Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Hong Kong Ophthalmic Associates, Hong Kong.
Am J Ophthalmol. 2020 Sep;217:232-239. doi: 10.1016/j.ajo.2020.05.004. Epub 2020 May 11.
To investigate the long-term stability of corneal astigmatism after combined femtosecond (fs)-assisted phacoemulsification and arcuate keratotomy.
Retrospective, interventional case series.
Surgery was performed using a Victus (Bausch & Lomb) platform. A single, 450-μm-deep arcuate keratotomy was paired at the 8-mm zone with the main phacoemulsification incision in the opposite meridian. The keratotomy incisions were not opened. Corneal astigmatism measurements obtained preoperatively and at 2 and 5 years postoperatively were analyzed using vector analysis.
A total of 44 eyes of 44 patients (mean age 66.0 ± 10.1 years) were included. The mean preoperative corneal astigmatism was 1.40 ± 0.66 diopters (D). This was reduced to 0.74 ± 0.54 D at 2 years and 0.70 ± 0.50 at 5 years postoperatively (P < .001). There were no statistically significant differences between postoperative corneal astigmatism at 2 years and at 5 years (P = .609). Both magnitude of error and absolute angle of error were comparable between the 2 postoperative time points (P > .805). At the end of 5 years, 65% of the eyes were within 15 degrees of the preoperative astigmatic meridian. Comparative analysis showed significantly higher surgically induced astigmatism, lower differences in vector and absolute angles of error for the eyes with preoperative with-the-rule (WTR) astigmatism than eyes with against-the-rule (ATR) astigmatism at 5 years (P < .004).
Our study showed the stability of femtosecond (fs)-assisted arcuate keratotomy was well-maintained over 5 years. There was a tendency of increasing overcorrection of preoperative WTR astigmatism and undercorrection of ATR astigmatism over time.
研究飞秒（fs）辅助超声乳化白内障吸除术联合弧形角膜切开术后角膜散光的长期稳定性。
回顾性、干预性病例系列。
使用 Victus（Bausch & Lomb）平台进行手术。在 8 毫米区域进行单个 450μm 深的弧形角膜切开术，并在对侧子午线与主要超声乳化切口配对。角膜切开术切口未打开。使用向量分析对术前和术后 2 年和 5 年的角膜散光测量值进行分析。
共纳入 44 例 44 眼（平均年龄 66.0±10.1 岁）。术前角膜散光平均为 1.40±0.66 屈光度（D）。术后 2 年降至 0.74±0.54 D，术后 5 年降至 0.70±0.50 D（P<0.001）。术后 2 年和 5 年的角膜散光无统计学差异（P=0.609）。两个术后时间点的误差幅度和绝对角度误差相当（P>0.805）。5 年末，65%的眼在术前散光子午线 15 度以内。比较分析显示，术前顺规性（WTR）散光眼的手术诱导散光较高，向量和绝对角度误差差值较小，而逆规性（ATR）散光眼的手术诱导散光较高，向量和绝对角度误差差值较大（P<0.004）。
我们的研究表明，飞秒（fs）辅助弧形角膜切开术的稳定性在 5 年内保持良好。随着时间的推移，WTR 散光的过矫和 ATR 散光的欠矫有增加的趋势。
