Beijing Aier Intech Eye Hospital, Panjiayuan Plaza, #12 Panjiayuan Nanli, Chaoyang District, Beijing, China.
Beijing Ophthalmology and Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
Graefes Arch Clin Exp Ophthalmol. 2024 Nov;262(11):3681-3692. doi: 10.1007/s00417-024-06547-1. Epub 2024 Jun 19.
To investigate the factors associated with and impact on the femtosecond-assisted (FS-assisted) limbal relaxing incision (LRI) combined with the steep-meridian tri-planar clear corneal incision (TCCI) to reduce astigmatism in patients undergoing Implantable Collamer Lens (ICL) surgery.
Retrospective case series. The study reviewed patients with ICL surgery combined with FS-assisted LRIs paired with steep-meridian TCCIs. Correlation analysis examined the relationship between independent variables, including preoperative characteristics (intraocular pressure, corneal thickness, axial length, et al.), TCCI, and LRI surgical parameters. The predictors of surgically induced astigmatism (SIA) were determined using individual-level analysis and accounting for inter-eye correlation with the generalized estimating equation (GEE).
The study enrolled 69 patients, with 114 eyes (55 right and 59 left). The mean spherical equivalent (SEQ) was - 10.29 ± 2.99D and - 9.99 ± 2.72D for the right and left eye, respectively, while the mean preoperative corneal astigmatism was - 1.54 ± 0.47D and - 1.54 ± 0.46D for the right and left eyes, respectively. After 12 months of follow-up, univariate analysis revealed significant correlations between SIA and intraocular pressure (IOP), astigmatism type, TCCI position (degree), peripheral corneal thickness (PCT), LRI arc incision diameter, post depth (%), and angle, respectively (P = 0.046, 0.016, 0.039, 0.040, 0.009, 0.000, 0.000). Multivariate analysis using GEE demonstrated that axial length (AL), astigmatism type, LRI arc diameter, and angle were independent predictors of SIA (P = 0.000, 0.005, 0.029, 0.000).
The type of astigmatism and axial length were independent factors that affected SIA when modifying the LRI arc diameter and angle through FS-assisted steep-meridian TCCI paired with LRI in ICL surgery.
探讨飞秒辅助（FS 辅助）角膜缘松解切口（LRI）联合陡峭子午线三平面透明角膜切口（TCCI）降低 ICL 手术患者散光的相关因素及影响。
回顾性病例系列研究。本研究回顾了 ICL 手术联合 FS 辅助 LRI 加陡峭子午线 TCCI 的患者。相关性分析检查了包括术前特征（眼压、角膜厚度、眼轴等）、TCCI 和 LRI 手术参数在内的独立变量之间的关系。使用个体水平分析和广义估计方程（GEE）考虑眼间相关性来确定手术诱导散光（SIA）的预测因子。
本研究共纳入 69 例患者，共 114 只眼（55 只右眼和 59 只左眼）。右眼平均等效球镜（SEQ）为-10.29±2.99D，左眼为-9.99±2.72D，右眼术前平均角膜散光为-1.54±0.47D，左眼为-1.54±0.46D。随访 12 个月后，单因素分析显示 SIA 与眼压（IOP）、散光类型、TCCI 位置（度）、周边角膜厚度（PCT）、LRI 弧形切口直径、后深度（%）和角度分别呈显著相关（P=0.046、0.016、0.039、0.040、0.009、0.000、0.000）。使用 GEE 的多变量分析表明，眼轴（AL）、散光类型、LRI 弧形直径和角度是 SIA 的独立预测因子（P=0.000、0.005、0.029、0.000）。
在 ICL 手术中，通过 FS 辅助陡峭子午线 TCCI 联合 LRI 来改变 LRI 弧形直径和角度时，散光类型和眼轴是影响 SIA 的独立因素。
