Doeller Birgit, Hirnschall Nino, Fichtenbaum Maria, Nguyen Phuong-Mai, Varsits Ralph, Findl Oliver
VIROS-Vienna Institute for Research in Ocular Surgery, a Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria.
Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Ophthalmol Ther. 2021 Jun;10(2):313-320. doi: 10.1007/s40123-021-00339-0. Epub 2021 Mar 11.
The aim of the current study was to assess the effect of a 600-µm corneal pre-cut on wound architecture and its impact on surgically induced astigmatism. The images were acquired intraoperatively and postoperatively with high-resolution spectral-domain optical coherence tomography (SD-OCT).
This study included patients scheduled for cataract surgery. Preoperatively, optical biometry and corneal topography were performed (IOL Master 500 and Atlas 9000, both Carl Zeiss Meditec AG, Germany). The first eye randomly received a 600-µm corneal pre-cut during cataract surgery, or a single-plane stab-incision and the second eye received the other incision technique. Incision architecture was assessed intraoperatively using a continuous intraoperative optical coherence tomography (iOCT) device (ReScan 700, Carl Zeiss Meditec AG, Germany) at three time points: after the incision, after irrigation/aspiration and after intraocular lens (IOL) implantation. Additionally, OCT (Spectralis, Heidelberg Engineering, Germany) measurements were performed 1 h, 1 week and 1 month postoperatively.
Forty eight eyes of 24 patients were analysed. The pre-cut group and the stab-incision group had a significant decrease in wound thickness from the 1-h to the 1-week measurement (p = 0.022 and p = 0.001). Corneal astigmatism showed a vector difference from preoperatively to the 1-week measurement of 0.48 D (SD, ± 0.27) in the stab incision group and 0.49 D (SD, ± 0.24) in the stab incision group. No significant differences were found between the groups.
To our knowledge, this was the first study which compared the wound alterations in pre-cut and stab-incision groups.
NCT02155270.
本研究的目的是评估600微米角膜预切口对伤口结构的影响及其对手术性散光的影响。术中及术后使用高分辨率光谱域光学相干断层扫描（SD-OCT）采集图像。
本研究纳入计划行白内障手术的患者。术前进行光学生物测量和角膜地形图检查（均使用德国卡尔蔡司医疗技术公司的IOL Master 500和Atlas 9000）。第一只眼在白内障手术期间随机接受600微米角膜预切口或单平面穿刺切口，第二只眼接受另一种切口技术。术中使用连续术中光学相干断层扫描（iOCT）设备（德国卡尔蔡司医疗技术公司的ReScan 700）在三个时间点评估切口结构：切口后、冲洗/抽吸后和人工晶状体（IOL）植入后。此外，术后1小时、1周和1个月进行OCT（德国海德堡工程公司的Spectralis）测量。
分析了24例患者的48只眼。预切口组和穿刺切口组从术后1小时到1周测量时伤口厚度均显著降低（p = 0.022和p = 0.001）。穿刺切口组角膜散光从术前到术后1周测量的矢量差为0.48 D（标准差，±0.27），预切口组为0.49 D（标准差，±0.24）。两组之间未发现显著差异。
据我们所知，这是第一项比较预切口组和穿刺切口组伤口变化的研究。
NCT02155270。
