Wan Ting, Chen Huaicheng, Wu Shirou, Jin Hongying
Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China.
Department of Ophthalmology, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China.
BMC Ophthalmol. 2024 Jun 12;24(1):252. doi: 10.1186/s12886-024-03501-x.
To comparatively analyze the surgically induced astigmatism (SIA) of the anterior, posterior, and total corneas of eyes undertaking implantable collamer lens (ICL) implantation with temporal or superior corneal incisions.
One hundred and nine eyes of 109 patients who received ICL implantation were recruited: 40 eyes had temporal incisions and 69 eyes had superior incisions. Total corneal refractive power (TCRP); simulated keratometry of the anterior (Sim-K) and posterior (Sim-K) corneal curvature; and astigmatism of the anterior (CA), posterior (CA), and total (CA) cornea were recorded through a Pentacam preoperatively and 3 months postoperatively. The SIA of the anterior, posterior, and total cornea were also compared between the two groups.
There were no significant intergroup differences for TCRP, Sim-K, Sim-K, CA, CA, or CA, preoperatively. However, values of CA, CA, and CA with temporal incision were significantly higher than those parameters with superior incision postoperatively. All of the SIA of the anterior, posterior, and total cornea were significantly lower for temporal incision than those with a superior incision (p < 0.001, p = 0.006 and p = 0.001 respectively). Meanwhile, the superior incisions created against-the-rule (ATR) astigmatism, and temporal incisions always induce with-the-rule (WTR) astigmatism in total cornea.
A superior incision may be suitable for correcting WTR astigmatism, while a temporal incision for correcting ATR astigmatism when using a non-toric ICL. Meanwhile, temporal incision could be a better choice with little preoperative astigmatism or that preoperative astigmatism would be corrected with toric ICLs.
Registration number: ChiCTR2100051739. Prospectively registered: 01 October 2021.
比较采用颞侧或上方角膜切口进行可植入式角膜接触镜（ICL）植入术的眼睛的前、后和全角膜手术诱导散光（SIA）。
招募了109例行ICL植入术患者的109只眼睛：40只眼睛采用颞侧切口，69只眼睛采用上方切口。术前及术后3个月通过Pentacam记录全角膜屈光力（TCRP）、前（Sim-K）和后（Sim-K）角膜曲率的模拟角膜曲率计测量值，以及前（CA）、后（CA）和全（CA）角膜的散光。还比较了两组之间前、后和全角膜的SIA。
术前，两组在TCRP、Sim-K、Sim-K、CA、CA或CA方面无显著组间差异。然而，术后颞侧切口的CA、CA和CA值显著高于上方切口的这些参数。颞侧切口的前、后和全角膜的所有SIA均显著低于上方切口（分别为p < 0.001、p = 0.006和p = 0.001）。同时，上方切口产生逆规（ATR）散光，而颞侧切口在全角膜中总是诱导顺规（WTR）散光。
使用非散光型ICL时，上方切口可能适合矫正WTR散光，而颞侧切口适合矫正ATR散光。同时，对于术前散光较小或术前散光将通过散光型ICL矫正的情况，颞侧切口可能是更好的选择。
注册号：ChiCTR2100051739。前瞻性注册：2021年10月1日。
