Kim Gyu Ah, Lee Si Hyung, Lee Sang Yeop, Kwon Hee Jung, Bae Hyoung Won, Seong Gong Je, Kim Chan Yun
Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Bucheon Hospital, Soonchunhyang University, Bucheon, Korea.
Eye (Lond). 2018 Jul;32(7):1265-1270. doi: 10.1038/s41433-018-0072-9. Epub 2018 Mar 14.
Surgically induced astigmatism (SIA) has attracted much interest in recent times because changes in corneal astigmatism can lead to decreased uncorrected visual acuity and patient discomfort. This study aimed to evaluate SIA and to identify factors correlated therewith after trabeculectomy.
We retrospectively reviewed medical charts of patients who were treated with trabeculectomy at 120° meridian (superotemporal area on right eye and superonasal area on left eye) by the same surgeon. Preoperative keratometric data were compared with data collected from 2 months to 12 months postoperatively. SIA was evaluated using Naeser's polar value analysis.
Using Naeser's method, ΔKP(120) was calculated as 0.7 ± 0.7 (0.82@104°), which indicates a with-the-rule change. After surgery, the combined mean polar values changed significantly (Hotelling T = 22.47; p < 0.001). Multivariate analysis of variance indicated that postoperative intraocular pressure and location of surgery were independent factors that were significantly associated with SIA (p = 0.002 and 0.03, respectively).
Trabeculectomy at the 120° meridian was not astigmatically neutral. In addition, the SIA after trabeculectomy appears to be greater in eyes with low postoperative intraocular pressure and a superonasal surgical wound rather than a superotemporal wound.
手术诱导性散光（SIA）近来备受关注，因为角膜散光的变化会导致未矫正视力下降和患者不适。本研究旨在评估小梁切除术后的SIA并确定与之相关的因素。
我们回顾性分析了由同一位外科医生在120°子午线（右眼颞上区域和左眼鼻上区域）进行小梁切除术的患者的病历。将术前角膜曲率计数据与术后2个月至12个月收集的数据进行比较。使用内泽尔（Naeser）的极差值分析评估SIA。
采用内泽尔方法，计算出ΔKP(120)为0.7±0.7（104°时为0.82），这表明是顺规变化。手术后，综合平均极差值有显著变化（霍特林T = 22.47；p < 0.001）。多变量方差分析表明，术后眼压和手术部位是与SIA显著相关的独立因素（分别为p = 0.002和0.03）。
在120°子午线处进行的小梁切除术并非散光中性。此外，小梁切除术后，术后眼压较低且手术伤口位于鼻上而非颞上区域的眼睛，其SIA似乎更大。
