Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv...

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Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors have no financial interest to disclose COMPARISON OF WOUND SEALING IN SINGLE PLANAR AND MULTI-PLANAR FEMTOSECOND LASER CORNEAL CATARACT SURGERY INCISIONS

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Transcript of Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv...

Page 1: Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors.

AuthorsWaseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD;

Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD

The authors have no financial interest to disclose

COMPARISON OF WOUND SEALING IN SINGLE PLANAR AND MULTI-PLANAR

FEMTOSECOND LASER CORNEAL CATARACT SURGERY INCISIONS

Page 2: Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors.

PURPOSE:

To compare single plane (SP) and multi plane (MP) corneal incisions by Femtosecond laser (FL) in terms of invasion of bacterial size particles in response to a pressure challenge.

Page 3: Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors.

METHODS:• Two corneal incisions (one SP and one MP) were created using

femtosecond laser on five human eyeballs.

• The eye was brought to physiologic pressure by injections of normal saline with a 30-gauge needle.

• Pressure was checked and found to be between 14mm Hg to 18mm Hg

• India ink was placed on the wounds and washed away .

• The wound was photographed with a millimeter ruler.

Page 4: Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors.

METHODS:• The IOP was then reset between 12 to 18 mmHg and the India ink was

again placed on the eye.

• A pressure challenge of 80mm Hg was made with an ophthalmodynamometer (figure 1).

• The ink was washed away.

• A second photograph was taken of the same wound in the same manner.

• Length-wise invasion (LI) and area-wise invasion (AI) of dye was measured by planimetry (figure 2,3) .

• The difference of invasion in SP vs. MP group was compared both with and without pressure challenge.

Page 5: Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors.

RESULTS:• The mean rank of LI difference before and after pressure in five

eyes through SP wound was 4.9mm and through MP wound was 6.1mm.

• The observed variation by type of surgical wound making was not statistically significant (p = 0.53).

• The mean rank of AI difference before and after pressure in five eyes through SP wound was 3.8mm2 and through MP wound was 7.2mm2.

• The observed variation by type of surgical wound was statistically significant (p = 0.007).

Page 6: Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors.

FIGURE 1 : OPHTHALMODYNAMOMETER AND RULER

Page 7: Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors.

FIGURE 2 : SINGLE PLANE WOUND. (A) BEFORE PRESSURE CHALLENGE (B) AFTER PRESSURE CHALLENGE.

Page 8: Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors.

FIGURE 3 : MULTI PLANE WOUND (A) BEFORE PRESSURE CHALLENGE (B) AFTER PRESSURE CHALLENGE.

Page 9: Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors.

FIGURE 4:DEFAULT INCISION CONTOUR FOR MULTI PLANE AND SINGLE PLANE FS WOUND.

Page 10: Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors.

FIGURE 5: SETTINGS FOR SINGLE-PLANE DEFAULT INCISION ON FEMTOSECOND ASSISTED LASER MACHINE (ALCON LENSEX LASER)

Page 11: Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors.

FIGURE 6: SETTINGS FOR MULTI-PLANE DEFAULT INCISION ON FEMTOSECOND ASSISTED LASER MACHINE (ALCON LENSEX LASER)

Page 12: Authors Waseem Aalam, MD; William May, MD; Sultan Alrashidi, MD; Abdul Elah al Towerki, MD; Rajiv Khandekar, MS, PG Dip; Yassine Daoud, MD The authors.

CONCLUSION:

A femtosecond laser created multi-planar wound contour allows significantly more invasion of bacterial sized particles of India Ink in response to a pressure challenge equivalent to a hard squeeze than a single plane FL incision.


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