Tutchenko Larysa, Patel Sudi, Skovron Mykhailo, Voytsekhivskyy Oleksiy V, Gilevska Fanka
Department of Corneal Pathology, Ophthalmic Oncology and Oculoplasty, Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center, Kyiv, 03680, Ukraine.
Department of Cataract and Refractive Surgery, University Eye Clinic Svjetlost, Zagreb, 10000, Croatia.
Clin Ophthalmol. 2024 Dec 13;18:3739-3752. doi: 10.2147/OPTH.S492253. eCollection 2024.
To explore the significance of changes in anterior chamber depth (ΔACD) and astigmatism between 4 and 8 weeks following uneventful phacoemulsification.
Anterior chamber depth (ACD, mm), autorefractometry and subjective refraction were monitored in pseudophakic eyes implanted with non-toric IOLs (group 1, SA60AT, n=36; group 2, SN60WF, n=34; group 3, ICBOO, n=16) and phakic control group (n=30, group 4a, for ACD and autorefractometry) over four weeks. Changes in subjective refractions were compared with repeatability in normal phakic eyes (n=30, group 4b).
Reporting key results (p<0.01), mean (±sd 95% CI) ΔACD values (ACD at start minus ACD at four weeks) were +0.02 (±0.37, -0.16 to 0.08), +0.22 (±0.51,0.05 to 0.39), -0.33 (±0.51, -0.58 to -0.08), -0.02 (±0.07, -0.04 to 0.01) in groups 1-4a respectively. Differences were significant (1-way ANOVA, F=7.02). Pooling data from the pseudophakic eyes (n=86) induced astigmatism (IA) by autorefractometry was significantly greater in comparison with group 4a [-0.78D (±0.67, -0.92 to -0.64) and -0.19D (±0.16, -0.25 to - 0.13)]. IA power correlated with the initial power of refractive astigmatism at 4 weeks (A), [IA = 0.36A-0.30 (r=0.207) and IA = 0.39A-0.29 (r=0.232) by autorefractometry and subjective refraction, respectively]. In groups 1-3, vector analysis revealed i) the change in refraction in over 55% of eyes was beyond the 95% confidence interval limits observed in groups 4a and 4b, ii) some significant associations between changes in vectors describing astigmatism with ΔACD and IOL labelled power.
Changes in ACD and refraction still occur four weeks after unremarkable phacoemulsification and the inter-relationship depends on IOL design/type. Other factors, such as tilt or dislocation of the IOL along the X-Y axes parallel to Listing's plane, accompanying changes in ACD are expected to affect the postop astigmatism.
探讨在顺利完成白内障超声乳化吸除术后4至8周期间前房深度（ΔACD）变化及散光的意义。
对植入非散光型人工晶状体的假晶状体眼（第1组，SA60AT，n = 36；第2组，SN60WF，n = 34；第3组，ICBOO，n = 16）以及晶状体眼对照组（n = 30，第4a组，用于前房深度和自动验光）进行为期四周的前房深度（ACD，毫米）、自动验光及主观验光监测。将主观验光的变化与正常晶状体眼（n = 30，第4b组）的重复性进行比较。
报告主要结果（p<0.01），第1 - 4a组的平均（±标准差95%置信区间）ΔACD值（起始时ACD减去4周时ACD）分别为+0.02（±0.37，-0.16至0.08）、+0.22（±0.51，0.05至0.39）、-0.33（±0.51，-0.58至-0.08）、-0.02（±0.07，-0.04至0.01）。差异具有显著性（单因素方差分析，F = 7.02）。汇总假晶状体眼（n = 86）的数据后，自动验光得出的诱导散光（IA）与第4a组相比显著更大[-0.78D（±0.67，-0.92至-0.64）和-0.19D（±0.16，-0.25至-0.13）]。IA度数与4周时屈光性散光的初始度数相关（A），[通过自动验光和主观验光分别得出IA = 0.36A - 0.30（r = 0.207）和IA = 0.39A - 0.29（r = 0.232）]。在第1 - 3组中，矢量分析显示：i）超过55%的眼睛的屈光变化超出了第4a组和第4b组观察到的95%置信区间范围；ii）描述散光变化的矢量与ΔACD和人工晶状体标记度数之间存在一些显著关联。
在顺利完成白内障超声乳化吸除术后四周，ACD和屈光仍会发生变化，且相互关系取决于人工晶状体的设计/类型。其他因素，如人工晶状体沿平行于Listing平面的X - Y轴倾斜或脱位，伴随ACD的变化预计会影响术后散光。
