Chen Ming, Reinsbach Michael, Wilbanks Nathan D, Chang Chaokai, Chao Chen Cheng
Department of Surgery, Division of Ophthalmology, John A Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.
Nassau University Medical Center, New York, NY, USA.
Taiwan J Ophthalmol. 2019 Jan-Mar;9(1):27-32. doi: 10.4103/tjo.tjo_6_18.
The purpose of the study is to develop a novel nomogram and validate with a retrospective comparative study for manual astigmatic keratotomy (MAK) with the assistance of intraoperative aberrometry (Optiwave Refractive Analysis [ORA]) and digital eye tracking (VERION) in mild astigmatic correction enhancement.
The study was conducted in Honolulu, Hawaii.
This was a single-surgeon comparative study with retrospective data collection.
Sixty consecutive adult cataract surgery cases with regular astigmatism of 1.25 D or less were included for study from April 2016 to April 2017. VERION was used preoperatively in all cases. MAK was performed before phacoemulsification according to the surgeon's own nomogram. ORA then was utilized to obtain the axis and remaining cylinder power after phacoemulsification and intraocular lens implant implantation. MAK extension was performed for eyes with 1 D or more of remaining cylinder. Extensions were carried out slowly and slightly until the amount of cylinder was 1½ D or less under ORA. The mean degrees of extension plus the original MAK plan were calculated to develop the new nomogram. Sixty consecutive similar cases by the same surgeon using the surgeon's nomogram without using ORA/VERION for enhancement were reviewed from April 2015 to April 2016 for comparison. All patients included in this study signed the consent form.
Using Alpins vector analysis for comparison, the proportion of patients with cylinder <0.5 D 3 months postoperatively was 87% in the ORA/VERION group compared to 70% in the non-ORA/VERION group ( < 0.05). Better than 20/25 best-corrected visual acuity was achieved more in the ORA/VERION group compared to non-ORA/VERION group.
This novel nomogram developed by the surgeon may have better outcomes than the old surgeon's own nomogram. Further prospective control study is needed to validate the efficacy. If validated, those surgeons who do not have ORA/VERION can hopefully use this nomogram with greater success.
本研究旨在开发一种新型列线图，并通过回顾性对比研究，在术中像差仪（Optiwave屈光分析[ORA]）和数字眼跟踪（VERION）辅助下，对轻度散光矫正增强的手动散光角膜切开术（MAK）进行验证。
该研究在夏威夷檀香山进行。
这是一项单术者对比研究，采用回顾性数据收集。
纳入2016年4月至2017年4月连续60例规则散光1.25 D或更低的成年白内障手术病例进行研究。所有病例术前均使用VERION。MAK在超声乳化术前根据术者自己的列线图进行。然后在超声乳化和人工晶状体植入后，利用ORA获得轴位和剩余柱镜度数。对剩余柱镜度数为1 D或更高的眼睛进行MAK扩展。扩展操作缓慢且幅度较小，直至在ORA下柱镜度数为1½ D或更低。计算扩展的平均度数加上原始MAK计划，以开发新的列线图。回顾2015年4月至2016年4月由同一术者连续60例使用术者列线图但未使用ORA/VERION进行增强的类似病例进行比较。本研究纳入的所有患者均签署了知情同意书。
采用阿尔平斯矢量分析进行比较，术后3个月柱镜度数<0.5 D的患者比例，ORA/VERION组为87%，非ORA/VERION组为70%（P<0.05）。与非ORA/VERION组相比，ORA/VERION组更多患者实现了优于20/25的最佳矫正视力。
术者开发的这种新型列线图可能比旧的术者自己的列线图有更好的效果。需要进一步进行前瞻性对照研究以验证其疗效。如果得到验证，那些没有ORA/VERION的术者有望更成功地使用此列线图。
