New technique for femtosecond laser creation of clear corneal incisions for cataract surgery.
To evaluate the changes in corneal topography and corneal higher-order wavefront aberrations with the use of a new technique in which clear corneal incisions (CCIs) for cataract surgery are created with a femtosecond laser.



IRCCS Fondazione G.B. Bietti, Rome, Italy.



Prospective randomized case series.



Cataract surgery patients were randomized into 2 groups. In the study group, a 3-plane CCI was created with a femtosecond laser. In the control group, the single plane-angled CCI was created manually using disposable knives. Simulated keratometry (K) values and corneal higher-order wavefront aberrations with 3.5 mm and 6.0 mm pupils were compared between groups.



Each group comprised 10 eyes. At 6 months, the mean change in K values from preoperatively was 0.16 diopter (D) ± 0.14 (SD) in the study group and 0.34 ± 0.16 D in the control group, with no differences between groups (P > .05). The manual CCI significantly increased corneal higher-order wavefront aberrations with 3.5 mm and 6.0 mm pupils (both P < .05). In the study group, corneal higher-order wavefront aberrations increased significantly with a 6.0 mm pupil only (P ≤ .02). The induced changes in corneal higher-order wavefront aberrations were significantly different between groups over both pupil sizes (P < .05).



The femtosecond laser-created CCI did not induce significant changes in simulated K or corneal higher-order wavefront aberrations over the mesopic pupil size. The lower amount of induced corneal higher-order wavefront aberrations with the new technique than with manual CCI could be related to the different geometry of the 2 techniques.
From the Fondazione G.B. Bietti IRCCS (Serrao, Giannini, Schiano-Lomoriello, M. Lombardo), Vision Engineering Italy srl (G. Lombardo), Rome, and Consiglio Nazionale delle Ricerche (G. Lombardo), Istituto per i Processi Chimico-Fisici, Messina, Italy. Electronic address: serrao@serraolaser.it.
Sebastiano
S
Serrao
From the Fondazione G.B. Bietti IRCCS (Serrao, Giannini, Schiano-Lomoriello, M. Lombardo), Vision Engineering Italy srl (G. Lombardo), Rome, and Consiglio Nazionale delle Ricerche (G. Lombardo), Istituto per i Processi Chimico-Fisici, Messina, Italy.
Daniela
D
Giannini
From the Fondazione G.B. Bietti IRCCS (Serrao, Giannini, Schiano-Lomoriello, M. Lombardo), Vision Engineering Italy srl (G. Lombardo), Rome, and Consiglio Nazionale delle Ricerche (G. Lombardo), Istituto per i Processi Chimico-Fisici, Messina, Italy.
Domenico
D
Schiano-Lomoriello
From the Fondazione G.B. Bietti IRCCS (Serrao, Giannini, Schiano-Lomoriello, M. Lombardo), Vision Engineering Italy srl (G. Lombardo), Rome, and Consiglio Nazionale delle Ricerche (G. Lombardo), Istituto per i Processi Chimico-Fisici, Messina, Italy.
Giuseppe
G
Lombardo
From the Fondazione G.B. Bietti IRCCS (Serrao, Giannini, Schiano-Lomoriello, M. Lombardo), Vision Engineering Italy srl (G. Lombardo), Rome, and Consiglio Nazionale delle Ricerche (G. Lombardo), Istituto per i Processi Chimico-Fisici, Messina, Italy.
Marco
M
Lombardo
D057128:Aberrometry; D000328:Adult; D000368:Aged; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D063171:Corneal Pachymetry; D019781:Corneal Topography; D057108:Corneal Wavefront Aberration / Q000503:physiopathology; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology; D000072836:Surgical Wound; D014792:Visual Acuity / Q000502:physiology