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Teshigawara T, Akaishi M, Mizuki Y, Takeuchi M, Hata S, Meguro A, Mizuki N. Effect of Long-Acting Diquafosol Sodium on Astigmatism Measurement Repeatability in Preoperative Cataract Cases with Dry Eyes: A Multicenter Prospective Study. Ophthalmol Ther 2024; 13:1743-1755. [PMID: 38662192 PMCID: PMC11109081 DOI: 10.1007/s40123-024-00940-z] [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: 01/16/2024] [Accepted: 03/22/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Dry eye can compromise corneal astigmatism measurement repeatability during preoperative cataract surgery examination. No previous studies have analyzed the effectiveness of long-acting 3% diquafosol sodium (LA-DQS) on astigmatism measurement repeatability. This research assessed the effect of LA-DQS on astigmatism measurement repeatability in preoperative patients with cataract and short tear break-up time (TBUT) type dry eyes in both eyes of the same patient. Correlations between repeatability and TBUT, corneal high-order aberrations (HOAs), and corneal astigmatism magnitude were also analyzed. METHODS In total, 122 eyes (61 patients) with short TBUT-type dry eye were enrolled. Preoperatively, only one eye of all patients was treated with LA-DQS for 4 weeks. TBUT and corneal HOAs were checked using CASIA 2 before and 4 weeks post-treatment. The cylindrical power and meridian of astigmatism were measured at 3- and 4-week post-treatment using IOLMaster 700. Power vectors J0 and J45 were used for astigmatism calculations. Repeatability of astigmatism measurements was assessed as the within-subject standard deviation (Sw). The relative effects of TBUT and HOAs on J0 Sw and J45 Sw were also analyzed. Comparative changes in these variables were evaluated between treated and non-treated eyes, with additional analysis of their correlations. RESULTS Treated eyes exhibited significant improvements in TBUT, HOAs, and post-treatment measurements of J0 Sw and J45 Sw at 3 and 4 weeks. In non-treated eyes, J0 Sw and J45 Sw showed significant correlation with TBUT and corneal HOAs. HOAs showed stronger relative associations with J0 Sw and J45 Sw than TBUT. In non-treated eyes, no significant correlation was found between cylindrical power and astigmatism measurement repeatability. CONCLUSIONS In short TBUT-type dry eye, preoperative treatment with LA-DQS significantly improved astigmatism measurement repeatability. This may improve the precision of intraocular lens (IOL) power calculations regardless of the magnitude of corneal astigmatism, especially when toric IOLs are used.
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Affiliation(s)
- Takeshi Teshigawara
- Department of Ophthalmology, Yokosuka Chuoh Eye Clinic, 2-6 Odaki-cho, Yokosuka, Kanagawa, 238-0008, Japan.
- Department of Ophthalmology, Tsurumi Chuoh Eye Clinic, Tsurumi, Yokohama, Kanagawa, Japan.
- Department of Ophthalmology, Yokohama City University School of Medicine, Kanazawa, Yokohama, Kanagawa, Japan.
| | - Miki Akaishi
- Department of Ophthalmology, Yokohama City University School of Medicine, Kanazawa, Yokohama, Kanagawa, Japan
| | - Yuki Mizuki
- Department of Ophthalmology, Yokohama City University School of Medicine, Kanazawa, Yokohama, Kanagawa, Japan
| | - Masaki Takeuchi
- Department of Ophthalmology, Yokohama City University School of Medicine, Kanazawa, Yokohama, Kanagawa, Japan
| | - Seiichiro Hata
- Department of Ophthalmology, Yokohama Sky Eye Clinic, Yokohama, Kanagawa, Japan
| | - Akira Meguro
- Department of Ophthalmology, Yokohama City University School of Medicine, Kanazawa, Yokohama, Kanagawa, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology, Yokohama City University School of Medicine, Kanazawa, Yokohama, Kanagawa, Japan
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Li H, He W, Guo D, Fang Y, Meng J, Zhang K, Zhu X, Lu Y. Correction of Asymmetric Bowtie Corneal Astigmatism with a Toric Intraocular Lens: Outcomes and Accuracy of Measurement Modes. J Pers Med 2023; 13:jpm13030401. [PMID: 36983583 PMCID: PMC10057716 DOI: 10.3390/jpm13030401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
The outcomes of toric intraocular lens (IOL) implantation in correcting asymmetric bowtie corneal astigmatism remain uncertain. The accurate measurement of corneal astigmatism is essential for surgical planning. In this prospective cohort study, patients with asymmetric or symmetric bowtie corneal astigmatism who underwent toric IOL implantation were recruited. Preoperative corneal astigmatism was measured with an IOLMaster and Pentacam (including the simulated keratometry (SimK), total corneal refractive power (TCRP), and wavefront aberration (WFA) modes). At 3 months after surgery, the refractive outcomes and residual astigmatic refractive errors were compared with patients with symmetric bowtie astigmatism. The prediction errors (the differences between the calculated actual corneal astigmatism and the measured corneal astigmatism) were compared among the different measurement modes in the asymmetric group. There were no differences in residual astigmatism between the asymmetric and symmetric groups. However, the mean absolute residual astigmatic refractive error was greater in the asymmetric group than in the symmetric group (0.72 ± 0.42 D vs. 0.53 ± 0.24 D, p = 0.043). In the asymmetric group, the mean absolute prediction errors for the IOLMaster, SimK, TCRP and WFA modes were 0.53 ± 0.40, 0.56 ± 0.47, 0.68 ± 0.52, and 0.43 ± 0.40 D, respectively. The Pentacam WFA mode was the most accurate mode (p < 0.05). The absolute prediction error of the WFA mode was positively correlated with the total corneal irregular astigmatism higher-order aberrations and coma (r = 0.416 and r = 0.473, respectively; both p < 0.05). Our study suggests toric IOL implantation effectively corrected asymmetric bowtie corneal astigmatism. The Pentacam WFA mode may be the most accurate measurement mode, although its accuracy decreased as asymmetry increased.
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Affiliation(s)
- Hao Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Wenwen He
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Donglin Guo
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Yanwen Fang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Jiaqi Meng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Keke Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
- Correspondence: (X.Z.); (Y.L.)
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
- Correspondence: (X.Z.); (Y.L.)
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Achiron A, Elhaddad O, Leadbetter D, Levinger E, Voytsekhivskyy O, Smith K, Avadhanam V, Darcy K, Tole D. Intraocular lens power calculation in patients with irregular astigmatism. Graefes Arch Clin Exp Ophthalmol 2022; 260:3889-3895. [PMID: 35776172 DOI: 10.1007/s00417-022-05729-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/07/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Accurate intraocular lens (IOL) calculation in subjects with irregular astigmatism is challenging. This study evaluated the accuracy of using Scheimpflug-derived central 2-mm equivalent keratometry reading (EKR) values for IOL calculation in irregular astigmatism. METHODS This retrospective study included subjects (31 eyes of 30 patients) who underwent cataract surgery and IOL calculation using the 2-mm central EKR methods. We compared prediction error (PE) and absolute PE (APE) outcomes using SRK/T and Barrett Universal II formulas for keratometry data obtained from the IOLMaster 500 and Pentacam (anterior corneal sim k) devices. RESULTS Cataract surgery and IOL calculation using the 2-mm central EKR methods resulted in improved visual acuity (uncorrected: from 1.13 ± 0.38 to 0.65 ± 0.46 logMar, p < 0.01; best-corrected: from 0.45 ± 0.24 to 0.26 ± 0.20 logMar, p < 0.01) after surgery. The percentage of subjects with best-corrected visual acuity of 6/6 was 22%, < 6/9 was 58%, and < 6/12 was 71%. For both the SRK/T and the Barrett formulas, the PE was similar to those obtained by IOLMaster (> 0.14) but lower than those obtained by the anterior corneal sim k (p < 0.02). IOLMaster provided keratometry reading in only 23/31 (74.1%) of cases. CONCLUSIONS The use of Scheimpflug central 2-mm EKR for IOL calculation in irregular astigmatism was beneficial in terms of visual acuity improvement. It had comparable refractive prediction performance to the IOLMaster 500 and better than the anterior corneal sim K. The 2-mm EKR method can be used when IOLMaster cannot provide a reliable reading in abnormal corneas.
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Affiliation(s)
- Asaf Achiron
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK.
- Sourasky Tel-Aviv Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Omar Elhaddad
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Duncan Leadbetter
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| | - Eliya Levinger
- Sourasky Tel-Aviv Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Katy Smith
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| | - Venkata Avadhanam
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| | - Kieren Darcy
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| | - Derek Tole
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
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Elkadim M, Nasef MH, Alagorie AR, Allam WA. Corneal Topographic versus Manifest Refractive Astigmatism in Patients with Keratoconus: A Retrospective Cross-Sectional Study. Clin Ophthalmol 2022; 16:2033-2039. [PMID: 35757018 PMCID: PMC9231632 DOI: 10.2147/opth.s361338] [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: 02/06/2022] [Accepted: 06/09/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the subjective manifest astigmatism to the corneal topographic astigmatism in patients with keratoconus. Methods This retrospective study included data of 230 keratoconic eyes of 115 patients. Topographic corneal astigmatism (TA), which was measured by pentacam, was compared and correlated to manifest refractive cylinder (MRC) in terms of power, axis, vector components, and mean vector. The difference between TA and MRC was correlated to the maximum keratometric reading (Kmax) and the thinnest pachymetry location (TL), as indicators of keratoconus severity. Results There was a significant positive correlation between MRC power and TA power (p < 0.001; r = 0.58). TA power was significantly higher than MRC power (p < 0.001). A significant correlation was present between the axis of TA and MRC (r = 0.73; p < 0.001) with the axis of the MRC tending to be more vertical (more against the rule) than the axis of TA. The vector difference between TA and MRC is correlated to the Kmax (p < 0.001; r = 0.62) and TL (p < 0.001; r = 0.3). Conclusions A significant difference is present between TA and MRC in keratoconic eyes, the power of MRC tends to be less and the axis tends to be more vertical than those of TA; this difference increases as keratoconus becomes more advanced.
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Affiliation(s)
- Mohamed Elkadim
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
- Correspondence: Mohamed Elkadim, Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt, Email
| | - Mohamed H Nasef
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Waleed A Allam
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
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The Effect of Rebamipide on Refractive Accuracy of Cataract Surgery in Patients with Dry Eye. Ophthalmol Ther 2022; 11:603-611. [PMID: 35064909 PMCID: PMC8927481 DOI: 10.1007/s40123-022-00457-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/06/2022] [Indexed: 12/18/2022] Open
Abstract
Introduction Refractive accuracy is crucial for increasing patient satisfaction after cataract surgery. Tear film instability caused by dry eye can lead to inaccurate measurement of corneal power, which is one of the most important factors for postoperative refractive calculation. This study investigated the effect of 2% rebamipide ophthalmic suspension on the predicted refractive accuracy for cataract surgery in patients with dry eye. Methods This single-center, prospective, open-label study included 35 dry eyes (with tear breakup time < 5 s) who underwent cataract surgery. The patients were treated with rebamipide for 4 weeks before the preoperative examination. In addition to the usual evaluation of biometric variables essential for cataract surgery, tear breakup time (TBUT), superficial punctate keratopathy in the central part of the cornea (C-SPK), corneal higher-order aberrations (HOAs), and predicted postoperative spherical equivalent (P-SE) were evaluated at baseline and 4 weeks after dry eye treatment. The patients’ subjective spherical equivalent (S-SE) was evaluated 1 month postoperatively. The difference between S-SE and P-SE was used to assess the accuracy of the P-SE. Improvement in TBUT, C-SPK, HOA, and the accuracy of P-SE after dry eye treatment were analyzed. Results The accuracy of the biometry readings for the achieved P-SE was within 0.25 D in 42.9% and 54.3%; within 0.5 D in 71.4% and 88.6%; and within 0.75 D in 88.6% and 97.1% of eyes before and after rebamipide treatment, respectively (p < 0.01). TBUT, C-SPK, and HOAs significantly improved after rebamipide treatment (p < 0.01). Conclusion Rebamipide significantly improved the corneal surface condition and accuracy of the predicted postoperative refraction in dry eyes. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-022-00457-3.
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Meng J, Yu J, He W, Wei L, Lu Y, Zhu X. The Influence of Analysis Mode Selection on Prediction Accuracy of Corneal Astigmatism Using Pentacam. Front Med (Lausanne) 2021; 8:713502. [PMID: 34722562 PMCID: PMC8554023 DOI: 10.3389/fmed.2021.713502] [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: 05/23/2021] [Accepted: 09/13/2021] [Indexed: 11/15/2022] Open
Abstract
Purpose: To evaluate the influence of analysis mode selection on prediction accuracy of corneal astigmatism using Pentacam. Methods: Fifty-nine eyes of 59 patients implanted with toric intraocular lenses (IOLs) were included in the retrospective study. Preoperative corneal astigmatism (total refractive power) measured with Pentacam was analyzed based on 2-, 3-, 4-, or 5-mm ring or zone mode either centered on corneal apex or pupil center. Actual corneal astigmatism was calculated based on residual astigmatism on the corneal plane, surgical-induced astigmatism, and effective toric power on the corneal plane. Prediction error, the difference between actual corneal astigmatism and measured astigmatism, was compared among different analysis modes. Influences of local topography on prediction error were also evaluated. Results: Based on the zone mode, prediction error was lower when centered on corneal apex than on pupil center at different diameters, whereas based on the ring mode, this difference was only seen at 2-mm cornea (all P < 0.05). When centered on the corneal apex, the zone mode showed lower prediction error than the ring mode at 4- and 5-mm corneas (both P < 0.001), regardless of asymmetric or symmetric astigmatism. In symmetric bowtie, the zone mode showed lower prediction error than the ring mode at 2-mm cornea of the small bowtie, and 4- and 5-mm corneas of the large bowtie (all P < 0.05). Conclusions: For toric IOL planning, the corneal apex may be a better reference center. At a cornea diameter ≥4 mm, the zone mode is more accurate than the ring mode. Local topography affects prediction accuracy in the symmetric bowtie.
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Affiliation(s)
- Jiaqi Meng
- Eye Institute, Eye & Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China
| | - Jifeng Yu
- Department of Ophthalmology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Wenwen He
- Eye Institute, Eye & Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health, Shanghai, China.,Key Laboratory of Visual Impairment and Restoration, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ling Wei
- Eye Institute, Eye & Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China
| | - Yi Lu
- Eye Institute, Eye & Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health, Shanghai, China.,Key Laboratory of Visual Impairment and Restoration, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiangjia Zhu
- Eye Institute, Eye & Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Key Laboratory of Myopia, Ministry of Health, Shanghai, China.,Key Laboratory of Visual Impairment and Restoration, Shanghai, China.,National Health Commission (NHC) Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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Spadea L, Visioli G, Mastromarino D, Alexander S, Pistella S. Topography-Guided Trans-Epithelial No-Touch Photorefractive Keratectomy for High Irregular Astigmatism After Penetrating Keratoplasty: A Prospective 12-Months Follow-Up. Ther Clin Risk Manag 2021; 17:1027-1035. [PMID: 34594105 PMCID: PMC8478484 DOI: 10.2147/tcrm.s329932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/19/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe the efficacy and safety of topography-guided trans-epithelial no-touch photorefractive keratectomy (PRK) for the correction of highly irregular astigmatism after penetrating keratoplasty (PK). Patients and Methods A prospective study was conducted on 12 eyes of 12 patients affected by highly irregular astigmatism after PK for keratoconus. Each patient underwent a single-step topography-guided trans-epithelial ablation (CIPTA®2 software, iVis Technologies). Corneal topography data as well as uncorrected (UDVA) and corrected distance visual acuity (CDVA) and spherical equivalent (SEQ) were collected preoperatively (T0) and at 1 (T1), 3 (T2) and 12 (T3) months after surgery. Results Mean UDVA and CDVA significantly improved, respectively, from 1.22±0.17 and 0.18±0.03LogMAR at T0 to 0.63±0.17 (CI 95%, P<0.001) and 0.04±0.03LogMAR at T3 (CI 95%, P<0.001). Mean SEQ significantly decreased from −3.75±1.32 to –1.60±1.32D (CI 95%, P<0.02). Mean subjective refractive astigmatism (SRAST) and mean keratometry astigmatism (SimK) significantly decreased, respectively, from 7.83±0.98 and 8.10±1.48D to 2.83±0.98 and 5.29±1.48D (CI 95%, P<0.001). Corneal Morphological Irregularity index (CMI) significantly decreased from 62.76±7.26 µm to 23.24±7.26 µm (CI 95%, P<0.001). Apart from a single episode of graft rejection 5 days after ablation, successfully reverted with topical steroids, no other complications were noted. A mild corneal haze was observed in two eyes (16.7%) at 3 months post-PRK, and no regression was observed at 12 months. Conclusion Our study demonstrates the safety and long-term effectiveness of a trans-epithelial topography-guided ablation in the treatment of post-PK highly irregular astigmatism.
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Affiliation(s)
- Leopoldo Spadea
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
| | - Giacomo Visioli
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
| | - Davide Mastromarino
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
| | - Shehani Alexander
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
| | - Santino Pistella
- Eye Clinic, Policlinico Umberto 1, "Sapienza" University of Rome, Rome, Italy
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Teshigawara T, Meguro A, Mizuki N. Effects of Rebamipide on Differences in Power and Axis of Corneal Astigmatism Between Two Intra-patient Keratometric Measurements in Dry Eyes. Ophthalmol Ther 2021; 10:891-904. [PMID: 34292514 PMCID: PMC8589897 DOI: 10.1007/s40123-021-00368-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/23/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction This study investigated the effect of rebamipide on discrepancies in the power and axis of astigmatism between two intra-patient keratometric measurements in patients with dry eyes. Methods Fifty-eight dry eyes (with a short tear breakup time [TBUT] of less than 5 s) were analyzed. Patients with dry eye were treated with 2% rebamipide ophthalmic suspension (group R) or Mytear® artificial tear ophthalmic solution (group M) for 4 weeks. TBUT and corneal higher-order aberrations (HOAs) were evaluated at baseline and 4 weeks after treatment. Astigmatism power and axis were measured twice during both evaluations, at 5-min intervals. Baseline and post-treatment measurements were compared. Changes in TBUT and HOAs, and intra-patient discrepancies in astigmatism power and axis measurements were evaluated. Results HOAs showed significant positive correlations with intra-patient differences in astigmatism power and axis (P < 0.001). At the 4-week post-treatment follow-up, TBUT increased, and HOAs and astigmatism power and axis discrepancies decreased in a significant number of patients in group R (P < 0.001). In group M, only differences in astigmatism power decreased in a significant number of cases (P = 0.005). The degree of change in the intra-patient difference in astigmatism power between the two post-treatment keratometric measurements was significantly greater in group R than in group M (P < 0.001). In group R, baseline HOAs exhibited a significant positive correlation with changes in HOAs and intra-patient differences in astigmatism power (both P < 0.001). In group M, baseline HOAs were only significantly correlated with changes in intra-patient differences in astigmatism power (P = 0.030). Conclusion In dry eyes with short TBUTs, rebamipide significantly improved the corneal surface condition and significantly reduced intra-patient discrepancies in astigmatism power and axis measurements. Rebamipide may improve the accuracy of intraocular lens (IOL) power calculations in dry eyes, particularly when toric IOLs are implanted. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-021-00368-9. This study investigated the effect of rebamipide on discrepancies in power and axis of astigmatism between two intra-patient keratometric measurements in patients with dry eyes. Short tear break-up time and corneal high-order aberrations were evaluated at baseline and 4 weeks after treatment. Astigmatism power and axis were measured twice at both evaluations. Baseline and post-treatment measurements were compared, and changes in short tear break-up time and high-order aberrations, as well as intra-patient discrepancies in astigmatism power and axis measurements, were evaluated. High-order aberrations at baseline showed significant positive correlations with intra-patient differences in astigmatism power and axis. Rebamipide significantly improved the corneal surface condition and significantly reduced intra-patient discrepancies in astigmatism power and axis measurements. Rebamipide may improve the accuracy of intraocular lens power calculations in dry eyes, particularly when toric intraocular lenses are implanted.
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Affiliation(s)
- Takeshi Teshigawara
- Department of Ophthalmology, Yokosuka Chuoh Eye Clinic, 2-6 Odaki-cho, Yokosuka, 238-0008, Kanagawa, Japan. .,Tsurumi Chuoh Eye Clinic, 1-2-1 Tsurumi-chuo, Tsurumi, Yokohama, 230-0051, Kanagawa, Japan. .,Department of Ophthalmology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, 236-0004, Kanagawa, Japan.
| | - Akira Meguro
- Department of Ophthalmology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, 236-0004, Kanagawa, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa, Yokohama, 236-0004, Kanagawa, Japan
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Noh H, Yoo YS, Shin KY, Lim DH, Chung TY. Comparison of penetrating femtosecond laser-assisted astigmatic keratotomy and toric intraocular lens implantation for correction of astigmatism in cataract surgery. Sci Rep 2021; 11:7340. [PMID: 33795782 PMCID: PMC8016891 DOI: 10.1038/s41598-021-86763-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/19/2021] [Indexed: 02/01/2023] Open
Abstract
This study tried to compare the clinical outcomes of femtosecond laser-assisted astigmatic keratotomy (FSAK) and toric intraocular lens (IOL) implantation for astigmatism correction and identify factors affecting the efficacy of FSAK and toric IOL implantation in astigmatism correction. This retrospective case series comprised patients with corneal astigmatism ranging between 0.5 D and 4.5 D. Patients underwent FSAK or toric IOL implantation for cataract treatment and correction of astigmatism at the Samsung Medical Center, a tertiary surgical center, between April 2016 and December 2018. All patients underwent examination before and at three months after the surgery for comparative evaluation of refractive astigmatism, corneal high order aberrations and irregularity index. The astigmatism correction was analyzed by the Alpins method. Subgroup analysis of preoperative factors was based on the extent of target-induced astigmatism (TIA), the degree of astigmatism, and astigmatism classification based on topography. Thirty-one eyes underwent toric IOL implantation and 35 eyes underwent FSAK. The refractive astigmatism was significantly decreased in both toric IOL (P = 0.000) and FSAK group (P = 0.003). The correction index (CI) of refractive astigmatism was 0.84 ± 0.39 in the toric IOL and 0.71 ± 0.60 in the FSAK group. There was no difference between the two groups (P = 0.337). The CI of the FSAK group was significantly lower than in the toric IOL group when TIA was more than 1.5 D (P = 0.006), when correcting against-the-rule (P = 0.017), and limbus-to-limbus astigmatism (P = 0.008). In conclusion, toric IOL implantation is an effective and safe procedure for correcting preoperative astigmatism in cataract surgery in the short-term observation.
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Affiliation(s)
- Hoon Noh
- grid.264381.a0000 0001 2181 989XDepartment of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351 Republic of Korea
| | - Young-Sik Yoo
- grid.264381.a0000 0001 2181 989XDepartment of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351 Republic of Korea ,grid.411947.e0000 0004 0470 4224Department of Ophthalmology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyeonggi-do Republic of Korea
| | - Kyoung Yoon Shin
- grid.264381.a0000 0001 2181 989XDepartment of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351 Republic of Korea ,Department of Ophthalmology, Seongnam Citizens Medical Center, Seongnam-si, Gyeonggi-do Republic of Korea
| | - Dong Hui Lim
- grid.264381.a0000 0001 2181 989XDepartment of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351 Republic of Korea ,grid.264381.a0000 0001 2181 989XDepartment of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Tae-Young Chung
- grid.264381.a0000 0001 2181 989XDepartment of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351 Republic of Korea
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Kim B, Choi A, Park JH, Jeon S. Prevalence of epiretinal membrane in the phakic eyes based on spectral-domain optical coherence tomography. PLoS One 2021; 16:e0245063. [PMID: 33411853 PMCID: PMC7790294 DOI: 10.1371/journal.pone.0245063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/21/2020] [Indexed: 11/18/2022] Open
Abstract
The prevalence of epiretinal membrane (ERM) and associated factors in the phakic eyes have not been fully elucidated yet. This cross-sectional study included 2,354 phakic eyes without retinal diseases or surgical history. Ocular parameters, such as uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), intraocular pressure (IOP), white-to-white corneal diameter (WTW), mean keratometric value (Km) of total corneal refractive power at 4-mm diameter (TCRP4), astigmatism of TCRP4, total corneal irregular astigmatism (TCIA), pupil diameter, axial length (AXL), anterior chamber depth (ACD), lens thickness (LT), and posterior vitreous detachment (PVD) were compared between ERM group and control group. Additionally, an age-matched control group was selected by individual matching and compared with the ERM group to eliminate the confounders. Multiple logistic regression analysis was performed to evaluate the factors associated with the presence of ERM. Among 2,354 eyes, 429 eyes (18.2%) had ERM based on spectral-domain optical coherence tomography. The ERM group showed higher prevalence of PVD, worse CDVA, higher astigmatism of TCRP4, higher TCIA, smaller pupil size, longer AXL, and thicker LT than control group (P < 0.001, P < 0.001, P = 0.011, P < 0.001, P = 0.023, P < 0.001, and P < 0.001, respectively). Only PVD, CDVA, SE, astigmatism of TCRP4, TCIA, and AXL maintained the significance when compared with the age-matched control group (P < 0.001, P = 0.026, P < 0.001, P = 0.001, P = 0.003, and P < 0.001, respectively). Multivariate logistic regression analysis showed that age, PVD, CDVA, and TCIA were independently associated with the presence of ERM (P < 0.001, P < 0.001, P = 0.011, and P = 0.002). The prevalence of ERM detected using SD-OCT was 18.2% in the middle aged phakic population. Eyes with TCIA, in addition to older age and PVD, were more likely to have ERM.
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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.
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Zvorničanin J. Corneal astigmatism in cataract surgery patients from Bosnia and Herzegovina. Int Ophthalmol 2018; 39:1753-1760. [PMID: 30051216 DOI: 10.1007/s10792-018-0998-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/21/2018] [Indexed: 01/16/2023]
Abstract
PURPOSE To determine corneal astigmatism prevalence, its correlations with age and symmetry pattern in fellow eyes of patients undergoing cataract surgery. METHODS This is a clinical-based retrospective cross-sectional study. Keratometry measurements of patients undergoing cataract surgery assigned to University Clinical Center Tuzla, Bosnia and Herzegovina, between January 2011 and June 2012 were recorded and analyzed retrospectively. RESULTS The study consisted of 4080 eyes of 2205 consecutive cataract surgery patients with a mean age of 68.24 years ± 9.25 (SD) (range 32-84 years), and 54.0% of the patients were women. Mean corneal astigmatism was 0.72 ± 0.61 D (range 0-6.5 D). The prevalence of corneal astigmatism 1.0 D or more was in 1291 eyes (31.64%), 1.5 D or more in 736 eyes (18.03%), 2.0 D or more in 396 eyes (9.71%) and 3.0 D or more in 108 eyes (2.65%). There was no significant difference in the magnitude of astigmatism between age groups (p = 0.10), male and female (p = 0.29) or right and left (p = 0.75) eyes. The prevalence and amount of astigmatism increased with age (p < 0.05). Gradual shift from with-the-rule astigmatism toward against-the-rule astigmatism was observed (p = 0.03). Patients with higher amount of astigmatism in one eye are more likely to have significant astigmatism in fellow eye (p < 0.01). Symmetry in pairs of eyes is present in eyes with astigmatism greater than 2.5 D (p < 0.01). CONCLUSION This study provides useful reference data for cataract surgeons and patients from Bosnia and Herzegovina.
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Affiliation(s)
- Jasmin Zvorničanin
- Department of Ophthalmology, University Clinical Center Tuzla, Trnovac bb, 75000, Tuzla, Bosnia and Herzegovina.
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Fu Y, Yu X, Savini G, Huang J, Lian H, Song B, Wang Q, Zhao Y. Assessment of Corneal Keratometric and Astigmatism Measurements Using Verion System and Other Instruments in Cataract Patient. Curr Eye Res 2018; 43:1205-1214. [PMID: 29890084 DOI: 10.1080/02713683.2018.1488264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE To compare keratometry and corneal astigmatism measurements obtained by the Verion Image Guided System to those obtained by automated keratometry (IOLMaster), manual keratometry (YZ38, Suzhou 66 visual Polytron Technologies Inc., China), and Scheimpflug imaging (Pentacam HR) in eyes with cataract. METHODS A total of 149 cataractous eyes of 149 patients were examined and categorized as low astigmatism (<1.0 D, N = 50), moderate astigmatism (1.0-2.0 D, N = 49), and high astigmatism (>2.0 D, N = 50). The flattest and the steepest keratometric values (Kf and Ks), the magnitude of astigmatism (Ast), the orientation of the steepest meridian (Axis), and power vectors J0 and J45 were compared. RESULTS Keratometry readings (Kf, Ks, and Km) obtained by the Verion system showed statistically significant differences as compared to the other three devices. The magnitude of astigmatism (Ast) measured by the Verion (1.50 ± 0.85 D) was similar to that measured by the YZ38 (1.45 ± 0.82 D, P = 0.110) and slightly lower than that by the IOLMaster (1.56 ± 0.87 D, P = 0.014), but much higher than that by the Pentacam (1.36 ± 0.81 D, P = 0.000) significantly. However, no statistically significant differences were observed in the J0 and J45 vectors in the whole sample, besides moderate and high astigmatism subgroups. A difference in astigmatism magnitude of 0.50 D or more was detected between the Verion system and other three devices most commonly in moderate astigmatism eyes (16.3-24.5%). The difference in the location of the steep meridian was greater than 10 degrees most frequently in the low astigmatism eyes (26.0-52.0%). CONCLUSIONS Keratometric and astigmatic results obtained with Verion were not completely interchangeable with those obtained with IOLMaster, manual keratometry, and Pentacam. The individual differences in power and orientation of the corneal cylinder should be considered while selecting the appropriate toric intraocular lens.
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Affiliation(s)
- Yana Fu
- a School of Ophthalmology and Eye Hospital , Wenzhou Medical University , Wenzhou , China
| | - Xinxin Yu
- a School of Ophthalmology and Eye Hospital , Wenzhou Medical University , Wenzhou , China
| | | | - Jinhai Huang
- a School of Ophthalmology and Eye Hospital , Wenzhou Medical University , Wenzhou , China
| | - Hengli Lian
- a School of Ophthalmology and Eye Hospital , Wenzhou Medical University , Wenzhou , China
| | - Benhao Song
- a School of Ophthalmology and Eye Hospital , Wenzhou Medical University , Wenzhou , China
| | - Qinmei Wang
- a School of Ophthalmology and Eye Hospital , Wenzhou Medical University , Wenzhou , China
| | - Yune Zhao
- a School of Ophthalmology and Eye Hospital , Wenzhou Medical University , Wenzhou , China
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Galindo-Ferreiro A, De Miguel-Gutierrez J, González-Sagrado M, Galvez-Ruiz A, Khandekar R, Schellini S, Galindo-Alonso J. Validity of autorefractor based screening method for irregular astigmatism compared to the corneal topography- a cross sectional study. Int J Ophthalmol 2017; 10:1412-1418. [PMID: 28944202 DOI: 10.18240/ijo.2017.09.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 04/27/2017] [Indexed: 01/19/2023] Open
Abstract
AIM To present a method of screening for irregular astigmatism with an autorefractor and its determinants compared to corneal topography. METHODS This cross-sectional validity study was conducted in 2013 at an eye hospital in Spain. A tabletop autorefractor (test 1) was used to measure the refractive status of the anterior surface of the cornea at two corneal meridians of each eye. Then corneal topography (test 2) and Bogan's classification was used to group eyes into those with regular or no astigmatism (GRI) and irregular astigmatism (GRII). Test 1 provided a single absolute value for the greatest cylinder difference (Vr). The receiver operating characteristic (ROC) were plotted for the Vr values measured by test 1 for GRI and GRII eyes. On the basis a Vr value of 1.25 D as cut off, sensitivity, specificity were also calculated. RESULTS The study sample was comprised of 260 eyes (135 patients). The prevalence of irregular astigmatism was 42% [95% confidence interval (CI): 36, 48]. Based on test 2, there were 151 eyes in GRI and 109 eyes in GRII. The median Vr was 0.75 D (25% quartile, 0.5 D) for GRI and 1.75 D (25% quartile, 1.25 D) for GRII. The area under curve was 0.171 for GRI and 0.83 for GRII. The sensitivity of test I was 78.1% and the specificity was 76.1%. CONCLUSION A conventional autorefractor can be effective as a first level screening method to detect irregular corneal astigmatism in places where corneal topography facilities are not available.
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Affiliation(s)
- Alicia Galindo-Ferreiro
- King Khaled Eye Specialist Hospital, Riyadh 12329, Saudi Arabia.,Department of Ophthalmology, Río-Hortega University Hospital, Valladolid 47012, Spain
| | | | | | | | - Rajiv Khandekar
- King Khaled Eye Specialist Hospital, Riyadh 12329, Saudi Arabia
| | - Silvana Schellini
- King Khaled Eye Specialist Hospital, Riyadh 12329, Saudi Arabia.,Faculdade de Medicina de Botucatu, State University of São Paulo, UNESP 18618687, Brazil
| | - Julio Galindo-Alonso
- Department of Ophthalmology, Río-Hortega University Hospital, Valladolid 47012, Spain.,Galindo Clinic, Valladolid 47003, Spain
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Comparison of Corneal Power and Astigmatism between Simulated Keratometry, True Net Power, and Total Corneal Refractive Power before and after SMILE Surgery. J Ophthalmol 2017; 2017:9659481. [PMID: 28421140 PMCID: PMC5381197 DOI: 10.1155/2017/9659481] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 02/16/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose. To compare the mean corneal power (Km) and total astigmatism (Ka) estimated by three methods: simulated keratometry (simK), true net power (TNP), and total corneal refractive power (TCRP) before and after femtosecond laser small incision lenticule extraction (SMILE) surgery. Methods. A retrospective, cross-sectional study. SimK, TNP, and TCRP from a Scheimpflug analyzer were obtained from 144 patients before and 6 months after SMILE surgery. Km and Ka were recorded as the mean of individual paracentral rings of 1.0 to 8.0 mm (R1 to R8). The surgically induced changes in Km (delta-simK, delta-TNP, and delta-TCRP) and Ka (delta-simKa, delta-TNPa, and delta-TCRPa) were compared to the changes in spherical equivalent of the cycloplegic refraction (delta-SE) and astigmatism (delta-RA). Results. Preoperatively, astigmatism values were greatest with simKa from R1 to R5 and greatest with TCRPa from R6 to R8. Astigmatism values were smallest with TNPa from R1 to R7. Postoperatively, astigmatism values were greatest with simKa from R1 to R5 and greatest with TCRPa from R6 to R8. Delta-TCRP3 and Delta-TCRP4 matched delta-SE most closely, and delta-TCRPa3 matched delta-RA most closely. Conclusions. TCRP proved to be the most accurate method in estimating corneal power and astigmatism both before and after SMILE surgery.
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Zhou W, Stojanovic A, Utheim TP. Assessment of refractive astigmatism and simulated therapeutic refractive surgery strategies in coma-like-aberrations-dominant corneal optics. EYE AND VISION 2016; 3:13. [PMID: 27175371 PMCID: PMC4864917 DOI: 10.1186/s40662-016-0044-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 04/21/2016] [Indexed: 12/03/2022]
Abstract
Background The aim of the study is to raise the awareness of the influence of coma-like higher-order aberrations (HOAs) on power and orientation of refractive astigmatism (RA) and to explore how to account for that influence in the planning of topography-guided refractive surgery in eyes with coma-like-aberrations-dominant corneal optics. Methods Eleven eyes with coma-like-aberrations-dominant corneal optics and with low lenticular astigmatism (LA) were selected for astigmatism analysis and for treatment simulations with topography-guided custom ablation. Vector analysis was used to evaluate the contribution of coma-like corneal HOAs to RA. Two different strategies were used for simulated treatments aiming to regularize irregular corneal optics: With both strategies correction of anterior corneal surface irregularities (corneal HOAs) were intended. Correction of total corneal astigmatism (TCA) and RA was intended as well with strategies 1 and 2, respectively. Results Axis of discrepant astigmatism (RA minus TCA minus LA) correlated strongly with axis of coma. Vertical coma influenced RA by canceling the effect of the with-the-rule astigmatism and increasing the effect of the against-the-rule astigmatism. After simulated correction of anterior corneal HOAs along with TCA and RA (strategies 1 and 2), only a small amount of anterior corneal astigmatism (ACA) and no TCA remained after strategy 1, while considerable amount of ACA and TCA remained after strategy 2. Conclusions Coma-like corneal aberrations seem to contribute a considerable astigmatic component to RA in eyes with coma-like-aberrations dominant corneal optics. If topography-guided ablation is programmed to correct the corneal HOAs and RA, the astigmatic component caused by the coma-like corneal HOAs will be treated twice and will result in induced astigmatism. Disregarding RA and treating TCA along with the corneal HOAs is recommended instead.
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Affiliation(s)
- Wen Zhou
- SynsLaser Kirurgi AS, Tromsø, Troms Norway ; School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Aleksandar Stojanovic
- SynsLaser Kirurgi AS, Tromsø, Troms Norway ; Eye Department, University Hospital North Norway, Tromsø, Norway
| | - Tor Paaske Utheim
- Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway ; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway ; Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Cavas-Martínez F, De la Cruz Sánchez E, Nieto Martínez J, Fernández Cañavate FJ, Fernández-Pacheco DG. Corneal topography in keratoconus: state of the art. EYE AND VISION 2016; 3:5. [PMID: 26904709 PMCID: PMC4762162 DOI: 10.1186/s40662-016-0036-8] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 02/14/2016] [Indexed: 11/12/2022]
Abstract
The morphological characterization of the cornea using corneal topographers is a widespread clinical practice that is essential for the diagnosis of keratoconus. The current state of this non-invasive exploratory technique has evolved with the possibility of achieving a great number of measuring points of both anterior and posterior corneal surfaces, which is possible due to the development of new and advanced measurement devices. All these data are later used to extract a series of topographic valuation indices that permit to offer the most exact and reliable clinical diagnosis. This paper describes the technologies in which current corneal topographers are based on, being possible to define the main morphological characteristics that the keratoconus pathology produces on corneal surface. Finally, the main valuation indices, which are provided by the corneal topographers and used for the diagnosis of keratoconus, are also defined.
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Affiliation(s)
- F Cavas-Martínez
- Department of Graphical Expression, Technical University of Cartagena, C/Doctor Fleming s/n, Cartagena, 30202, Murcia Spain
| | - E De la Cruz Sánchez
- Faculty of Sports Science, C/ Santa Alicia s/n, Santiago de la Ribera, 30720 Murcia, Spain
| | - J Nieto Martínez
- Department of Graphical Expression, Technical University of Cartagena, C/Doctor Fleming s/n, Cartagena, 30202, Murcia Spain
| | - F J Fernández Cañavate
- Department of Graphical Expression, Technical University of Cartagena, C/Doctor Fleming s/n, Cartagena, 30202, Murcia Spain
| | - D G Fernández-Pacheco
- Department of Graphical Expression, Technical University of Cartagena, C/Doctor Fleming s/n, Cartagena, 30202, Murcia Spain
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