Zuo Qingyun, Zhang Yu, He Ming, Wang Siyi, Du ZhiYu
Department of Ophthalmology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
Medal Eye Institute, Chongqing, 400050, China.
Sci Rep. 2025 Jul 15;15(1):25442. doi: 10.1038/s41598-025-08868-5.
To evaluate the impact of ocular residual astigmatism (ORA) on the astigmatic correction outcomes of wavefront-guided femtosecond laser-assisted in situ keratomileusis (WFG FS-LASIK) in myopic astigmatism patients. Retrospective cohort study. This study analyzed 90 patients (177 eyes) undergoing WFG FS-LASIK at Chongqing Medal Eye Institute between January 2015 and May 2021, all with complete follow-up data spanning 15 days-6 months postoperatively. Participants were categorized into three groups based on the ratio of ORA to refractive astigmatism (RA), and the axial difference between ORA and anterior corneal astigmatism (ACA): Group1 (42 eyes): |ORA|/|RA| < 1 and the axial difference between ORA and ACA was ≦ 45°. Group 2 (86 eyes): |ORA|/|RA| < 1 and the axial difference between ORA and ACA was > 45°. Group3 (49 eyes): |ORA|/|RA| > 1 and the axial difference between ORA and ACA was > 45°. Uncorrected distance visual acuity (UDVA) at 6 months postoperatively was compared among the three groups. Alpins vector analysis was performed to compare the accuracy of astigmatic correction, quantified by: Angle of error (AE): axial deviation between the surgically induced astigmatism (SIA) and target induced astigmatism (TIA); Correction index (CI): ratio of SIA to TIA (ideal value = 1.0). The mean |AE| values significantly differed among groups (P < 0.05), being lowest in Group 1 (9.29°) and highest in Group 3 (26.64°). Correction index (CI) defined as the ratio of SIA to TIA. The mean CI values were1.00 (Group 1), 1.19 (Group 2) and 3.26 (Group 3).No statistically significant differences were observed in postoperative UDVA among the three groups (P > 0.05). In WGF FS-LASIK, the consistency between the axis of ORA and ACA affects the degree of deviation in astigmatic axis correction, but had no significant impact on UDVA.
评估眼部残余散光（ORA）对近视散光患者波前引导飞秒激光原位角膜磨镶术（WFG FS-LASIK）散光矫正效果的影响。回顾性队列研究。本研究分析了2015年1月至2021年5月期间在重庆爱尔眼科医院接受WFG FS-LASIK手术的90例患者（177只眼），所有患者均有术后15天至6个月的完整随访数据。根据ORA与屈光性散光（RA）的比值以及ORA与角膜前表面散光（ACA）的轴向差异，将参与者分为三组：第1组（42只眼）：|ORA|/|RA|<1且ORA与ACA的轴向差异≤45°。第2组（86只眼）：|ORA|/|RA|<1且ORA与ACA的轴向差异>45°。第3组（49只眼）：|ORA|/|RA|>1且ORA与ACA的轴向差异>45°。比较三组术后6个月的未矫正远视力（UDVA）。采用Alpins矢量分析比较散光矫正的准确性，量化指标为：误差角（AE）：手术诱导散光（SIA）与目标诱导散光（TIA）之间的轴向偏差；矫正指数（CI）：SIA与TIA的比值（理想值=1.0）。三组间平均|AE|值差异有统计学意义（P<0.05），第1组最低（9.29°），第3组最高（26.64°）。矫正指数（CI）定义为SIA与TIA的比值。第1组、第2组和第3组的平均CI值分别为1.00、1.19和3.26。三组术后UDVA差异无统计学意义（P>0.05）。在WGF FS-LASIK手术中，ORA与ACA轴的一致性影响散光轴矫正的偏差程度，但对UDVA无显著影响。
