J Refract Surg. 2020 Mar 1;36(3):142-149. doi: 10.3928/1081597X-20200210-01.
To evaluate the effect of cyclotorsion compensation with an image-guided system (Callisto eye; Carl Zeiss Meditec AG, Jena, Germany) on the visual and refractive outcomes of small incision lenticule extraction (SMILE) surgery for astigmatism.
The medical records of 124 right eyes of 124 patients with astigmatism of 0.75 diopters (D) or greater who underwent SMILE for myopic astigmatism were reviewed. Patients were treated with cyclotorsion compensated SMILE or standard SMILE. After the sitting position reference axis was registered with IOLMaster 700 (Carl Zeiss Meditec AG), these data were transferred to the Callisto eye system, which was connected to the operating VisuMax microscope (Carl Zeiss Meditec AG). Cyclotorsion was measured by activating the Z-align function and compensated for by repositioning the patient's body or tilting the head until the reference axis from the IOLMaster 700 (0-180) was parallel to a manually drawn reference axis on the screen (0-180) before docking. The visual and refractive results were studied preoperatively and postoperatively. Astigmatic changes were interpreted using the Alpins method.
Six months after surgery, the results showed that the astigmatic eyes in the cyclotorsion compensated group had improved axial alignment, more precise astigmatic correction, and better postoperative uncorrected distance visual acuity (UDVA) compared with the standard group. The mean logMAR UDVA was 0.02 ± 0.10 (range: -0.15 to 0.30) and 0.06 ± 0.11 (range: -0.15 to 0.30) (P = .13) and the mean astigmatic error was -0.19 ± 0.17 D (range: -0.50 to 0.00 D) and -0.45 ± 0.38 D (range: -1.50 to 0.00 D) (P < .001) in the cyclotorsion compensated group and the standard group, respectively. In regard to vector analysis, the mean index of success was 0.00 ± 0.00 (range: 0.00 to 0.00) and 0.40 ± 0.48 (range: 0.00 to 2.72) (P < .001), and the mean absolute angle of error in degrees was 1.18 ± 2.23 (range: 0.00 to 13.00) and 3.76 ± 3.80 (range: 0.00 to 14.00) (P < .001) in the cyclotorsion compensated group and the standard group, respectively.
The combination of the Callisto eye system with a VisuMax laser might be an efficacious and reliable approach to enhance astigmatism treatment with SMILE surgery. [J Refract Surg. 2020;36(3):142-149.].
评估使用图像引导系统（Callisto 眼；卡尔蔡司 Meditec AG，耶拿，德国）对小切口透镜切除术（SMILE）治疗散光的视觉和屈光结果的影响。
回顾了 124 例 124 只眼近视散光 0.75 屈光度（D）或更高的患者的病历，这些患者接受了 SMILE 治疗近视散光。患者接受了有或无扭转补偿的 SMILE 治疗。在 IOLMaster 700（卡尔蔡司 Meditec AG）上登记坐姿参考轴后，这些数据被传输到 Callisto 眼系统，该系统连接到操作 VisuMax 显微镜（卡尔蔡司 Meditec AG）。通过激活 Z 对齐功能测量扭转，并通过重新定位患者的身体或倾斜头部来补偿，直到从 IOLMaster 700（0-180）的参考轴与屏幕上手动绘制的参考轴（0-180）平行，然后进行对接。术前和术后研究了视觉和屈光结果。使用 Alpins 方法解释散光变化。
术后 6 个月，结果显示扭转补偿组的散光眼轴向定位得到改善，散光矫正更精确，术后未矫正距离视力（UDVA）更好。平均 logMAR UDVA 分别为 0.02 ± 0.10（范围：-0.15 至 0.30）和 0.06 ± 0.11（范围：-0.15 至 0.30）（P=.13），平均散光误差分别为-0.19 ± 0.17 D（范围：-0.50 至 0.00 D）和-0.45 ± 0.38 D（范围：-1.50 至 0.00 D）（P<.001）。在扭转补偿组和标准组中，分别为 0.00 ± 0.00（范围：0.00 至 0.00）和 0.40 ± 0.48（范围：0.00 至 2.72）（P<.001）。平均绝对误差角为 1.18 ± 2.23（范围：0.00 至 13.00）和 3.76 ± 3.80（范围：0.00 至 14.00）（P<.001）。在扭转补偿组和标准组中，分别为 1.18 ± 2.23（范围：0.00 至 13.00）和 3.76 ± 3.80（范围：0.00 至 14.00）（P<.001）。
Callisto 眼系统与 VisuMax 激光的结合可能是增强 SMILE 手术治疗散光的有效且可靠的方法。[J Refract Surg。2020;36(3):142-149.]。
