CHNO des Quinze-Vingts, IHU Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France.
CHNO des Quinze-Vingts, IHU Foresight, Inserm-DGOS CIC 1423, 28, rue de Charenton, 75012 Paris, France; Sorbonne Université, Inserm, CNRS, Institut de la Vision, 17, rue Moreau, 75012 Paris, France.
J Fr Ophtalmol. 2021 Feb;44(2):189-195. doi: 10.1016/j.jfo.2020.04.059. Epub 2020 Dec 25.
To determine whether manifest refractive astigmatism (RA) or anterior corneal astigmatism (CA) is the best value for excimer laser programming in cases of ocular residual astigmatism (ORA).
Patients who had undergone LASIK surgery with a disagreement between manifest refractive and corneal cylinder (ocular residual astigmatism ORA)>0.75 D were included retrospectively in this study. We calculated target induced astigmatism vector (TIA), surgically induced astigmatism vector (SIA), difference vector between the astigmatism correction programmed in the excimer laser and refractive astigmatism (DVRA), difference vector between the astigmatism correction programmed in the excimer laser and corneal astigmatism (DVCA) and difference vector between TIA and SIA (DV), by the Alpins method. Vectorial differences between DV and DVRA, and between DV and DVCA, were then calculated to determine whether RA or CA was closest to the ideal cylinder for laser programming.
Of a total of 104 eyes undergoing LASIK, 22 eyes of 12 patients (21.1%) had an ORA>0.75 D and were included. Mean ORA was 0.9±0.2 D and mean postoperative subjective cylinder was 0.45 D. The DV-DVRA difference vector was 0.57±0.2 D, and the DV-DVCA difference vector was 0.86±0.4 D (P=0.02). RA was closer than CA to the ideal astigmatism correction.
In cases of discrepancy between manifest astigmatism and corneal astigmatism, correction of manifest refractive astigmatism seems to give a better refractive result.
确定在存在眼内残余散光（ORA）的情况下，对于准分子激光编程，是显性折射性散光（RA）还是前角膜散光（CA）更能得到最佳值。
回顾性纳入了曾接受过 LASIK 手术但显性屈光性和角膜散光（眼内残余散光 ORA）之间存在差异（>0.75 D）的患者。我们通过 Alpins 法计算目标诱导散光矢量（TIA）、手术诱导散光矢量（SIA）、准分子激光编程的散光矫正值与折射性散光（DVRA）之间的差异矢量、准分子激光编程的散光矫正值与角膜散光（DVCA）之间的差异矢量以及 TIA 和 SIA 之间的差异矢量（DV）。然后计算 DV 与 DVRA 和 DV 与 DVCA 之间的矢量差异，以确定 RA 或 CA 与激光编程的理想散光值最为接近。
共有 104 只眼接受了 LASIK，12 名患者（21.1%）的 22 只眼存在 ORA>0.75 D，纳入本研究。平均 ORA 为 0.9±0.2 D，平均术后主观散光为 0.45 D。DV-DVRA 差异矢量为 0.57±0.2 D，DV-DVCA 差异矢量为 0.86±0.4 D（P=0.02）。RA 比 CA 更接近理想的散光矫正值。
在显性散光和角膜散光之间存在差异的情况下，矫正显性屈光性散光似乎能获得更好的屈光效果。
