Cataract Clinical Trial
Official title:
Impact of a Corneal Pre-cut on Wound Architecture and Astigmatism in Cataract Surgery - a Pilot Study
We would like to evaluate the use of a 600μm pre-cut regarding wound architecture and
surgically induced astigmatism as compared to a stab-incision (a corneal incision without a
pre-cut). A dedicated wound architecture score will be used to evaluate wound configuration.
Postoperatively, OCT scans will be obtained, corneal curvature will be measured and
subjective and objective refraction will be performed in order to measure the
surgically-induced astigmatism.
Corneal wound architecture in cataract surgery has recently been assessed1-4 using optical
coherence tomography. However, none of these studies observed the effect of the wound
architecture on postoperative astigmatism. In a previous study performed at our center,
cataract surgery using a 1.8 mm micro incision (MICS) was compared to a 2.5 mm standard
incision (SICS) regarding wound architecture and surgically induced astigmatism. Wound size
and wound architecture were assessed using a Time-Domain OCT intraand postoperatively. After
implantation of the IOL the incisions were shown to be larger than planned.
This effect was shown to be more pronounced in the small incision group. Both epithelial and
endothelial wound gaping at the end of surgery occurred more often in the MICS group.
Furthermore, this study showed no effect of a 300 μm pre-cut on postoperative wound
architecture and surgically induced astigmatism. Based on these findings we would like to
perform another study using a high-resolution Spectral-Domain OCT, which allows for a
three-dimensional depiction of wound architecture and a better understanding of the dynamic
changes in wound structure during surgery. Furthermore a new high resolution OCT device will
be available outside the operating theatre for postoperative measurements. Both devices are
CE certified, will be used according to their indication and allow noncontact and therefore
pain free measurements. As no significant impact of a 300μm pre-cut on wound architecture
and astigmatism was shown in the predecessor study, we would like to evaluate the use of a
600μm pre-cut regarding wound architecture and surgically induced astigmatism as compared to
a stab-incision (a corneal incision without a pre-cut). A dedicated wound architecture score
will be used to evaluate wound configuration.
Postoperatively, OCT scans will be obtained, corneal curvature will be measured and
subjective and objective refraction will be performed in order to measure the
surgically-induced astigmatism.
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