Manual Incisions Versus Femtosecond Laser Incisions in Cataract Surgery: Comparison of Corneal Parameters
Purpose
To compare differences in keratometric and aberrometric parameters of the anterior corneal surface after femtosecond laser-guided cataract surgery between patients in whom incisions were made manually or with the femtosecond laser.
Methods
In the femtosecond laser incision group, 96 eyes from 56 patients were included. In the manual incision group, 47 eyes from 28 patients were included. All patients followed the same surgical protocol, with the exception of the incisions. The study was performed in accordance with the guidelines and principles of the Declaration of Helsinki. All subjects were over 18 years of age and signed informed consent. Corneal astigmatism and keratometric radii, 4th order spherical aberration, horizontal and vertical coma and trefoil were evaluated before surgery and one month after the procedure.
Results
65.6% in the femtosecond laser incision group and 61% in the manual incision group had induced corneal astigmatism of less than 0.25 diopters. Only 5.2% of the patients in the femtosecond incision group had induced astigmatism of greater than 0.5 diopters, compared to 8.6% of the patients with manual incisions. Furthermore, statistically significant differences were found between corneal astigmatism and flat K in the manual incision group before and after the procedure (p < 0.05). In contrast, there were no significant changes for any of the keratometric or aberrometric parameters evaluated in the femtosecond laser incision group.
Conclusion
No significant topographic and aberrometric changes in the anterior corneal surface were found, with both manual incisions. Only differences were found in corneal astigmatism, where a better performance was noted in the femtosecond laser group, probably due to greater precision in the size and position of the incision.