Fernández Joaquín, Rodríguez-Vallejo Manuel, Martínez Javier, Tauste Ana, Piñero David P
1 Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería, Spain.
2 Department of Ophthalmology, Torrecárdenas Hospital Complex, Almería, Spain.
Eur J Ophthalmol. 2018 Jul;28(4):398-405. doi: 10.1177/1120672117747017. Epub 2018 Feb 23.
To assess the surgically induced astigmatism with femtosecond laser-assisted and manual temporal clear corneal incisions and to evaluate the performance of a model for prediction of the surgically induced astigmatism based on the preoperative corneal astigmatism.
Clinical data of 104 right eyes and 104 left eyes undergoing cataract surgery, 52 with manual incisions and 52 with femtosecond laser-assisted incisions in each eye group, were extracted and revised retrospectively. In all cases, manual incisions were 2.2 mm width and femtosecond incisions were 2.5 mm width, both at temporal location. A predictive model of the surgically induced astigmatism was obtained by means of simple linear regression analyses.
Mean surgically induced astigmatisms for right eyes were 0.14D@65 (manual) and 0.24D@92 (femtosecond) (p > 0.05) and for left eyes, 0.15D@101 (manual) and 0.19D@104 (femtosecond) (p > 0.05). The orthogonal components of the surgically induced astigmatism (X, Y) were significantly correlated (p < 0.05) with the preoperative orthogonal components of corneal astigmatism (X, Y) (r = -0.29 for X and r = -0.1 for Y). The preoperative astigmatism explained 8% of the variability of the X and 3% of the variability of Y. The postoperative corneal astigmatism prediction was not improved by the surgically induced astigmatism obtained from the model in comparison with the simple vector subtraction of the mean surgically induced astigmatism.
Temporal incisions induce similar astigmatism either for manual or for femtosecond procedures. This can be clinically negligible for being considered for toric intraocular lens calculation due to the great standard deviation in comparison with the mean. The usefulness of the prediction model should be confirmed in patients with high preoperative corneal astigmatism.
评估飞秒激光辅助颞侧透明角膜切口和手动颞侧透明角膜切口手术引起的散光，并基于术前角膜散光评估预测手术性散光模型的性能。
回顾性提取并分析104例右眼和104例左眼白内障手术患者的临床资料，每组各52例采用手动切口，52例采用飞秒激光辅助切口。所有病例中，手动切口宽度为2.2mm，飞秒切口宽度为2.5mm，均位于颞侧。通过简单线性回归分析获得手术性散光的预测模型。
右眼手术性散光平均值分别为0.14D@65（手动）和0.24D@92（飞秒）（p>0.05），左眼分别为0.15D@101（手动）和0.19D@104（飞秒）（p>0.05）。手术性散光的正交分量（X，Y）与术前角膜散光的正交分量（X，Y）显著相关（p<0.05）（X的r=-0.29，Y的r=-0.1）。术前散光解释了X变异性的8%和Y变异性的3%。与平均手术性散光的简单矢量减法相比，模型获得的手术性散光并未改善术后角膜散光的预测。
颞侧切口无论是手动还是飞秒手术引起的散光相似。与平均值相比，由于标准差较大，在考虑计算散光人工晶状体时，这在临床上可忽略不计。预测模型的实用性应在术前角膜散光较高的患者中得到证实。
