1. Optimization of femtosecond laser–constructed clear corneal wound sealability for cataract surgery
- Author
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Paul Harasymowycz, Charles-Édouard Giguère, Cristina Bostan, Hasitha de Alwis Weerasekera, Isabelle Brunette, Raphaëlle Fadous, Étienne Benard-Seguin, and Antoine Sylvestre-Bouchard
- Subjects
medicine.medical_treatment ,Cataract Extraction ,Cataract ,law.invention ,Cornea ,03 medical and health sciences ,0302 clinical medicine ,law ,medicine ,Humans ,Retrospective Studies ,Leakage (electronics) ,Wound Healing ,business.industry ,Lasers ,Retrospective cohort study ,Cataract surgery ,Laser ,Sensory Systems ,Design phase ,Ophthalmology ,Private practice ,030221 ophthalmology & optometry ,Corneal wound ,Surgery ,Laser Therapy ,business ,Nuclear medicine ,030217 neurology & neurosurgery - Abstract
PURPOSE To compare the sealability of femtosecond laser (FSL)-assisted corneal incisions (CIs) with that of triplanar manual (M)-CIs and to determine FSL wound parameters minimizing leakage. SETTING Private practice. DESIGN Phase IV, single-surgeon, retrospective cohort study. METHODS One eye per patient was included. Two groups defined by the main wound (FSL-CI or M-CI) were compared for leakage, inferred by placement of a suture at the end of surgery. Leakage in FSL-CIs was analyzed as a function of customizable wound parameters: anterior plane depth (APD), posterior plane depth (PPD), anterior side-cut angle (ASCA), and posterior side-cut angle (PSCA). The risk of leakage of FSL-CIs with optimal and nonoptimal parameters was further compared with that of M-CIs. RESULTS A total of 1100 eyes (757 [68.8%] FSL-CI; 343 [31.2%] M-CI) were included. Wound leakage occurred in 133 FSL-CI (17.6%) and 30 M-CI eyes (8.7%) (P < .001). FSL wound parameters associated with the lowest risk of leakage were 60% APD, 70% PPD, 120 degrees ASCA, and 70 degrees PSCA. FSL-CIs constructed with at least 3 optimal parameters (60% APD, 70% PPD, and 120 degrees ASCA) had a similar risk of leakage to M-CIs (odds ratio [OR], 1.1; 95% CI, 0.5-2.3). FSL-CIs with suboptimal parameters had twice the risk of leakage of M-CIs (OR, 2.0; 95% CI, 1.1-3.8). CONCLUSIONS Overall, FSL-CIs leaked more than M-CIs. However, FSL-CIs with optimized wound profiles had an equivalent risk of leakage to M-CIs. Wound parameter customization is an asset of FSL technology that allows optimization of FSL-CI sealability.
- Published
- 2020
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