Comparison of Wound Sealability Between Femtosecond Laser–Constructed and Manual Clear Corneal Incisions in Patients Undergoing Cataract Surgery: A Pilot Study

This article describes the current status of the femtosecond generated arcuate incision to correct corneal steepening. It covers the history of the surgical correction of astigmatism and describes the entrance of the femtosecond laser into modern corneal and cataract surgery. The process of photodisruption is explained as are the current indications for use of the femtosecond laser to make corneal incisions. A detailed narrative for programming the laser to perform arcuate incisions is included. Nomograms are referenced, and advantages over bladed incisions are described. A case is presented to show the use of these incisions in clinical practice. Finally, future developments are contemplated.

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Histological Sections of Corneal Incisions in OCT-Guided Femtosecond Laser Cataract Surgery

Journal of Refractive Surgery ◽

10.3928/1081597x-20131029-01 ◽

2013 ◽

Vol 29 (12) ◽

pp. 863-864 ◽

Cited By ~ 8

Author(s):

Tim Schultz ◽

Iris Tischoff ◽

Edak Ezeanosike ◽

H. Burkhard Dick

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Histological Sections ◽

Corneal Incisions

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Tomographic analysis of anterior and posterior surgically induced astigmatism after 2.2 mm temporal clear corneal incisions in femtosecond laser–assisted cataract surgery

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2019.06.010 ◽

2019 ◽

Vol 45 (11) ◽

pp. 1602-1611

Author(s):

Thomas Kohnen ◽

Franziska Löffler ◽

Michael Herzog ◽

Kerstin Petermann ◽

Myriam Böhm

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Surgically Induced Astigmatism ◽

Induced Astigmatism ◽

Tomographic Analysis ◽

Surgically Induced ◽

Corneal Incisions

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New technique for femtosecond laser creation of clear corneal incisions for cataract surgery

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2016.08.038 ◽

2017 ◽

Vol 43 (1) ◽

pp. 80-86 ◽

Cited By ~ 3

Author(s):

Sebastiano Serrao ◽

Daniela Giannini ◽

Domenico Schiano-Lomoriello ◽

Giuseppe Lombardo ◽

Marco Lombardo

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

New Technique ◽

Corneal Incisions

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Effect of femtosecond laser-assisted steepest-meridian clear corneal incisions on preexisting corneal regular astigmatism at the time of cataract surgery

International Journal of Ophthalmology ◽

10.18240/ijo.2020.12.08 ◽

2020 ◽

Vol 13 (12) ◽

pp. 1895-1900

Author(s):

Wei Chen ◽

Jian Wu ◽

Yong Wang ◽

Jing Zhou ◽

Rong-Rong Zhu ◽

...

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Corneal Astigmatism ◽

Corneal Incision ◽

Surgically Induced Astigmatism ◽

Clear Corneal Incision ◽

Case Series Study ◽

Induced Astigmatism ◽

Surgically Induced ◽

Corneal Incisions

AIM: To investigate the clinical efficacy and safety of femtosecond laser-assisted steepest-meridian clear corneal incisions for correcting preexisting corneal astigmatism performed at the time of cataract surgery. METHODS: This prospective case series study comprised consecutive age-related cataract patients with corneal regular astigmatism (range: +0.75 to +2.50 D) who had femtosecond laser-assisted steepest-meridian clear corneal incisions (single or paired). Corneal astigmatism was performed with the Pentacam preoperatively and 3mo postoperatively. Total corneal astigmatism and steepest-meridian measured in the 3-mm central zone were used to guide the location, size and number of clear corneal incision. The vector analysis of astigmatic change was performed using the Alpins method. RESULTS: Totally 138 eyes of 138 patients were included. The mean preoperative corneal astigmatism was 1.31±0.41 D, and was significantly reduced to 0.69±0.34 D (equivalent to difference vector) after surgery (P<0.01). The surgically-induced astigmatism was 1.02±0.54 D. The correction index (ratio of target induced astigmatism and surgically-induced astigmatism: 0.72±0.36) as well as the magnitude of error (difference between surgically-induced astigmatism and target induced astigmatism: -0.29±0.51) represented a slight under correction. For angle of error, the arithmetic mean was 1.11±13.70, indicating no significant systematic alignment errors. CONCLUSION: Femtosecond-assisted steepest-meridian clear corneal incision is a fast, customizable, adjustable, precise, and safe technique for the reduction of low to moderate corneal astigmatism during cataract surgery.

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Correcting Corneal Astigmatism with Corneal Arcuate Incisions during Femtosecond Laser Assisted Cataract Surgery

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.371 ◽

2019 ◽

Vol 7 (24) ◽

pp. 4260-4265 ◽

Cited By ~ 1

Author(s):

Nguyen Xuan Hiep ◽

Pham Thi Minh Khanh ◽

Do Quyet ◽

Than Van Thai ◽

Vu Thi Nga ◽

...

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Modern Method ◽

Corneal Astigmatism ◽

Spherical Equivalent ◽

Efficacy And Safety ◽

Interventional Study ◽

Corrected Distance Visual Acuity ◽

Induced Astigmatism ◽

Corneal Incisions

BACKGROUND: Astigmatic management is an important step to achieve the best visual quality after refractive cataract surgery. Nowadays, along with progress in cataract surgery, the femtosecond laser can produce the arcuate incisions high precisely that help the astigmatic correction. In Vietnam, it has not yet any study about this issue, so we perform this study. AIM: To assess the efficacy and safety of arcuate corneal incisions in treatment corneal astigmatism during femtosecond laser-assisted cataract surgery. METHODS: In this clinical interventional study, forty-five cases with cataract and corneal astigmatism (> 0.50D) were treated with corneal arcuate incisions and femtosecond-laser assisted cataract surgery in Vietnam National Institute of Ophthalmology, from January 2017 to May 2018. The uncorrected and corrected distance visual acuity, refraction spherical equivalent, corneal astigmatism were measured (using an OPD-Scan III topographer) before, 1 week and 3 months after surgery. Some features of arcuate corneal incisions (quantity, depth, length and morphology), spectacle independence at a distance and complications were recorded. RESULTS: The rate of postoperative spherical refraction equivalent was within ± 0.50D and ± 1.0D at 3 months (in 95.6% and 100% of the eyes respectively). Mean length of arcuate corneal incisions was 53.78o ± 17.683o (range: 20o to 85o). The average of preoperative corneal astigmatism was 1.65 ± 0.83D, decreased to 0.59 ± 0.549D in the third month after surgery. Surgical induced astigmatism was 1.05 ± 0.449D and lower than preoperative corneal astigmatism (1.65 ± 0.83D), thereby this indicated undercorrection. However, the rate of spectacle independence was 82.3%, and no complications were recorded. CONCLUSION: Correcting of corneal astigmatism in femtosecond laser-assisted cataract surgery combined with the formation of the arcuate incisions is a new and modern method for high safety and efficacy.

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The LenSx Laser—A Review of Current Literature on its Use in Cataract Surgery

US Ophthalmic Review ◽

10.17925/usor.2016.09.01.16 ◽

2016 ◽

Vol 09 (01) ◽

pp. 16

Author(s):

John Davidson ◽

Keyword(s):

Surgical Technique ◽

Femtosecond Laser ◽

Cataract Surgery ◽

Current Literature ◽

Precision Control ◽

Corneal Incisions

Laser cataract surgery (LCS) offers several surgical advantages over manual cataract surgery: the laser fragments the lens and creates corneal incisions and capsulotomies with a level of precision, control and reproducibility unachievable with manual techniques. The literature continues to expand and demonstrate many of the surgical benefits of LCS. There are important distinctions among the various femtosecond laser platforms that affect surgical technique. This review consolidates, organizes, and summarizes key published literature on the LenSx® Laser.

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