Wu S, Yu T, Feng X L, Ye J
Department of Ophthalmology, Army Medical Center of PLA (Daping Hospital), Chongqing 400042, China.
Zhonghua Yan Ke Za Zhi. 2023 Feb 11;59(2):96-101. doi: 10.3760/cma.j.cn112142-20220815-00402.
To compare the effects of femtosecond laser-assisted astigmatic keratotomy (FSAK) with and without a manual opening for correction of low to moderate corneal astigmatism at the time of cataract surgery. It was a prospective cohort study. Patients undergoing cataract surgery from June 2021 to June 2022 at the Army Specialty Medical Center were consecutively enrolled. To correct low to moderate astigmatism, they had combined FSAK with the corneal epithelium manually opened or not according to their own decisions. Pentacam HR corneal topography was performed at 3 months after surgery. The main indicators were target induced astigmatism, surgically induced astigmatism, difference vector, correction index and angle of error. The independent samples -test was used for continuous variables conforming to a normal distribution, the Mann-Whitney -test for those not conforming to a normal distribution, and the Chi-square test for categorical variables. There were 51 patients (61 eyes), including 27 patients (31 eyes) receiving combined open FSAK and 24 patients (30 eyes) with non-open keratotomy. No statistical difference was found between the two groups of patients in terms of age, gender and mean follow-up time (>0.05). The target induced astigmatism was 1.10(0.80, 1.50) D in patients with open keratotomy and 1.30(0.98, 1.73) D in patients with non-open keratotomy (=1.729, =0.084). The surgically induced astigmatism was 0.70 (0.59, 1.25) D and 0.42 (0.20, 0.66) D (=-3.571, <0.001), the difference vector was (0.51±0.31) D and (1.21±0.44) D (=-7.238, <0.001), the correction index was 0.78±0.32 and 0.38±0.25 (=5.386, <0.001), and the angle of error was -1.08°±10.76° and 5.93°±46.98° (=0.809, =0.422) in the two groups, respectively. Open FSAK can achieve better astigmatism correction and less postoperative residual astigmatism than non-open FSAK in cataract surgery.
比较在白内障手术时，有手动开口和无手动开口的飞秒激光辅助散光角膜切开术（FSAK）矫正中低度角膜散光的效果。这是一项前瞻性队列研究。连续纳入2021年6月至2022年6月在陆军专科医疗中心接受白内障手术的患者。为矫正中低度散光，他们根据自身决定，将FSAK与手动切开或未切开角膜上皮相结合。术后3个月进行Pentacam HR角膜地形图检查。主要指标为目标诱导散光、手术诱导散光、差异向量、矫正指数和误差角。符合正态分布的连续变量采用独立样本t检验，不符合正态分布的采用Mann-Whitney U检验，分类变量采用卡方检验。共有51例患者（61只眼），其中27例患者（31只眼）接受了开放式FSAK联合手术，24例患者（30只眼）接受了非开放式角膜切开术。两组患者在年龄、性别和平均随访时间方面无统计学差异（P>0.05）。开放式角膜切开术患者的目标诱导散光为1.10（0.80，1.50）D，非开放式角膜切开术患者为1.30（0.98，1.73）D（t=1.729，P=0.084）。手术诱导散光分别为0.70（0.59，1.25）D和0.42（0.20，0.66）D（t=-3.571，P<0.001），差异向量分别为（0.51±0.31）D和（1.21±0.44）D（t=-7.238，P<0.001），矫正指数分别为0.78±0.32和0.38±0.25（t=5.386，P<0.001），两组的误差角分别为-1.08°±10.76°和5.93°±46.98°（t=0.809，P=0.422）。在白内障手术中，开放式FSAK比非开放式FSAK能实现更好的散光矫正，且术后残余散光更少。
