To pursue the least corneal implication during cataract surgery, this study aimed to monitor corneal wound injury after cataract surgery with a novel method. The prospective cohort study involved thirty-two patients, who were assessed by a Scheimpflug tomography AxL® (Oculus GmbH, Wetzlar, Germany) via the following two kinds of indices: whole corneal optical density (COD) and corneal thickness (CT), two weeks before and one month after cataract surgery. The results of the COD revealed that corneal annuli 0.0–2.0 mm and 2.0–6.0 mm, and the average and maximal values at the incisional site significantly increased postoperatively. Also, the anterior and central stroma of 0.0–2.0 mm, and all three depths of 2.0–6.0 mm, increased remarkably after the operation. For the CT, all ranges of diameters plus incisional sites showed significant increases postoperatively. Furthermore, we analyzed the differences (delta) of COD and CT between pre- and post-operation, and found significant correlations between the delta of COD and the delta of CT, regarding annuli 0.0–2.0 mm, 2.0–6.0 mm, and 6.0–10.0 mm, but no correlation at the incisional site, with either average density or maximal density, was detected. We concluded that whole COD and CT, especially at the central zones of the cornea (annulus < 6 mm), are both valuable parameters in the assessment of corneal damage post-cataract surgery, and are independent indices at the incisional site.
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