Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.
Department of Ophthalmology, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Gyeonggi-do, Republic of Korea.
Sci Rep. 2020 Jun 30;10(1):10666. doi: 10.1038/s41598-020-67726-8.
This retrospective study is to evaluate refractive and visual outcomes of topography-guided femtosecond laser-assisted in situ keratomileusis (TGL) for correcting corneal high-order aberrations (HoA) after multifocal intraocular lens (mIOL) implantation. Twenty-eight eyes of 28 patients with both corrected distance visual acuity (CDVA) under 20/25 and subjective visual discomfort at 3 months after mIOL implantation were included in the study. TGL was performed to correct corneal HoA. Visual acuity, manifest refraction, and corneal HoA were measured 3 months after TGL. CDVA was improved in 22 (78.57%) of 28 eyes after TGL. Uncorrected distance visual acuity (0.12 ± 0.16 logMAR) and uncorrected near visual acuity (0.081 ± 0.16 logMAR) were better than those before TGL (P < 0.001). Residual refractive astigmatism showed no difference compared to that before TGL. Root mean square (RMS) of HoA (P = 0.012), spherical aberration (P = 0.013), and RMS of coma (P = 0.001) were reduced relative to those before TGL. Amount of improvement in CDVA was correlated with amount of reduced coma RMS (R = 0.524; P = 0.005) and spherical aberration (R = 0.443; P = 0.021). TGL showed to improve both refractive and visual outcomes in patients with mIOL implantation by correcting corneal HoA.
这项回顾性研究旨在评估地形图引导的飞秒激光辅助原位角膜磨镶术（TGL）矫正多焦点人工晶状体（mIOL）植入术后角膜高阶像差（HoA）的屈光和视觉效果。28 例 mIOL 植入术后 3 个月矫正远视力（CDVA）低于 20/25，主观视觉不适的患者共 28 只眼纳入本研究。TGL 用于矫正角膜 HoA。TGL 后 3 个月测量视力、角膜屈光度和角膜 HoA。28 只眼中有 22 只（78.57%）TGL 后 CDVA 得到改善。TGL 后未矫正远视力（0.12±0.16 logMAR）和未矫正近视力（0.081±0.16 logMAR）优于 TGL 前（P<0.001）。残余屈光性散光与 TGL 前无差异。与 TGL 前相比，均方根（RMS）HoA（P=0.012）、球差（P=0.013）和 RMS 彗差（P=0.001）均降低。CDVA 的改善量与彗差 RMS（R=0.524；P=0.005）和球差（R=0.443；P=0.021）的降低量相关。TGL 通过矫正角膜 HoA，改善了 mIOL 植入术后患者的屈光和视觉效果。
