Fourier-domain optical coherence tomography evaluation of clear corneal incision structure according to blade material

Purpose: To use Fourier-domain optical coherence tomography (OCT) to evaluate the wound characteristics of clear corneal incisions (CCIs) created with a metal or diamond blade in cataract surgery.

Design: Prospective comparative observational study.

Methods: Patients who had cataract surgery were randomized into 2 groups based on whether a metal blade (Group 1, 37 eyes) or diamond blade (Group 2, 33 eyes) was used to create a 2.8 mm temporal CCI. One day, 1 week, and 1 month postoperatively, structural characteristics of the CCI were analyzed using RTVue-100 Fourier-domain OCT. Parameters included incision angle, corneal thickness, epithelial or endothelial gaps, and Descemet membrane detachment. Visual acuity, surgically induced astigmatism (SIA), and ocular aberrations were evaluated.

Results: There was a significant difference in corneal thickness at the 1.0 mm temporal side from midpoint. The mean uncorrected distance visual acuity in Group 2 (33 eyes) improved significantly over time. In both groups, corneal thickness at the midpoint, 1.0 mm temporal side, and 1.0 mm nasal side from the midpoint of the incision significantly decreased over time. At all timepoints, temporal and nasal thickness in Group 2 was significantly greater than in Group 1 (37 eyes), with the exception of temporal thickness at 1 month. In both groups, wound healing was reliable over time. There were no significant between-group differences in SIA or changes in aberrations.

Conclusions: Corneal thickness at the incision site showed a significant difference between the 2 groups. Both groups achieved structural stabilization.

Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.