标准化巩膜缘切口的微切口白内障手术后手术源性散光的特点。
Characteristics of surgically induced astigmatism after standardized microincisional cataract surgery with a superior limbal incision.
机构信息
From the Department of Ophthalmology and Optometry, Kepler University Hospital GmbH, Linz, Austria (Wendelstein, Casazza, Fischinger, Fuchs, Bolz); Johannes Kepler University Linz, Medical Faculty, Linz, Austria (Wendelstein, Casazza, Fischinger, Fuchs, Bolz); Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany (Wendelstein, Langenbucher); Dean McGee Eye Institute, University of Oklahoma, Oklahoma City, Oklahoma (Riaz); Department of Ophthalmology, Augentagesklinik Spreebogen Berlin, Berlin, Germany (Fischinger); Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zurich, Switzerland (Wendelstein, Seiler); Klinik für Augenheilkunde, Universitätsklinikum Düsseldorf, Duesseldorf, Germany (Seiler); Universitätsklinik für Augenheilkunde, Inselspital Bern, Bern, Switzerland (Seiler); Department of Ophthalmology, Goethe University, Frankfurt, Germany (Kohnen).
出版信息
J Cataract Refract Surg. 2023 Oct 1;49(10):1025-1035. doi: 10.1097/j.jcrs.0000000000001271.
PURPOSE
To determine (1) if measurements of surgically induced astigmatism (SIA) as measured by keratometry (K) and total keratometry (TK) differ (2) if SIA affects the magnitude and/or meridian of keratometric astigmatism (3) if SIA evolves over time.
SETTING
Tertiary care center.
DESIGN
Retrospective data analysis.
METHODS
A swept-source optical coherence tomography biometry dataset (IOLMaster700) consisting of 498 eyes (327 patients) from a tertiary care center was analyzed. For all eyes preoperative and postoperative biometric measurements at 1-month, 3-month, and 6-months postoperative visits were considered for vector analysis of SIA K and SIA TK .
RESULTS
Centroids in right and left eyes were 0.26 diopters (D) @5 degrees/0.31 D @1 degree for SIA K and 0.27 D @4 degrees/0.34 D @1 degree for SIA TK . Centroids for difference vectors K-TK in right and left eyes were 0.02 D @ 176 degrees/0.03 D @6 degrees. The mean SIA magnitudes in right and left eyes were 0.48 ± 0.41 D and 0.50 ± 0.37 D for SIA K and 0.53 ± 0.42 D and 0.54 ± 0.40 D for SIA TK . In eyes with ATR astigmatism, an increase in postoperative astigmatism magnitude was more common than a decrease. More than 30% of eyes showed changes in the meridian of more than 15 degrees.
CONCLUSIONS
Overall, we observed differences in K- and TK-derived SIA, and changes in SIA magnitude over time. For postsurgical interventions, postoperative astigmatism meridian values should be measured to base treatments. Astigmatism magnitude showed a tendency to decrease for steep-meridian incisions and to increase in flat-meridian incisions.
目的
确定（1）通过角膜曲率计（K）和总角膜曲率计（TK）测量的手术诱导散光（SIA）是否存在差异，（2）SIA 是否影响角膜散光的大小和/或子午线，（3）SIA 是否随时间演变。
背景
三级护理中心。
设计
回顾性数据分析。
方法
对来自三级护理中心的 498 只眼（327 例患者）的扫频源光相干断层生物测量数据集（IOLMaster700）进行了分析。对于所有眼，考虑术前和术后 1 个月、3 个月和 6 个月的生物测量值，以进行 SIA K 和 SIA TK 的向量分析。
结果
右眼和左眼的质心分别为 0.26 屈光度（D）@5 度/0.31 D@1 度，SIA K 为 0.27 D@4 度/0.34 D@1 度，右眼和左眼的差异向量 K-TK 质心分别为 0.02 D@176 度/0.03 D@6 度。右眼和左眼 SIA 幅度的平均值分别为 0.48±0.41 D 和 0.50±0.37 D，SIA K 为 0.53±0.42 D 和 0.54±0.40 D，SIA TK 为 0.53±0.42 D 和 0.54±0.40 D。在ATR 散光眼中，术后散光幅度增加比减少更常见。超过 30%的眼在子午线方向上的变化超过 15 度。
结论
总的来说，我们观察到了 K 和 TK 衍生的 SIA 之间的差异，以及随时间推移 SIA 幅度的变化。对于术后干预，应测量术后散光子午线值以确定治疗方案。散光幅度在陡峭子午线切口处有减小的趋势，在平坦子午线切口处有增大的趋势。
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