Ahn Hyunmin, Jun Ikhyun, Seo Kyoung Yul, Kim Eung Kweon, Kim Tae-Im
Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
Front Med (Lausanne). 2022 Aug 25;9:914504. doi: 10.3389/fmed.2022.914504. eCollection 2022.
To assess the effects of femtosecond laser arcuate keratotomy with femtosecond laser-assisted cataract surgery in the management of corneal astigmatism, compared with conventional phacoemulsification cataract surgery.
Retrospective comparative interventional case series.
A total of 2,498 eyes of consecutive patients who presented with 3.00 diopters (D) or under of astigmatism were included. The patients were treated with conventional phacoemulsification cataract surgery (conventional group) and femtosecond laser arcuate keratotomy with femtosecond laser-assisted cataract surgery (femtosecond group).
Surgically induced astigmatism (SIA) was higher in the femtosecond group than the conventional group (0.215, < 0.001). Difference vector (DV) was lower in the femtosecond group (-0.136, < 0.001). The cut-off value of the overcorrection in the femtosecond group was 0.752 D of target induced astigmatism (TIA). For patients with TIA 0.75 D or under, DV and the value of index of success (TIA into DV) were significantly higher in the femtosecond group ( = 0.022 and < 0.001). The overcorrection ratios were 48.8% in the conventional and 58.9% in the femtosecond group. ( < 0.001). For patients with TIA over 0.75 D, SIA and correction index (TIA into SIA) was higher in femtosecond group (0.310 and 0.250, < 0.001 and < 0.001, respectively). Absolute angle of error was 20.612 ± 18.497 in the femtosecond group and higher than the conventional group (2.778, = 0.010).
Femtosecond laser arcuate keratotomy in cataract surgery was effective in SIA between 0.75 to 3.00 D of corneal astigmatism. However, the overcorrection in the lower astigmatism and angle of error in the higher astigmatism were due to the postoperative corneal astigmatism not decreasing as much as SIA. Overcoming these challenges will lead to better management of corneal astigmatism.
评估飞秒激光弧形角膜切开术联合飞秒激光辅助白内障手术在治疗角膜散光方面的效果，并与传统超声乳化白内障手术进行比较。
回顾性对比干预性病例系列研究。
纳入2498例连续患者的患眼，这些患者的散光度数为3.00屈光度（D）及以下。患者分别接受传统超声乳化白内障手术（传统组）和飞秒激光弧形角膜切开术联合飞秒激光辅助白内障手术（飞秒组）。
飞秒组的手术源性散光（SIA）高于传统组（0.215，<0.001）。差异向量（DV）在飞秒组较低（-0.136，<0.001）。飞秒组过矫的临界值为目标诱导散光（TIA）0.752 D。对于TIA为0.75 D及以下的患者，飞秒组的DV和成功指数值（TIA与DV之比）显著更高（分别为0.022和<0.001）。传统组的过矫率为48.8%，飞秒组为58.9%（<0.001）。对于TIA超过0.75 D的患者，飞秒组的SIA和矫正指数（TIA与SIA之比）更高（分别为0.310和0.250，<0.001和<0.001）。飞秒组的绝对误差角为20.612±18.497，高于传统组（2.778，P = 0.010）。
白内障手术中飞秒激光弧形角膜切开术对0.75至3.00 D的角膜散光的SIA有效。然而，低散光时的过矫和高散光时的误差角是由于术后角膜散光减少幅度不如SIA。克服这些挑战将有助于更好地治疗角膜散光。
