He Qin, Huang Jiani, He Xiaoying, Yu Wangshu, Yap Maurice, Han Wei
The Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China.
Acta Ophthalmol. 2021 Nov;99(7):e1027-e1040. doi: 10.1111/aos.14778. Epub 2021 Mar 4.
To evaluate the influence of 2.2 mm clear corneal incision (CCI) features in surgically induced astigmatism (SIA) and higher-order aberrations (HOAs) after cataract surgery.
Right eyes of 92 subjects receiving 2.2 mm incision cataract surgery were involved. A total of 38 eyes were categorized as the intact incision group, and 54 eyes were the defective incision group. Pre- and postoperative (1 month and 6 months) corneal astigmatism and HOAs on anterior and posterior corneal surfaces, corneal volume, and corneal thickness (CT) were measured using Pentacam. The CCI features including incision length (IL), incision angles, distance from incision to central cornea (Dis-En/Ex), and CT at incision site were quantified using AS-OCT.
The defective incision group showed shorter IL and larger incision angles [false discovery rate (FDR) - p < 0.05]. Changes in CT at incision site were more pronounced for the defective incision group (FDR - p < 0.05). Some SIA parameters were related to the certain specific CCI features, especially IL (FDR - p < 0.05). Both groups exhibited significant increased 6 mm posterior corneal tHOAs at 1 month (Bonferroni corrected - p < 0.01) and the defective incision group showed increased 6 mm posterior tHOAs at 6 months (Bonferroni corrected - p = 0.023). There were characteristic correlations between Zernike terms and CCI features including IL, CT, Dis-En/Ex, and incision angles at 1 month, especially over 6 mm zone.
The CCI deformities can affect corneal recovery and induce more HOAs at 1 month postoperatively. Such effects became minor, but could persist until 6 months. The IL combined with Angle-En/Ex was important factor influencing CCI integrity and corneal optical quality.
评估白内障手术后2.2毫米透明角膜切口（CCI）特征对手术性散光（SIA）和高阶像差（HOA）的影响。
纳入92例行2.2毫米切口白内障手术患者的右眼。其中38眼为完整切口组，54眼为缺陷切口组。使用Pentacam测量术前及术后（1个月和6个月）角膜散光、角膜前后表面的HOA、角膜体积和角膜厚度（CT）。使用AS-OCT对CCI特征进行量化，包括切口长度（IL）、切口角度、切口至角膜中心的距离（Dis-En/Ex）以及切口部位的CT。
缺陷切口组的IL较短且切口角度较大[错误发现率（FDR）-p<0.05]。缺陷切口组切口部位CT的变化更为明显（FDR-p<0.05）。一些SIA参数与特定的CCI特征相关，尤其是IL（FDR-p<0.05）。两组在术后1个月时6毫米后角膜总HOA均显著增加（Bonferroni校正-p<0.01），缺陷切口组在术后6个月时6毫米后总HOA增加（Bonferroni校正-p=0.023）。在术后1个月时，泽尼克项与CCI特征（包括IL、CT、Dis-En/Ex和切口角度）之间存在特征性相关性，尤其是在6毫米以上区域。
CCI畸形可影响角膜恢复，并在术后1个月诱导更多的HOA。这种影响在术后6个月时变小，但可能持续存在。IL与Angle-En/Ex相结合是影响CCI完整性和角膜光学质量的重要因素。
