Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist, Taipei, 100008, Taiwan.
Sci Rep. 2024 Sep 27;14(1):22224. doi: 10.1038/s41598-024-73303-0.
To evaluate the efficiency, predictability, and residual astigmatism between first- and second-generation keratorefractive lenticule extraction (KLEx) surgeries in a prominent astigmatism population. A retrospective cohort study was conducted, and individuals who underwent first- and second-generation KLEx surgeries were enrolled. A total of 31 and 35 eyes were categorized into first and second KLEx groups, respectively. Visual acuity, refraction, topographic parameters, and surgical indices were recorded. Independent t tests were used to compare the postoperative uncorrected distance visual acuity (UDVA), spherical equivalent (SE), and residual astigmatism between the two groups. The difference in UDVA was not significant three months after KLEx surgery (P = 0.509), and the SEs three months after surgery also presented similar values between the two groups (P = 0.552). The first KLEx group demonstrated greater residual astigmatism than did the second KLEx group throughout the three-month follow-up period (all P < 0.05). The values of surgically induced astigmatism (SIA), difference vector (DV), magnitude of error (ME) and correction index (CoI) were significantly better in the second KLEx group via vector analysis (all P < 0.05). Old age, high steep keratometry (K), high topographic cylinder, large angle kappa, and a small optic zone were correlated with greater residual astigmatism in the first KLEx group (all P < 0.05), whereas only a small optic zone was significantly correlated with greater residual astigmatism in the second KLEx group (P = 0.047). The second-generation KLEx is correlated with a lower risk of residual astigmatism.
评估在高度散光人群中第一代和第二代准分子激光角膜微透镜切除术（KLEx）手术的效率、可预测性和残余散光。进行了一项回顾性队列研究，招募了接受第一代和第二代 KLEx 手术的患者。共将 31 只眼和 35 只眼分别归类为第一代和第二代 KLEx 组。记录了视力、屈光度、地形参数和手术指标。使用独立 t 检验比较两组术后未矫正远视力（UDVA）、球镜等效（SE）和残余散光。KLEx 手术后三个月，两组之间的 UDVA 差异无统计学意义（P=0.509），术后三个月 SE 也呈现出两组之间相似的值（P=0.552）。在整个三个月的随访期间，第一代 KLEx 组的残余散光大于第二代 KLEx 组（均 P<0.05）。通过向量分析，第二代 KLEx 组的手术诱导散光（SIA）、差异向量（DV）、误差幅度（ME）和校正指数（CoI）值显著更好（均 P<0.05）。在第一代 KLEx 组中，年龄较大、陡峭角膜曲率（K）较高、地形散光较高、大角度 κ 和小光区与残余散光较大相关（均 P<0.05），而在第二代 KLEx 组中，只有小光区与残余散光较大显著相关（P=0.047）。第二代 KLEx 与残余散光风险降低相关。
