoemul’sifikatsii. Vestnik Rossiyskoy voenno-meditsinskoy akademii. 2012; 37(1):92-97. (In Russ).]
  2. Анисимова С.Ю., Анисимов С.И., и др. Результаты факоэмульсификации катаракты с фемтолазерным сопровождением // Современные технологии катарактальной и рефракционной хирургии: сб. науч. трудов / ФГБУ «МНТК «Микрохирургии глаза». - М., 2013. - С. 31-35. [Anisimova SY, Anisimov SI, et al. Rezul’taty fakoemul’sifikatsii katarakty s femtolazernym soprovozhdeniem. Modern Technologies in Cataract and Refractive Surgery: sb. nauch. trudov / FGBU MNTK Mikrokhirurgii glaza. Moscow; 2013. P. 31-35. (In Russ).]
  3. Бикбов М.М., и др. Результаты фемтолазерной хирургии катаракты с использованием платформы VICTUS // Современные технологии катарактальной и рефракционной хирургии: сб. науч. статей / ФГБУ «МНТК «Микрохирургия глаза». - М., 2013. - С. 40-44. [Bikbov MM, et al. Rezul’taty femtolazernoy khirurgii katarakty s ispol’zovaniem platformy VICTUS. Modern Technologies in Cataract and Refractive Surgery: sb. nauch. statey / FGBU MNTK Mikrokhirurgiya glaza. Moscow; 2013. P. 40-44. (In Russ).]
  4. Тахтаев Ю.В. Хирургия катаракты через малый разрез // Мир медицины. - 2000. - № 7-8. - С. 15-17. [Takhtaev YV. Khirurgiya katarakty cherez malyy razrez. The World of Medicine. 2000;(7-8):15-17. (In Russ).]
  5. Фабрикантов О.Л., Кузьмин С.И., Козлов В.А. Конфигурация роговичных разрезов при факоэмульсификации катаракты // Современные технологии катарактальной и рефракционной хирургии. - 2011. - М., 2011. [Fabrikantov OL, Kuz’min SI, Kozlov VA. Konfiguratsiya rogovichnykh razrezov pri fakoemul’sifikatsii katarakty. Modern technologies in Cataract and Refractive Surgery. 2011. Moscow; 2011. (In Russ).]
  6. Анисимова С.Ю., и др. Факоэмульсификация катаракты с фемтолазерным сопровождением. Первый отечественный опыт // Катарактальная и рефракционная хирургия. - 2012. - № 3. - С. 7-10. [Anisimova SY, et al. Fakoemul’sifikatsiya katarakty s femtolazer-nym soprovozhdeniem. Pervyy otechestvennyy opyt. Kataraktal’naya i refraktsionnaya khirurgiya. 2012(3):7-10. (In Russ).]
  7. Анисимова С.Ю., Анисимов С.И., Трубилин В.Н., Трубилин А.В. Фемтолазерное сопровождение хирургии катаракты: методическое пособие. - М., 2013. [Anisimova SY, Anisimov SI, Trubilin VN, Trubilin AV. Femtolazernoe soprovozhdenie khirurgii katarakty: metodicheskoe posobie. Moscow; 2013. (In Russ).]
  8. Binder PS. Perfecting Clear Corneal Incisions. Cataract & Refractive Surgery Today. 2013(May). P. 20-30.
  9. Calladine D, Packard R. Clear Corneal Incision Architecture in the Immediate Postoperative Period Evaluated Using Optical Coherence Tomography. JCRS. 2007;33(8):1429-1435. doi: 10.1016/j.jcrs.2007.04.011.
  10. Steinert R, Binder PS, Gray B, et al. Determining femtosecond laser parameters for clear corneal incisions. Invest Ophthalmol Vis Sci. 2012:53.
  11. Nagy ZZ, et al. Evaluation of femtosecond laser-assisted and manual clear corneal incisions and their effect on surgically induced astigmatism and higher-order aberrations. J Refract Surg. 2014;30(8):522-525. doi: 10.3928/1081597X-20140711-04.
  12. Serrao S, Lombardo G, Ducoli P, Rosati M, Lombardo M. Evaluation of femtosecond laser clear corneal incision: an experimental study. J Refract Surg. 2013;29(6):418-24. doi: 10.3928/1081597X-20130430-01.
  13. Serrao S, Steinert RF, et al. Effect of femtosecond laser-created clear corneal incision on corneal topography. J Cataract Refract Surg. 2014;40(4):531-7. doi: 10.1016/j.jcrs.2013.11.027.
  14. Farid M. Femtosecond laser-assisted corneal surgery. Curr Opin Ophthalmol. 2010;21:288-292. doi: 10.1097/icu.0b013e32833a8dbc.
  15. Hodge C, Bali SJ, Lawless M, et al. Femtosecond cataract surgery: A review of current literature and the experience from an initial installation. Saudi J Ophthalmol. 2012;26:73-78. doi: 10.1016/j.sjopt.2011.11.003.
  16. Palanker DV, et al. Femtosecond laser-assisted cataract surgery with integrated optical coherence tomography. Sci Transl Med. 2010;2:58-85. doi: 1126/scitranslmed.3001305.
  17. Nordan LT, Slade SG, Baker RN, et al. Femtosecond laser flap creation for laser in situ keratomileusis: six-month follow-up of initial U.S. clinical series. J Refract Surg. 2003;19:8-14.
  18. Mastropasqua L, et al. Femtosecond laser versus manual clear corneal incision in cataract surgery. J Refract Surg. 2014;30(1):27-33. doi: 10.3928/1081597X-20131 217-03.
  19. Fine IH, Hoffman RS, Packer MJ. Profile of clear corneal cataract incisions demonstrated by ocular coherence tomography. Cataract Refract Surg. 2007;33(1):94-97. doi: 10.1016/j.jcrs.2006.09.016.
  20. Greval DS, Basti S. Comparison of morphologic features of clear corneal incisions created with a femtosecond laser or a keratome. J Cataract Refract Surg. 2014;40(4):521-30. doi: 10.1016/j.jcrs.2013.11.028.
  21. Masket S, Sarayba M, Ignacio T, Fram N. Femtosecond laser-assisted cataract incisions: architectural stability and reproducibility. J Cataract Refract Surg. 2010;36(6):1048-1049. doi: 10.1016/j.jcrs.2010.03.027.
  22. Nagy ZZ, Takacs A, Filkorn T, Sarayba M. Initial clinical evaluation of intraocular femtosecond laser in cataract surgery. J Refract Surg. 2009;25:1053-1060. doi: 10.3928/1081597X-20091117-04
  23. Nagy ZZ. New technology update: femtosecond laser in cataract surgery. Clin Ophthalmol. 2014;8:1157-1167. doi: 10.2147/OPTH.S36040.

Statistics

Views

Abstract - 2121

PDF (Russian) - 381

PDF (English) - 169

Cited-By


PlumX


Copyright (c) 2016 Takhtaev Y.V., Nizametdinova Y.S., Shukhaev S.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies