1
|
Yen WT, Weng TH, Lin TY, Tai MC, Chen YH, Chang YM. Femtosecond laser-assisted astigmatic keratotomy versus toric IOL implantation for correcting astigmatism in cataract patients: a systematic review and meta-analysis with trial sequential analysis. Br J Ophthalmol 2024:bjo-2024-325195. [PMID: 38575199 DOI: 10.1136/bjo-2024-325195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/17/2024] [Indexed: 04/06/2024]
Abstract
AIMS To compare the refractive and visual outcomes of femtosecond laser-assisted astigmatic keratotomy (FSAK) and toric intraocular lens (IOL) implantation for correcting astigmatism in cataract patients. METHODS Studies were retrieved from the Ovid-Medline, EMBASE, Cochrane Central Register of Controlled Trials and Scopus which compared FSAK and toric IOL for astigmatism correction in cataract patients. Outcome measures included postoperative refractive cylinder, correction index, uncorrected distance visual acuity (UDVA), the proportion of patients achieving a residual refractive cylinder of 1.00 dioptre or less, target-induced astigmatism (TIA) and surgically induced astigmatism (SIA). The trial sequential analysis (TSA) was used to collect firm evidence supporting our conclusion. RESULTS 9 studies encompassing 590 participants were analysed. The meta-analysis revealed that toric IOLs could result in less postoperative refractive cylinder and provide better UDVA compared with FSAK. The TSA disclosed strong evidence of lower postoperative refractive cylinder in the toric IOL group compared with that of the FSAK group. FSAK showed a smaller correction index and lower mean TIA and SIA compared with toric IOLs. CONCLUSIONS For cataract patients, both FSAK and toric IOLs are effective methods for correcting astigmatism. However, toric IOLs offer less postoperative astigmatism and result in better postoperative UDVA compared with FSAK. In vector analysis of astigmatism, toric IOLs can also produce higher TIA and SIA. Additionally, neither method is associated with severe untreatable complications. Therefore, the conclusion is that toric IOLs are the preferred choice for astigmatism correction in cataract patients and FSAK serves as a viable alternative when toric IOLs are contraindicated.
Collapse
Affiliation(s)
- Wei-Ting Yen
- Department of Ophthalmology, Tri-Service General Hospital, Taipei City, Taiwan
- National Defense Medical Center, Taipei City, Taiwan
| | - Tzu-Heng Weng
- Department of Ophthalmology, Tri-Service General Hospital, Taipei City, Taiwan
- National Defense Medical Center, Taipei City, Taiwan
| | - Ting-Yi Lin
- Department of Ophthalmology, Tri-Service General Hospital, Taipei City, Taiwan
- National Defense Medical Center, Taipei City, Taiwan
| | - Ming-Cheng Tai
- Department of Ophthalmology, Tri-Service General Hospital, Taipei City, Taiwan
- National Defense Medical Center, Taipei City, Taiwan
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, Taipei City, Taiwan
- National Defense Medical Center, Taipei City, Taiwan
| | - Yu-Min Chang
- Department of Ophthalmology, Tri-Service General Hospital, Taipei City, Taiwan
- National Defense Medical Center, Taipei City, Taiwan
| |
Collapse
|
2
|
Lin X, Ma D, Yang J. Insights into the rotational stability of toric intraocular lens implantation: diagnostic approaches, influencing factors and intervention strategies. Front Med (Lausanne) 2024; 11:1349496. [PMID: 38414624 PMCID: PMC10896894 DOI: 10.3389/fmed.2024.1349496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/30/2024] [Indexed: 02/29/2024] Open
Abstract
Toric intraocular lenses (IOLs) have been developed to enhance visual acuity impaired by cataracts and correct corneal astigmatism. However, residual astigmatism caused by postoperative rotation of the toric IOL is an important factor affecting visual quality after implantation. To decrease the rotation of the toric IOL, significant advancements have been made in understanding the characteristics of toric IOL rotation, the factors influencing its postoperative rotation, as well as the development of various measurement techniques and interventions to address this issue. It has been established that factors such as the patient's preoperative refractive status, biological parameters, surgical techniques, postoperative care, and long-term management significantly impact the rotational stability of the toric IOL. Clinicians should adopt a personalized approach that considers these factors to minimize the risk of toric IOL rotation and ensure optimal outcomes for each patient. This article reviews the influence of various factors on toric IOL rotational stability. It discusses new challenges that may be encountered to reduce and intervene with rotation after toric IOL implantation in the foreseeable future.
Collapse
Affiliation(s)
- Xuanqiao Lin
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Fudan University, and Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Dongmei Ma
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Fudan University, and Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jin Yang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- Key NHC Laboratory of Myopia, Fudan University, and Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| |
Collapse
|
3
|
Shen J, Hua Z, Zhang L, Zhuo B, Shen W, Chen X, Guo H, Yang J. Comparison of astigmatism correction and visual outcomes in mix-and-match implantations of trifocal intraocular lenses with femtosecond laser-assisted arcuate keratotomy and contralateral bifocal Toric intraocular lenses. Front Med (Lausanne) 2023; 10:1237319. [PMID: 37601779 PMCID: PMC10436569 DOI: 10.3389/fmed.2023.1237319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Astigmatism reduces the postoperative visual performance after non-toric intraocular lenses (IOLs) implantation, and limits the use of refractive IOLs in cataract surgery. The purpose of this study was to compare the efficacy in astigmatism correction and the postoperative visual outcomes between the implantation of a trifocal IOL with femtosecond laser-assisted arcuate keratotomy (FSAK) in one eye and a bifocal toric IOL (TIOL) in the other, in patients with cataract and moderate astigmatism. Methods This prospective observational paired-eye study enrolled patients with cataract and corneal astigmatism (CA) between 0.75 and 2.25 D in both eyes. The patients underwent a mix-and-match treatment comprising trifocal IOL implantation with FSAK and bifocal TIOL implantation. We compared the visual acuity (VA) at all distances, defocus curve, postoperative refractive astigmatism (RfA), CA, high-order aberrations, modulation transfer function (MTF) curve, and Strehl ratio between the two eye groups. Results In total, 41 patients (82 eyes) were enrolled and completed a 6-month follow-up. The 1- and 3-month uncorrected distance VA and 3-month uncorrected near VA were greater in eyes with bifocal TIOLs than with trifocal IOLs and FSAK (p = 0.036, 0.010, and 0.030, respectively), whereas the latter had greater uncorrected intermediate VA at every visit and greater VA in the intermediate range of defocus curve (at -1.50 and - 2.00 D) than the eyes with bifocal TIOLs. The postoperative RA of the eyes with trifocal IOL and FSAK was significantly higher than that of the bifocal TIOL-implanted eyes at the 3- and 6-month follow-ups. Discussion Both FSAK and TIOL implantation effectively reduce pre-existing moderate astigmatism in patients with cataract. The eyes with bifocal TIOLs had more stable long-term astigmatism correction, whereas those with trifocal IOLs and FSAK had better intermediate VA. Therefore, a mix-and-match implantation of trifocal IOL with FSAK and contralateral bifocal TIOL could achieve effective astigmatism correction and provide an overall optimal VA.
Collapse
Affiliation(s)
- Jiying Shen
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Zhixiang Hua
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Ministry of Health, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Limei Zhang
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Baoxian Zhuo
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Ministry of Health, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Wenqian Shen
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Ministry of Health, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xuanzhu Chen
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Haike Guo
- Department of Ophthalmology, Shanghai Heping Eye Hospital, Shanghai, China
| | - Jin Yang
- Department of Ophthalmology and the Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Ministry of Health, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- Key National Health Committee of the Key Laboratory of Myopia, Fudan University, Shanghai, China
- The Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| |
Collapse
|
4
|
Almorín-Fernández-Vigo I, Sánchez-Guillén I, Fernández-Vigo JI, Burgos-Blasco B, De-Pablo-Gómez-de-Liaño L, Fernández-Vigo JÁ, Macarro-Merino A. Normative Topographic Anterior and Posterior Corneal Astigmatism: Axis Distribution and Its Relations with Ocular and Biometric Parameters. J Clin Med 2023; 12:jcm12113664. [PMID: 37297859 DOI: 10.3390/jcm12113664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Corneal astigmatism correction is a key factor when planning refractive treatment for ametropies with intraocular lenses. We aim to obtain normative anterior and posterior corneal astigmatism (ACA and PCA, respectively) data in a local population and to describe their axis distribution and their association with other parameters. A total of 795 patients with no ocular diseases were evaluated with corneal tomography and optical biometry. Only data of the right eye were included. Mean ACA and PCA were 1.01 ± 0.79 and 0.34 ± 0.17 D, respectively. Vertical steep axis distribution was 73.5% for ACA and 93.3% for PCA. Axis orientation between ACA and PCA matched best for vertical orientation (especially 90° to 120°). Vertical ACA orientation frequency decreased with age, with a more positive sphere and less ACA. Vertical PCA orientation frequency increased with higher PCA. Eyes with vertical ACA orientation were younger and showed a greater white-to-white (WTW) measurement, anterior corneal elevations, ACA and PCA. Eyes with vertical PCA orientation were younger and showed greater anterior corneal elevations and PCA. Normative ACA and PCA data in a Spanish population were presented. Steep axis orientations presented differences with age, WTW, anterior corneal elevations and astigmatism.
Collapse
Affiliation(s)
| | - Inés Sánchez-Guillén
- Centro Internacional de Oftalmología Avanzada, 06010 Badajoz, Spain
- Department of Ophthalmology, Hospital Perpetuo Socorro, 06010 Badajoz, Spain
| | - José Ignacio Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
- Department of Ophthalmology, Hospital Clínico San Carlos, 28040 Madrid, Spain
| | | | | | - José Ángel Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, 06010 Badajoz, Spain
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
- School of Medicine, Universidad de Extremadura, 06006 Badajoz, Spain
| | | |
Collapse
|
5
|
Zhang Z, Cheng N, Liu Y, Song J, Liu X, Zhang S, Zhang G. Prediction of corneal astigmatism based on corneal tomography after femtosecond laser arcuate keratotomy using a pix2pix conditional generative adversarial network. Front Public Health 2022; 10:1012929. [PMID: 36187623 PMCID: PMC9523441 DOI: 10.3389/fpubh.2022.1012929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 08/29/2022] [Indexed: 01/27/2023] Open
Abstract
Purpose This study aimed to develop a deep learning model to generate a postoperative corneal axial curvature map of femtosecond laser arcuate keratotomy (FLAK) based on corneal tomography using a pix2pix conditional generative adversarial network (pix2pix cGAN) for surgical planning. Methods A total of 451 eyes of 318 nonconsecutive patients were subjected to FLAK for corneal astigmatism correction during cataract surgery. Paired or single anterior penetrating FLAKs were performed at an 8.0-mm optical zone with a depth of 90% using a femtosecond laser (LenSx laser, Alcon Laboratories, Inc.). Corneal tomography images were acquired from Oculus Pentacam HR (Optikgeräte GmbH, Wetzlar, Germany) before and 3 months after the surgery. The raw data required for analysis consisted of the anterior corneal curvature for a range of ± 3.5 mm around the corneal apex in 0.1-mm steps, which the pseudo-color corneal curvature map synthesized was based on. The deep learning model used was a pix2pix conditional generative adversarial network. The prediction accuracy of synthetic postoperative corneal astigmatism in zones of different diameters centered on the corneal apex was assessed using vector analysis. The synthetic postoperative corneal axial curvature maps were compared with the real postoperative corneal axial curvature maps using the structural similarity index measure (SSIM) and peak signal-to-noise ratio (PSNR). Results A total of 386 pairs of preoperative and postoperative corneal tomography data were included in the training set, whereas 65 preoperative data were retrospectively included in the test set. The correlation coefficient between synthetic and real postoperative astigmatism (difference vector) in the 3-mm zone was 0.89, and that between surgically induced astigmatism (SIA) was 0.93. The mean absolute errors of SIA for real and synthetic postoperative corneal axial curvature maps in the 1-, 3-, and 5-mm zone were 0.20 ± 0.25, 0.12 ± 0.17, and 0.09 ± 0.13 diopters, respectively. The average SSIM and PSNR of the 3-mm zone were 0.86 ± 0.04 and 18.24 ± 5.78, respectively. Conclusion Our results showed that the application of pix2pix cGAN can synthesize plausible postoperative corneal tomography for FLAK, showing the possibility of using GAN to predict corneal tomography, with the potential of applying artificial intelligence to construct surgical planning models.
Collapse
Affiliation(s)
- Zhe Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China,Department of Cataract, Shanxi Eye Hospital, Taiyuan, China,First Hospital of Shanxi Medical University, Taiyuan, China
| | - Nan Cheng
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
| | - Yunfang Liu
- Department of Ophthalmology, First Affiliated Hospital of Huzhou University, Huzhou, China
| | - Junyang Song
- Department of Ophthalmology, First Affiliated Hospital of Huzhou University, Huzhou, China,*Correspondence: Junyang Song
| | - Xinhua Liu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Suhua Zhang
- Department of Cataract, Shanxi Eye Hospital, Taiyuan, China,Taiyuan Central Hospital of Shanxi Medical University, Taiyuan, China,Suhua Zhang
| | - Guanghua Zhang
- Department of Intelligence and Automation, Taiyuan University, Taiyuan, China,Graphics and Imaging Laboratory, University of Girona, Girona, Spain,Guanghua Zhang
| |
Collapse
|
6
|
Chang YH, Pu C, Lin KK, Lee JS, Hou CH. Prediction of residual astigmatism in cataract surgery at different diameter zones using optical biometry measurement. Sci Rep 2022; 12:4305. [PMID: 35277574 PMCID: PMC8917119 DOI: 10.1038/s41598-022-08253-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 03/04/2022] [Indexed: 11/18/2022] Open
Abstract
The studies for astigmatism prediction error at different diameters using optical biometry are scant. We investigated patients who underwent cataract surgery with monofocal, nontoric intraocular lens (IOL) from 2017 through 2019 in a medical center. Patients with prior refractive surgeries, corneal opacity, or surgical complications were excluded. Corneal astigmatism (CA) was measured using AL-Scan at 2.4- and 3.3-mm diameter zones and calculated using the Barrett toric calculator preoperatively and postoperatively. The mean absolute error and centroid prediction error for the two zones were computed using double-angle plots. In total, 101 eyes of 76 patients were analyzed. Mean patient age was 68.7 ± 9.3 years and mean preoperative CA power was 0.7 ± 0.5 D. The overall centroid prediction error a 3.3 mm (0.09 ± 0.58 D@25) was significantly lower than that at 2.4 mm (0.09 ± 0.68 D@87) on the X-axis (P = 0.003). The 3.3-mm measurement also had a lower centroid prediction error than the 2.4-mm did for eyes with against-the-rule (ATR) and oblique astigmatism (P = 0.024; 0.002 on X-axis, respectively). The 3.3-mm measurement provided a more accurate CA estimation than the 2.4-mm did, particularly for ATR astigmatism. Diameter zone and astigmatism type should be considered crucial to precise astigmatism calculation.
Collapse
Affiliation(s)
- Yin-Hsi Chang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing Street, Guishan District, Taoyuan, 33305, Taiwan, ROC.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Christy Pu
- Institute of Public Health, School of Medicine, National Yang Ming University, Taipei, Taiwan
| | - Ken-Kuo Lin
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing Street, Guishan District, Taoyuan, 33305, Taiwan, ROC.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jiahn-Shing Lee
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing Street, Guishan District, Taoyuan, 33305, Taiwan, ROC.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chiun-Ho Hou
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fuxing Street, Guishan District, Taoyuan, 33305, Taiwan, ROC. .,Institute of Public Health, School of Medicine, National Yang Ming University, Taipei, Taiwan. .,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
| |
Collapse
|
7
|
Kwon HJ, Lee H, Lee JA, Kim JY, Tchah H. Astigmatic correction of simultaneous femtosecond laser-assisted cataract surgery (FLACS) with intrastromal arcuate keratotomy (ISAK) versus Toric intraocular Lens Impantation with conventional phacoemulsification. BMC Ophthalmol 2021; 21:298. [PMID: 34391403 PMCID: PMC8364067 DOI: 10.1186/s12886-021-02059-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background To compare the efficacies in astigmatic correction of simultaneous femtosecond laser-assisted cataract surgery (FLACS) with intrastromal arcuate keratotomy (ISAK) versus toric intraocular lens (IOL) implantation with conventional phacoemulsification in moderate astigmatism. Methods A retrospective chart review was conducted for patients who had undergone cataract surgery by one surgeon. We identified patients with preoperative corneal astigmatism from + 0.75 to + 2.00 diopters (D) who had undergone astigmatic correction with FLACS with ISAK or toric IOL implantation with conventional phacoemulsification. We measured the visual acuity, intraocular pressure, automated keratometer, manifest refraction, and topography preoperatively and 1-day, 1-month, 3-month, and 6-month postoperatively. The vector analysis of refractive astigmatism was performed. Results Of a total of 48 eyes of 48 patients, 27 eyes of 27 patients had FLACS with ISAK (AK group), and 21 eyes of 21 patients had conventional cataract surgery with toric IOL implantation (toric IOL group). Refractive astigmatism was significantly decreased in both groups. The mean preoperative and 6-month postoperative refractive astigmatism were 1.85 ± 1.07 and 0.99 ± 0.51 D, respectively, in the AK group (P = 0.028), and 1.84 ± 0.81 and 0.68 ± 0.21 D, respectively, in the toric IOL group (P < 0.001). There was no significant difference in refractive astigmatism between the two groups at 6-month postoperatively (0.99 ± 0.51 vs 0.68 ± 0.21 D, P = 0.057). At 6-month postoperatively, parameters for vector analysis of refractive astigmatism showed no statistical difference between the two groups. Corneal astigmatism was significantly decreased in the AK group. Corneal astigmatism from topography and the automated keratometer were significantly lower in the AK group 6-month postoperatively compared to toric IOL group (0.94 ± 0.40 vs. 1.53 ± 0.46 D, P = 0.018 for topography; and 0.98 ± 0.69 vs. 1.37 ± 0.41 D, P = 0.032 for the automated keratometer). Conclusions FLACS with ISAK could be an effective procedure for reducing astigmatism as well as toric IOL implantation in cataract surgery.
Collapse
Affiliation(s)
- Hye Ji Kwon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Jin Ah Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Jae Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea
| | - Hungwon Tchah
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, South Korea.
| |
Collapse
|
8
|
Shajari M, Kolb CM, Mayer WJ, Agha B, Steinwender G, Dirisamer M, Priglinger S, Kohnen T, Schmack I. Characteristics of preoperative and postoperative astigmatism in patients having Descemet membrane endothelial keratoplasty. J Cataract Refract Surg 2020; 45:1001-1006. [PMID: 31262462 DOI: 10.1016/j.jcrs.2019.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 01/07/2019] [Accepted: 02/01/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate the characteristics of preoperative and postoperative astigmatism in patients having Descemet membrane endothelial keratoplasty (DMEK). SETTING Department of Ophthalmology, Goethe University, Frankfurt, Germany. DESIGN Retrospective case series. METHODS Measurements were obtained using a Scheimpflug camera (Pentacam AXL) preoperatively and 3 months and 12 months postoperatively. Values of front and back astigmatism and total astigmatism in the central 4.0 mm diameter zone (TCA4) were analyzed. RESULTS Fifty-three eyes of 45 patients were included. The prevalence of TCA4 above 1.0 diopter (D) was considerably higher (79%) and with-the-rule astigmatism was less frequent in this cohort of European patients with Fuchs endothelial dystrophy (mean age 65 years) than that reported in a meta-analysis of healthy European eyes. The TCA4 values correlated with anterior astigmatism preoperatively and postoperatively (P < .001) and with posterior astigmatism at the 1-year follow-up (P < .01). Although, no correlation was found between the preoperative and 1-year results for anterior astigmatism (P = .12), posterior astigmatism (P = .35), or total corneal astigmatism (P = .47), the difference in vector analysis between the two measurements was only 0.01 at 109 degrees, 0.03 at 98 degrees, and 0.02 at 157 degrees, respectively. However, the greater the difference between the preoperative TCA3 and preoperative TCA5 values, the greater the decrease in corneal astigmatism (P < .001). CONCLUSIONS The percentage of eyes with corneal astigmatism above 1.0 D was higher preoperatively and postoperatively in patients with Fuchs endothelial dystrophy than in a healthy population. Predicting postoperative astigmatism based on preoperative results is not possible; however, in eyes with a high difference between TCA3 and TCA5, a reduction in corneal astigmatism after DMEK is likely.
Collapse
Affiliation(s)
- Mehdi Shajari
- Department of Ophthalmology, Goethe-University, Frankfurt, Germany; Department of Ophthalmology, LM-University, Munich, Germany
| | - Carolin M Kolb
- Department of Ophthalmology, Goethe-University, Frankfurt, Germany
| | | | - Bishr Agha
- Department of Ophthalmology, Goethe-University, Frankfurt, Germany
| | | | | | | | - Thomas Kohnen
- Department of Ophthalmology, Goethe-University, Frankfurt, Germany.
| | - Ingo Schmack
- Department of Ophthalmology, Goethe-University, Frankfurt, Germany
| |
Collapse
|
9
|
Management of Cataract in Patients with Irregular Astigmatism with Regular Central Component by Phacoemulsification Combined with Toric Intraocular Lens Implantation. J Ophthalmol 2020; 2020:3520856. [PMID: 32411427 PMCID: PMC7210554 DOI: 10.1155/2020/3520856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/23/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose To evaluate visual acuity (VA) and refractive status in patients with cataract and irregular astigmatism with a regular central component after phacoemulsification with implantation of a toric intraocular lens (IOL). Methods Patients with cataract associated with irregular astigmatism with a regular central component were enrolled. All patients underwent phacoemulsification and toric IOL implantation. Postoperative visual acuity, residual astigmatism, toric IOL rotation, higher-order aberration, and objective and subjective visual quality were measured 3 months after surgery. Results Twenty-three eyes were included in the study. The logMAR corrected and uncorrected distance visual acuity values were decreased at 3 months postoperatively (p < 0.005). The preoperative average corneal astigmatism and postoperative residual astigmatism were 1.15–6.97 D (1.99 ± 1.26 D) and 0–2.75 D (0.65 ± 0.57 D), respectively. The average IOL rotation was 3.17 ± 2.01°. Some objective indicators of visual quality, including the modulation transfer function (p < 0.05), Strehl ratio (p < 0.005), 100% VA (p < 0.005), 20% VA (p < 0.005), and 9% VA (p < 0.005), were significantly higher than the corresponding preoperative values. The objective scatter index (p < 0.005) was significantly lower than that before surgery. The postoperative VF-14 scale score was 83.99 ± 14.58. Conclusion Toric IOL implantation has a good corrective effect on certain specific types of corneal irregular astigmatism with cataract. This effect can be attributed to its ability to correct the regular component of irregular astigmatism. The indications for toric IOL implantation could be expanded to some extent, thereby bringing benefit to more patients.
Collapse
|
10
|
Nabil KM. Cylinder Axis Agreement: Unexpected Scenarios. Clin Ophthalmol 2020; 14:977-984. [PMID: 32280192 PMCID: PMC7127776 DOI: 10.2147/opth.s237757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/04/2020] [Indexed: 11/23/2022] Open
Abstract
Background The purpose of this retrospective study was to evaluate cylinder axis agreement between manifest refraction (MR), cycloplegic refraction (CR), Allegro Oculyzer ІІ and Allegro Topolyzer-Vario. Methods We included 82 patients (32 males and 50 females, 28.1 ± 8.7 years old), with 156 eyes scheduled for wavefront optimized laser refractive surgery, photorefractive keratectomy (PRK) in 50 eyes and laser-assisted in situ keratomileusis (LASIK) in 106 eyes, for correction of simple, myopic, hyperopic or mixed astigmatism. Cylinder axis was determined under manifest and cycloplegic refractions and using Allegro Occulyzer ІІ and Allegro Topolyzer-Vario platforms. Cylinder axis agreement was assessed by intraclass correlation coefficient, Pearson correlation coefficient and by the method described by Bland and Altman. Results Intraclass correlation coefficient and Pearson correlation coefficient showed statistically significant cylinder axis agreement between manifest refraction, cycloplegic refraction, Allegro Oculyzer ІІ and Allegro Topolyzer-Vario (p <0.001). Despite statistically significant cylinder axis agreement between the four measuring tools, 4 of 156 eyes (2.5%) showed unexpected discrepancy between Allegro Oculyzer ІІ and Allegro Topolyzer-Vario cylinder axis. Conclusion Although cylinder axis shows statistically significant agreement between manifest refraction, cycloplegic refraction, Allegro Oculyzer ІІ and Allegro Topolyzer-Vario, unexpected discrepancies occur.
Collapse
Affiliation(s)
- Karim Mahmoud Nabil
- Department of Ophthalmology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| |
Collapse
|
11
|
Kern C, El Kaissi L, Kortuem K, Shajari M, Vounotrypidis E, Langenbucher A, Priglinger S, Mayer WJ. Comparing refractive outcomes of a standard industry toric IOL calculator using anterior corneal astigmatism and total corneal refractive power. Graefes Arch Clin Exp Ophthalmol 2019; 258:345-350. [PMID: 31863399 DOI: 10.1007/s00417-019-04570-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 12/12/2019] [Accepted: 12/13/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To evaluate refractive outcomes for a standard industry calculator using anterior corneal astigmatism or total corneal refractive power. METHODS This prospective interventional study evaluated the refractive outcomes of 56 eyes using a standard industry calculator (Zeiss ZCalc) and a digital IOL alignment software. After A-constant optimisation the ZCalc was recalculated with two different keratometry values using appropriate refractive indices: anterior corneal astigmatism (ACA) by IOLMaster 700 and total corneal refractive power (TCRP) by Pentacam. The Barrett toric calculator was used as a reference. RESULTS Undercorrection of 0.04 ± 0.42 D after 1 week and 0.13 ± 0.48 D after 3 months was achieved for the spherical equivalent by using a standard industry calculator. IOL misalignment was 2.8° ± 3.4° using a digital alignment system. For the ZCalc, the mean absolute error could be reduced from 0.19 ± 0.40 D using ACA to 0.04 ± 0.48 D when considering total corneal refractive power (p = 0.06). The Barrett calculator delivered better refractive outcomes than using a standard industry calculator with ACA measurements only (- 0.06 ± 0.43 D; p < 0.01). CONCLUSION Reliable and accurate refractive outcomes in toric IOL calculation were achieved by using the ZCalc calculator. The prediction error for a widely used standard industry toric IOL calculator could be reduced by using measured total corneal refractive power.
Collapse
Affiliation(s)
- C Kern
- Department of Ophthalmology, University Hospital, LMU Munich, Mathildenstraße 8, 80336, Munich, Germany.
| | - L El Kaissi
- Department of Ophthalmology, University Hospital, LMU Munich, Mathildenstraße 8, 80336, Munich, Germany
| | - K Kortuem
- Department of Ophthalmology, University Hospital, LMU Munich, Mathildenstraße 8, 80336, Munich, Germany
| | - M Shajari
- Department of Ophthalmology, University Hospital, LMU Munich, Mathildenstraße 8, 80336, Munich, Germany
| | - E Vounotrypidis
- Department of Ophthalmology, University Hospital, LMU Munich, Mathildenstraße 8, 80336, Munich, Germany
| | - A Langenbucher
- Institute of Experimental Ophthalmology, Saarland University, Saarbrücken, Germany
| | - S Priglinger
- Department of Ophthalmology, University Hospital, LMU Munich, Mathildenstraße 8, 80336, Munich, Germany
| | - W J Mayer
- Department of Ophthalmology, University Hospital, LMU Munich, Mathildenstraße 8, 80336, Munich, Germany
| |
Collapse
|
12
|
Mohammadi SF, Khorrami-Nejad M, Hamidirad M. Posterior corneal astigmatism: a review article. CLINICAL OPTOMETRY 2019; 11:85-96. [PMID: 31496856 PMCID: PMC6697663 DOI: 10.2147/opto.s210721] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/29/2019] [Indexed: 05/15/2023]
Abstract
Most human eyes show at least a small degree of corneal astigmatism and it can arise from both surfaces of the cornea. The shape of the anterior corneal surface provides no definitive basis for knowing the toricity of the posterior surface. In the previous studies, average astigmatism of the posterior corneal surface was -0.26 to -0.78 diopter. The radius of the posterior corneal surface is less than the radius of the anterior corneal surface. Most studies have found a clear correlation between the anterior and posterior corneal asphericities and the asphericity of the posterior surface is independent of the vertex radius of curvature, refractive error and gender. In contrast to the anterior corneal surface, the asphericity of the posterior corneal surface varies significantly between meridians. The anterior and posterior corneal surface would have approximately parallel principal meridians and both of these surfaces are often flatter in the horizontal meridian than the vertical one. This is especially true in the higher degrees of corneal astigmatism, and then about 10% of any anterior corneal astigmatism is neutralized by an astigmatism arising from the posterior corneal surface. Although the second corneal surface only contributes to about 10% of the total refractive power of the eye, a precise knowledge of its morphology is needed for the correct diagnosis and monitoring the corneal diseases or the surgical interventions and in many eyes neglecting the posterior corneal surface measurement may lead to significant deviations from the corneal astigmatism estimation. In this article, we have reviewed the shape and the toricity of the posterior corneal surface and also the effect of age on it. We investigated the contribution of posterior corneal astigmatism to the total corneal astigmatism and evaluated the accuracy of corneal astigmatism estimation by neglecting the posterior corneal surface measurement.
Collapse
Affiliation(s)
- Seyed-Farzad Mohammadi
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences
, Tehran, Iran
| | - Masoud Khorrami-Nejad
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences
, Tehran, Iran
- School of Rehabilitation, Shahid Beheshti University of Medical Sciences
, Tehran, Iran
| | - Moein Hamidirad
- School of Rehabilitation, Shahid Beheshti University of Medical Sciences
, Tehran, Iran
| |
Collapse
|
13
|
Cionni RJ, Breen M, Hamilton C, Williams R. Retrospective analysis of an intraoperative aberrometry database: a study investigating absolute prediction in eyes implanted with low cylinder power toric intraocular lenses. Clin Ophthalmol 2019; 13:1485-1492. [PMID: 31496639 PMCID: PMC6689545 DOI: 10.2147/opth.s191887] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 06/05/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the spherical equivalent outcomes of intraoperative aberrometry (IA) power calculations compared with the surgeons' preoperative power calculations in eyes implanted with AcrySof® IQ T3 intraocular lenses (IOLs). Patients and methods We assessed data collected by an IA system from multiple centers in the United States. Data was from patients who had undergone cataract extraction by phacoemulsification with the use of the Optiwave Refractive Analysis System and whose eyes had been implanted with model SN6AT3 (1.5 diopter [D] at IOL plane) aspheric lenses. The analysis was performed in 2 stages: hypothesis generation and confirmatory testing. Confirmatory endpoints were a comparison of absolute prediction errors for IA for the implanted IOL versus preoperative formula power calculations. Design Retrospective analysis of preoperative, intraoperative, and postoperative data concerning eyes implanted with model SN6AT3 (1.5 D) aspheric lenses from the AnalyzOR™ database. Results Mean absolute IA prediction error was significantly lower than preoperative prediction error (paired difference: -0.06 D; p<0.0001); this was mirrored by the median paired difference of -0.04 D (p<0.0001). For eyes where the power of the implanted IOL differed from the power of the preoperatively planned lens, mean and median paired differences in prediction errors were greater: -0.13 D (p<0.0001) and -0.15 D (p<0.0001), respectively. The percentage of eyes with prediction error ≤0.50 D was significantly higher with IA (83.4%, n=5388/6460) than with the preoperative formula (76.5%, n=4942/6460, p<0.0001). When the powers of the implanted IOL and the preoperatively planned lens were different, the percentage of eyes with prediction error ≤0.50 D was 83.3% (2155/2587) for IA and 68.8% (1781/2587, p<0.0001) for the preoperative formula. Conclusion IA produces more accurate spherical equivalent outcomes for eyes implanted with a low toric IOL than the preoperative formulas.
Collapse
Affiliation(s)
| | - Michael Breen
- North America Clinical Development and Medical Affairs, Alcon Laboratories, Inc., Fort Worth, TX, USA
| | - Cody Hamilton
- Biostatistics, Alcon Laboratories, Inc., Fort Worth, TX, USA
| | - Ravaughn Williams
- Global Clinical Development and Medical Affairs, Alcon Laboratories, Fort Worth, TX, USA
| |
Collapse
|
14
|
Comparison of Corneal Power and Corneal Astigmatism of Different Diameter Zones Centered on the Pupil and Corneal Apex Using Scheimpflug Tomography. Cornea 2019; 39:77-83. [PMID: 31335537 DOI: 10.1097/ico.0000000000002052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Using Scheimpflug tomography to investigate the difference in corneal power and corneal astigmatism between 3- and 4-mm diameter zones centered on the pupil and corneal apex. METHODS A total of 90 eyes were included in this study. Axial keratometry, total refractive power, and true net power centered on the pupil and corneal apex in 3- and 4-mm diameter zones were assessed. The paired sample t test and independent sample t test were used for data comparison. RESULTS For corneal power and corneal astigmatism for the 3- and 4-mm diameter zones, the flat K values of axial keratometry, total refractive power, and true net power centered on the pupil (3-mm: 43.99 ± 1.69 D, 43.12 ± 1.71 D, 42.53 ± 1.67 D; 4-mm: 44.04 ± 1.67 D, 43.38 ± 1.71 D, 42.61 ± 1.65 D) were significantly higher than those centered on the apex (3-mm: 43.93 ± 1.69 D, 43.05 ± 1.71 D, 42.46 ± 1.67 D; 4-mm: 44.01 ± 1.67 D, 43.34 ± 1.69 D, 42.58 ± 1.65 D; all P < 0.02). However, the steep K and astigmatism magnitude values centered on the pupil (3-mm: 45.71 ± 1.73 D, 45.01 ± 1.73 D, 44.38 ± 1.69 D; 1.72 ± 0.83 D, 1.89 ± 0.86 D, 1.85 ± 0.84 D; 4-mm: 45.78 ± 1.73 D, 45.28 ± 1.74 D, 44.45 ± 1.68 D; 1.73 ± 0.84 D, 1.90 ± 0.85 D, 1.84 ± 0.85 D) were lower than those centered on the apex (3-mm: 45.81 ± 1.74 D, 45.10 ± 1.72 D, 44.50 ± 1.70 D; 1.88 ± 0.90 D, 2.05 ± 0.90 D, 2.04 ± 0.90 D; 4-mm: 45.85 ± 1.73 D, 45.34 ± 1.73 D, 44.51 ± 1.69 D; 1.83 ± 0.88 D, 2.00 ± 0.90 D, 1.93 ± 0.86 D; all P < 0.01). Compared with the 3-mm diameter zone, the corresponding 4-mm diameter zone showed higher corneal power centered on both pupil and corneal apex. CONCLUSIONS The difference in corneal power and corneal astigmatism, measured at 3 and 4 mm, centered on the pupil and the corneal apex should be noted in corneal refractive surgery and toric intraocular lens calculation.
Collapse
|
15
|
Núñez MX, Henriquez MA, Escaf LJ, Ventura BV, Srur M, Newball L, Espaillat A, Centurion VA. Consensus on the management of astigmatism in cataract surgery. Clin Ophthalmol 2019; 13:311-324. [PMID: 30809088 PMCID: PMC6376888 DOI: 10.2147/opth.s178277] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This project was aimed at achieving consensus on the management of astigmatism during cataract surgery by ophthalmologists from Latin America using modified Delphi technique. Relevant peer-reviewed literature was identified, and 21 clinical research questions associated with the definition, classification, measurement, and treatment of astigmatism during cataract surgery were formulated. Twenty participants were divided into seven groups, and each group was assigned three questions to which they had to respond in written form, after thoroughly reviewing the literature. The assigned questions with corresponding responses by each group were discussed with other participants in round 4 – presentation of findings. The consensus was achieved if approval was obtained from at least 80% of participants. The present paper provides several agreements and recommendations for management of astigmatism during cataract surgery, which could potentially minimize the variability in practice patterns and help ophthalmologists adopt optimal practices for cataract patients with astigmatism and improve patient satisfaction.
Collapse
Affiliation(s)
- Maria X Núñez
- Unit of Cornea, Cataract and Refractive Surgery, Grupo de Investigacion Vision Sana, Clinica de Oftalmología de Cali, Universidad Javeriana, Cali, Colombia,
| | - Maria A Henriquez
- Department of Cataract, Department of Research, Oftalmosalud Instituto de Ojos, Lima, Peru
| | - Luis J Escaf
- Clinica Oftalmologica del Caribe (Cofca), Universidad Javeriana, Barranquilla, Colombia
| | - Bruna V Ventura
- Department of Cataract, Altino Ventura Foundation, HOPE Eye Hospital, Recife, Brazil
| | - Miguel Srur
- Centro de la Visión, Filial Clínica Las Condes, Universidad de Los Andes, Santiago de Chile, Chile
| | | | - Arnaldo Espaillat
- Cataract and refractive surgery service, Espaillat Cabral Institute, Santo Domingo, Dominican Republic
| | | |
Collapse
|
16
|
Zhao F, Li L, Zhou W, Shi D, Fan Y, Ma L. Correlative factors' analysis of postural-related ocular cyclotorsion with image-guided system. Jpn J Ophthalmol 2017; 62:237-242. [PMID: 29134322 DOI: 10.1007/s10384-017-0544-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 10/08/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore the correlation between ocular cyclotorsion induced by sitting and supine positions as well as other selected factors, validated by an image-guided system. STUDY DESIGN A cross-sectional study conducted in 73 inpatients (85 eyes) who received intraocular operations in China Medical University. METHODS The ocular cyclotorsion degree was recorded using an image-guided system (Verion Reference Unit, Alcon) by comparing images captured in sitting position, as well as pre- and post-different anesthesia methods in the supine position. Possible correlative factors including age, gender, eye axial length, best corrected visual acuity (BCVA), astigmatism degree, astigmatism axis, anesthesia, and comparison in laterality of eyes on ocular cyclotorsion were analyzed. RESULTS The total cyclotorsion rate was 88.24% and the cyclotorsion degree ranged from - 14.0° to + 12.0° with an average of 4.6° ± 3.4°. Excyclotorsion was predominant OD whereas incyclotorsion was predominant OS (p < 0.05). The effect of eye axial length, BCVA, astigmatism degree, astigmatism axis, anesthesia method, age and gender on cyclotorsion orientation was not statistically significant, neither did these factors show any significant differences in the ocular cyclotorsion degree (p > 0.05). Pre- and post-anesthesia, and different anesthetic methods, did not show any significant influence on the ocular cyclotorsion degree (p > 0.05). CONCLUSIONS Cyclotorsion orientation seems to be correlated only with eye laterality. None of the other investigated factors, including age, gender, eye axial length, BCVA, astigmatism degree, astigmatism axis and anesthesia seems to affect cyclotorsion orientation or degree.
Collapse
Affiliation(s)
- Fangkun Zhao
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, China
- The Key Lens Research Laboratory of Liaoning Province, Shenyang, China
| | - Ling Li
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, China
- The Key Lens Research Laboratory of Liaoning Province, Shenyang, China
- Beijing AIER-Intech Eye Hospital, Beijing, China
| | - Wenkai Zhou
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, China
- The Key Lens Research Laboratory of Liaoning Province, Shenyang, China
| | - Dong Shi
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, China
- The Key Lens Research Laboratory of Liaoning Province, Shenyang, China
| | - Yu Fan
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, China
- The Key Lens Research Laboratory of Liaoning Province, Shenyang, China
| | - Liwei Ma
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, China.
- The Key Lens Research Laboratory of Liaoning Province, Shenyang, China.
| |
Collapse
|
17
|
Ruiz-Belda C, Rodrigo F, Piñero DP. Validation of keratometric measurements obtained with an intraoperative image-guided system: intra-session repeatability and interchangeability with an optical biometer. Clin Exp Optom 2017; 101:200-205. [PMID: 29090488 DOI: 10.1111/cxo.12623] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 03/29/2017] [Accepted: 06/26/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To evaluate the intra-session repeatability of keratometric measurements obtained in healthy eyes with the Verion image-guided system (Alcon Laboratories Inc, Fort Worth, Texas, USA) as well as the interchangeability of such measurements with those obtained with an optical biometer (Aladdin, Topcon, Tokyo, Japan). METHODS A total of 53 eyes of 53 patients (age 31-67 years) were enrolled in the study. All eyes received a comprehensive ophthalmologic examination including an analysis with the Verion image-guided and Aladdin systems. Three consecutive measurements of keratometry were obtained with the Verion system to assess the intra-session repeatability. Within-subject standard deviation (Sw ) and intraobserver precision (± 1.96 × Sw ) were calculated. Bland-Altman analysis was used for the interchangeability analysis. RESULTS Mean Sw was 0.26, 0.24 and 0.10 D for the keratometric power in the flattest meridian (K1), keratometric power in the steepest meridian (K2) and astigmatism, respectively. Mean Sw was 4.29° for the axis of the flattest corneal meridian (AX1). Statistically significant but clinically acceptable differences were found in K1, K2 and keratometric astigmatism among systems (p < 0.01). In contrast, differences among systems in AX1 were not statistically significant (p = 0.385) but clinically relevant (mean difference: 15.74°; limits of agreement: -30.93 to 62.41°). CONCLUSIONS The Verion system provides consistent measurements of keratometric parameters, with measurements of AX1 that are not interchangeable with that provided by the optical biometer Aladdin, especially in cases of low and oblique astigmatism.
Collapse
Affiliation(s)
- Clara Ruiz-Belda
- Department of Ophthalmology, Marina Baixa Hospital, Alicante, Spain.,Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Fermín Rodrigo
- Department of Ophthalmology, Marina Baixa Hospital, Alicante, Spain
| | - David P Piñero
- Department of Ophthalmology, Marina Baixa Hospital, Alicante, Spain.,Department of Ophthalmology (Oftalmar), Vithas Medimar International Hospital, Alicante, Spain
| |
Collapse
|
18
|
Changes in Anterior, Posterior, and Total Corneal Astigmatism after Descemet Membrane Endothelial Keratoplasty. J Ophthalmol 2017; 2017:4068963. [PMID: 28553547 PMCID: PMC5434235 DOI: 10.1155/2017/4068963] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 03/25/2017] [Accepted: 03/27/2017] [Indexed: 11/17/2022] Open
Abstract
Purpose. To evaluate changes in anterior, posterior, and total corneal astigmatism in patients after Descemet membrane endothelial keratoplasty (DMEK). Methods. We retrospectively included 29 eyes of 23 patients (age 67.6 ± 9.8 years, 13 female, 10 male) after DMEK surgery. The magnitude and axis orientation of anterior, posterior, and total corneal astigmatism before and after DMEK were determined using a rotating Scheimpflug system (Pentacam HR, Oculus). Results. The magnitude of anterior, posterior, and total corneal astigmatism in the central cornea did not change significantly after surgery. Before surgery, we found a significant correlation between the magnitudes of anterior and posterior corneal astigmatism (Spearman's correlation coefficient (rS) = 0.526, P = 0.003), while after surgery this correlation was no longer significant (rS = 0.038, P = 0.843). There was a significant correlation between the vector difference between preoperative and postoperative posterior astigmatism and the change in corneal pachymetry (rP = 0.47, P = 0.010). Conclusions. Posterior corneal astigmatism (especially the orientation) and therefore the relationship between anterior and total corneal astigmatism may change after DMEK. This should be considered to improve the accuracy of toric IOL power calculations following phakic DMEK or in combined procedures.
Collapse
|
19
|
New regression formula for toric intraocular lens calculations. J Cataract Refract Surg 2016; 42:663-71. [DOI: 10.1016/j.jcrs.2016.02.038] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 01/29/2016] [Accepted: 02/01/2016] [Indexed: 11/23/2022]
|
20
|
Posterior Corneal Astigmatism and Current Strategies for Optimizing Outcomes with Toric IOLs. CURRENT OPHTHALMOLOGY REPORTS 2016. [DOI: 10.1007/s40135-016-0088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
21
|
Bissen-Miyajima H, Negishi K, Hieda O, Kinoshita S. Microincision Hydrophobic Acrylic Aspheric Toric Intraocular Lens for Astigmatism and Cataract Correction. J Refract Surg 2015; 31:358-64. [DOI: 10.3928/1081597x-20150521-01] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 04/02/2015] [Indexed: 11/20/2022]
|
22
|
Affiliation(s)
- Joanne W Ho
- Shiley Eye Center, University of California, San Diego, La Jolla, California, USA
| | | |
Collapse
|
23
|
Cha YJ, Kim MK, Wee WR. Effect of Toric Intraocular Lens Implantation on Astigmatism in Cataract Surgery. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.10.1544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yong Jae Cha
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Won Ryang Wee
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|