Vision Eye Centre, New Delhi, India.
Indian J Ophthalmol. 2020 Aug;68(8):1569-1572. doi: 10.4103/ijo.IJO_2060_19.
To evaluate the astigmatism correcting effect of penetrating arcuate keratotomy (AK) done during femtosecond laser-assisted cataract surgery (FLACS).
In this nonrandomized prospective study, 80 eyes of 70 patients were studied. The study included patients who underwent combined FLACS and AK, with corneal astigmatism ranging from 0.4 to 1.5 diopters (D). Femtosecond laser-assisted penetrating arcuate keratotomies were created at 8 mm optical zone at 80% depth and were centered at the limbus. Keratometric astigmatism was measured prior to and 3 months post-surgery. Vector analysis was performed using Power vector analysis method.
The mean preoperative keratometric astigmatism without accounting for axis was 0.85 ± 0.27 D, which reduced significantly to 0.47 ± 0.27 D at 3-month follow-up. The mean astigmatism correction attained without accounting for axis was 0.38 ± 0.32 D. The vector corrected mean preoperative astigmatism was 0.85 ± 0.27 D which reduced significantly to 0.50 ± 0.31 D postoperatively (P < 0.001, 95% CI). Vector corrected mean astigmatism correction attained was 0.35 ± 0.38 D. There were no significant intraoperative or postoperative complications.
Preexisting astigmatism can be tackled effectively with penetrating AK during FLACS although under correction is observed with present nomograms. Further refinements may achieve better correction.
评估飞秒激光辅助白内障手术（FLACS）期间行穿透性弧形角膜切开术（AK）矫正散光的效果。
在这项非随机前瞻性研究中，对 70 例 80 只眼进行了研究。研究对象为联合行 FLACS 和 AK 的患者，角膜散光范围为 0.4 至 1.5 屈光度（D）。用飞秒激光在 8mm 光学区以 80%的深度制作穿透性弧形角膜切开术，以角膜缘为中心。术前和术后 3 个月测量角膜散光。使用 Power 向量分析方法进行向量分析。
术前不考虑轴向的平均角膜散光为 0.85 ± 0.27 D，术后 3 个月显著降低至 0.47 ± 0.27 D。不考虑轴向的平均散光矫正值为 0.38 ± 0.32 D。术前未经向量校正的平均角膜散光为 0.85 ± 0.27 D，术后显著降低至 0.50 ± 0.31 D（P < 0.001，95%CI）。经向量校正的平均散光矫正值为 0.35 ± 0.38 D。术中及术后均无明显并发症。
尽管目前的列线图显示存在欠矫，但在 FLACS 期间行穿透性 AK 可有效矫正术前散光。进一步改进可能会获得更好的矫正效果。
