|Articles|September 1, 2016

Reverse side cut produces better self-sealing efficacy

A 110° reverse side cut primary incision created with a femtosecond laser provides an effective seal for potential wound leakage in a recent study.

Reviewed by Eric D. Donnenfeld, MD

Rockville Centre, NY-Clear corneal incisions are commonly used in today’s modern cataract surgery, as they tend to be no more than 3 mm wide; have minimal effect on pre-existing astigmatism; do not damage the conjunctiva; and can be made superiorly, temporally, or at the steepest axis of the cornea.

They are not, however, free from potential complications.

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More than a decade ago, members of the American Society of Cataract and Refractive Surgery Cataract Clinical Committee issued a white paper on the association between these types of incisions and postop endophthalmitis, 1and the concern remains today. 2, 3

There are suggestions today, however, that using a femtosecond laser to create these incisions may help resolve these issues and concerns.

One study has now shown one particular type of femtosecond-created incision to substantially reduce wound leakage compared with other types of incisions.

A 110° reverse side cut primary incision created with a femtosecond laser provides “the most effective seal for potential wound leakage, especially compared with manual incisions,” in patients undergoing cataract surgery, according to Eric D. Donnenfeld, MD, and colleagues.

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With femtosecond lasers becoming more integrated into cataract surgery procedures, the group wanted to evaluate and compare self-sealing efficacy and safety of 110° reverse side cuts, 70° forward side cuts, and manually created forward corneal incisions. Dr. Donnenfeld is founding partner of Ophthalmic Consultants of Long Island and Connecticut, Rockville Centre, NY, and clinical professor of ophthalmology, New York University Medical Center, New York.

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