Li Hao, He Wenwen, Guo Donglin, Fang Yanwen, Meng Jiaqi, Zhang Keke, Zhu Xiangjia, Lu Yi
Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.
NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China.
J Pers Med. 2023 Feb 24;13(3):401. doi: 10.3390/jpm13030401.
The outcomes of toric intraocular lens (IOL) implantation in correcting asymmetric bowtie corneal astigmatism remain uncertain. The accurate measurement of corneal astigmatism is essential for surgical planning. In this prospective cohort study, patients with asymmetric or symmetric bowtie corneal astigmatism who underwent toric IOL implantation were recruited. Preoperative corneal astigmatism was measured with an IOLMaster and Pentacam (including the simulated keratometry (SimK), total corneal refractive power (TCRP), and wavefront aberration (WFA) modes). At 3 months after surgery, the refractive outcomes and residual astigmatic refractive errors were compared with patients with symmetric bowtie astigmatism. The prediction errors (the differences between the calculated actual corneal astigmatism and the measured corneal astigmatism) were compared among the different measurement modes in the asymmetric group. There were no differences in residual astigmatism between the asymmetric and symmetric groups. However, the mean absolute residual astigmatic refractive error was greater in the asymmetric group than in the symmetric group (0.72 ± 0.42 D vs. 0.53 ± 0.24 D, = 0.043). In the asymmetric group, the mean absolute prediction errors for the IOLMaster, SimK, TCRP and WFA modes were 0.53 ± 0.40, 0.56 ± 0.47, 0.68 ± 0.52, and 0.43 ± 0.40 D, respectively. The Pentacam WFA mode was the most accurate mode ( < 0.05). The absolute prediction error of the WFA mode was positively correlated with the total corneal irregular astigmatism higher-order aberrations and coma (r = 0.416 and r = 0.473, respectively; both < 0.05). Our study suggests toric IOL implantation effectively corrected asymmetric bowtie corneal astigmatism. The Pentacam WFA mode may be the most accurate measurement mode, although its accuracy decreased as asymmetry increased.
矫正不对称领结形角膜散光的环曲面人工晶状体（IOL）植入效果仍不确定。准确测量角膜散光对于手术规划至关重要。在这项前瞻性队列研究中，招募了接受环曲面IOL植入的不对称或对称领结形角膜散光患者。术前使用IOLMaster和Pentacam测量角膜散光（包括模拟角膜曲率计（SimK）、总角膜屈光力（TCRP）和波前像差（WFA）模式）。术后3个月，将屈光结果和残余散光屈光误差与对称领结形散光患者进行比较。在不对称组中，比较不同测量模式之间的预测误差（计算的实际角膜散光与测量的角膜散光之间的差异）。不对称组和对称组之间的残余散光无差异。然而，不对称组的平均绝对残余散光屈光误差大于对称组（0.72±0.42 D对0.53±0.24 D，P = 0.043）。在不对称组中，IOLMaster、SimK、TCRP和WFA模式的平均绝对预测误差分别为0.53±0.40、0.56±0.47、0.68±0.52和0.43±0.40 D。Pentacam WFA模式是最准确的模式（P<0.05）。WFA模式的绝对预测误差与总角膜不规则散光高阶像差和彗差呈正相关（分别为r = 0.416和r = 0.473；均P<0.05）。我们的研究表明，环曲面IOL植入有效地矫正了不对称领结形角膜散光。Pentacam WFA模式可能是最准确的测量模式，但随着不对称性增加其准确性降低。
