Early changes in corneal edema following torsional phacoemulsification using anterior segment optical coherence tomography and Scheimpflug photography.

PURPOSE: To assess corneal edema after torsional phacoemulsification using anterior segment optical coherence tomography (AS-OCT) and Scheimpflug photography (Pentacam).

METHODS: Seventy-six eyes with cataract surgery were randomized into 2 groups: a 2.2 mm micro-coaxial incision group (n = 37) and a 2.8 mm standard incision group (n = 39). Patients were examined preoperatively and at 1 day, 1 week and 1 month postoperatively. Incision architecture and pachymetry at the wound level were measured by AS-OCT. The corneal volume within 3.0 and 10.0 mm circles of the cornea was measured using Pentacam.

RESULTS: The cumulative dissipated energy (CDE) was lower in the micro-coaxial incision (2.2 mm) group than in the standard incision (2.8 mm) group (P = 0.043). Corneal edema measurements showed less corneal thickness at the endothelial side of the incision on postoperative day 1 in the micro-incision group (1061 ± 76 vs. 1153 ± 97 μm, P = 0.041). The corneal volume within the 10.0 mm circle was less on postoperative day 1 in the micro-incision group (63.75 ± 4.83 vs. 65.97 ± 4.52 mm(3), P = 0.035). The endothelial cell count did not change significantly throughout the study.

CONCLUSION: The micro-coaxial 2.2 mm incision may incur slightly less damage than the 2.8 mm standard incision in the context of torsional phacoemulsification. Observation of corneal morphology and damage using AS-OCT and Pentacam can be helpful in the evaluation and quantification of fine corneal edema.