Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Department of Ophthalmology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyeonggi-do, Republic of Korea.
Sci Rep. 2021 Apr 1;11(1):7340. doi: 10.1038/s41598-021-86763-5.
This study tried to compare the clinical outcomes of femtosecond laser-assisted astigmatic keratotomy (FSAK) and toric intraocular lens (IOL) implantation for astigmatism correction and identify factors affecting the efficacy of FSAK and toric IOL implantation in astigmatism correction. This retrospective case series comprised patients with corneal astigmatism ranging between 0.5 D and 4.5 D. Patients underwent FSAK or toric IOL implantation for cataract treatment and correction of astigmatism at the Samsung Medical Center, a tertiary surgical center, between April 2016 and December 2018. All patients underwent examination before and at three months after the surgery for comparative evaluation of refractive astigmatism, corneal high order aberrations and irregularity index. The astigmatism correction was analyzed by the Alpins method. Subgroup analysis of preoperative factors was based on the extent of target-induced astigmatism (TIA), the degree of astigmatism, and astigmatism classification based on topography. Thirty-one eyes underwent toric IOL implantation and 35 eyes underwent FSAK. The refractive astigmatism was significantly decreased in both toric IOL (P = 0.000) and FSAK group (P = 0.003). The correction index (CI) of refractive astigmatism was 0.84 ± 0.39 in the toric IOL and 0.71 ± 0.60 in the FSAK group. There was no difference between the two groups (P = 0.337). The CI of the FSAK group was significantly lower than in the toric IOL group when TIA was more than 1.5 D (P = 0.006), when correcting against-the-rule (P = 0.017), and limbus-to-limbus astigmatism (P = 0.008). In conclusion, toric IOL implantation is an effective and safe procedure for correcting preoperative astigmatism in cataract surgery in the short-term observation.
本研究旨在比较飞秒激光辅助散光角膜切开术（FSAK）和散光人工晶状体（IOL）植入术治疗散光的临床疗效，并确定影响 FSAK 和散光 IOL 植入术矫正散光疗效的因素。这是一项回顾性病例系列研究，纳入了 2016 年 4 月至 2018 年 12 月在三星医疗中心接受白内障治疗并同时矫正散光的 0.5 D 至 4.5 D 角膜散光患者。所有患者均在术前和术后 3 个月接受检查，以比较评估屈光度、角膜高阶像差和不规则指数。散光矫正采用 Alpins 法分析。基于目标诱导散光（TIA）程度、散光程度和基于地形图的散光分类对术前因素进行亚组分析。31 眼接受散光 IOL 植入术，35 眼接受 FSAK。散光 IOL（P = 0.000）和 FSAK 组（P = 0.003）的屈光性散光均显著降低。散光 IOL 组和 FSAK 组的矫正指数（CI）分别为 0.84±0.39 和 0.71±0.60，两组间无差异（P = 0.337）。当 TIA 大于 1.5 D（P = 0.006）、矫正逆规散光（P = 0.017）和边对边散光（P = 0.008）时，FSAK 组的 CI 明显低于散光 IOL 组。总之，在短期观察中，散光 IOL 植入术是白内障手术中矫正术前散光的有效且安全的方法。
