OCT analysis of a corneal phaco incision

For teaching my resident surgeons who are completing their years of ophthalmology training at our UCLA hospitals, we have recently acquired a new microscope with an intra-operative OCT scanner (ocular coherence tomography). Today we used that device to analyze the corneal phaco incision right after making it.

Previous articles here on CataractCoach.com have taught the basics of excellent incisions:

Using the intra-operative OCT at the beginning of the case, we can see that the incision is done right with good dimensions and architecture. Then at the end of surgery we can see that the incision is tightly closed and the intra-ocular pressure exerts an outward force to keep the incision approximated as the corneal endothelial cells create a closure force with their pump action.

The OCT scan of the corneal incision shows proper architecture. The tunnel length is good and when scanning mid-incision, the roof and floor of the incision are balanced.
Previous articles here on CataractCoach.com used diagrams to illustrate proper incision architecture, Now with the OCT scan, we can see that the incision in this surgery is good and is expected to seal well.

Coming soon will be more OCT images of the corneal incisions, particularly in cases where the incision is not well-constructed.

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