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Zhao F, Yin Y, Pazo EE, Tian F, Jiang Y, Bu S. The Influence of Corneal Thickness on Surgically Induced Corneal Astigmatism Derived from Total Keratometry Measured by Anterior Segment Swept-Source OCT. Ophthalmol Ther 2024:10.1007/s40123-024-00996-x. [PMID: 39020238 DOI: 10.1007/s40123-024-00996-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 07/02/2024] [Indexed: 07/19/2024] Open
Abstract
INTRODUCTION The purpose of the study was to explore the possible correlations between the anterior segment parameters derived from anterior segment swept-source optical coherence tomography (AS-SS-OCT) with the surgically induced corneal astigmatism (CSIA) calculated from total keratometry (TK) measured by AS-SS-OCT. METHODS Seventy-one eyes of 67 patients with age-related cataract who underwent phacoemulsification combined with intraocular lens implantation with 2.2-mm incision were included. The CSIA values were calculated from anterior keratometry (CSIAKant) and TK (CSIATK) measured by AS-SS-OCT, respectively. Hotelling's T2 test was used to evaluate the difference. The correlation of CSIA with various parameters derived from AS-SS-OCT was tested with the Spearman correlation coefficient. RESULTS The centroid of CSIAKant and of CSIATK were 0.31 ± 0.55 D @ 54° and 0.41 ± 0.59 D @ 51°, with no significant difference (F = 1.283, p = 0.281, Hotelling's T2). The mean absolute CSIAKant and CSIATK were 0.58 ± 0.24 D and 0.65 ± 0.28 D. Spearman test showed that the magnitude of CSIAKant was negatively correlated with preoperative peripheral corneal thickness (PCT, p = 0.045) and the magnitude of anterior keratometry (p = 0.044). The magnitude of CSIATK was negatively correlated with preoperative central corneal thickness (CCT, p = 0.003) and preoperative PCT (p = 0.015). CONCLUSIONS The increased thickness of the peripheral cornea is correlated with the decrease in the magnitude of the CSIA. The correlation we identified between the corneal thickness and the CSIA indicated that certain preoperative parameters should be considered for the prediction of CSIA for a more precise refractive outcome.
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Affiliation(s)
- FangYu Zhao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, 300384, China
| | - Yufan Yin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, 300384, China
| | - Emmanuel Eric Pazo
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, 300384, China
| | - Fang Tian
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, 300384, China
| | - Yuanfeng Jiang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, 300384, China.
| | - Shaochong Bu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, 300384, China.
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Chen L, Chen X, Li F, Liu Z. Refractive surprise of irregular astigmatism following cataract surgery in two patients with neglected subclinical corneal ectasia: two case reports. BMC Ophthalmol 2023; 23:239. [PMID: 37248492 DOI: 10.1186/s12886-023-02984-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 05/22/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Corneal ectatic diseases are a group of corneal disorder characterized by the steepening and thinning of the cornea. Older people are not a high-risk population for corneal ectatic diseases; due to the lack of typical preoperative topographic manifestations, there is a high possibility that corneal ectasia is undetected. CASE PRESENTATION Two patients with subclinical corneal ectasia and senile cataracts presented with irregular astigmatism after steep-axis incision during cataract surgery. The two cases presented in this case report are rare because both patients experienced tremendous changes in astigmatism after cataract surgery. CONCLUSION This case report may shed some light on astigmatism-correcting steep-axis incisions in cataract surgeries.
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Affiliation(s)
- Leran Chen
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, 100191, China
| | - Xiaoyong Chen
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, 100191, China
| | - Fanshu Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, 100191, China
| | - Ziyuan Liu
- Department of Ophthalmology, Peking University Third Hospital, Beijing key laboratory of restoration of damaged ocular nerve, Beijing, 100191, China.
- Peking University Institute of Laser Medicine, Beijing, China.
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Ding N, Song X, Wang X, Wei W. Comparison of Visual Outcomes Between Toric Intraocular Lenses and Clear Corneal Incisions to Correct Astigmatism in Image–Guided Cataract Surgery. Front Med (Lausanne) 2022; 9:837800. [PMID: 35445047 PMCID: PMC9013847 DOI: 10.3389/fmed.2022.837800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeTo compare the astigmatism correction effects of toric intraocular lenses (IOL) and clear corneal incisions during image-guided cataract surgery.MethodsAll patients with regular corneal astigmatism of 0.75–1.5 D underwent cataract surgery and astigmatism correction using the Callisto eye image-guided system. One group had implantation of an AcrySof toric IOL. Another group had implantation of aspheric IOL with 3.0 mm single clear corneal incision (SCCI) on the steep axis. Uncorrected and best-corrected spectacle visual acuity, refraction, and toric IOL axis were evaluated at 1, 4, and 12 weeks postoperatively.ResultsSixty-eight eyes of 68 patients were included. The mean residual refractive cylinder was 0.34 ± 0.40 D in the toric group and 0.64 ± 0.57 D in the SCCI group. There were no significant differences in residual refractive cylinder, spherical equivalent, uncorrected distance visual acuity (UDVA), and best-corrected spectacle visual acuity (BCSVA) between groups. The percentage of the residual cylinder within ± 0.50 D was 75 and 56% for toric and SCCI cases, respectively (p > 0.1). The mean surgical induced astigmatism vector was 0.61 ± 0.29 D in the SCCI group and 1.04 ± 0.38 D in the toric group. The mean magnitude of error was negative (−0.54 ± 0.48 D) and the correction index was <1.0 (p < 0.05) in SCCI group. At 3 months, all toric IOL alignment errors were within 5 degrees from the intended axis.ConclusionsBoth toric IOL and SCCI can correct low and medium astigmatism effectively with the help of a precise image-guided system.
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Fernández J, Rodríguez-Vallejo M, Rocha-de-Lossada C, Hueso E, Piñero D. Toric Intraocular Lens Calculation Considering Anterior Surgically Induced Astigmatism and Posterior Corneal Astigmatism. Curr Eye Res 2021; 47:25-31. [PMID: 34166169 DOI: 10.1080/02713683.2021.1948064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: To evaluate the prediction error (PE) after applying the Abulafia-Koch formula in an online calculator with and without consideration of anterior corneal surgically induced astigmatism (SIACornea).Methods: SIACornea models were calculated with a historical database of 204 right eyes (REs) from a single surgeon, either for manual (2.2 mm) or femtosecond (2.5 mm) temporal clear corneal incisions. PE was assessed in 58 REs operated by the same surgeon with a monofocal toric IOL and calculated, considering the PCA estimation in an online calculator with the combination of each one of the following SIACornea calculation approaches: (A) considering only significant centroids after stratification, (B) all centroids after stratification and (C) a single centroid without stratification.Results: The consideration of all centroids resulted in an underestimation of SIACornea in cases of preoperative against-the-rule astigmatism (ATR-A) and an overestimation in with-the-rule astigmatism (WTR-A). After stratification, SIACornea was only significant in preoperative ATR and oblique astigmatism cases for femtosecond incisions. PE considering PCA only was 0.03@160º. The combination with SIACornea resulted in a WTR-A surprise in preoperative ATR-A and WTR-A, however only being significant for preoperative ATR-A in calculation approaches B (0.29@84º) and C (0.21@80º). SIACornea addition to PCA estimation only reduced the centroid for oblique preoperative astigmatism.Conclusions: Surgeons should consider the calculation of the SIACornea after stratification by astigmatism type when using the same incision location (i.e. temporal). However, SIACornea derived from the anterior corneal surface should not be combined with PCA estimation for IOL power calculations.
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Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision), VITHAS Hospital, Almería, Spain
| | | | - Carlos Rocha-de-Lossada
- Department of Ophthalmology (Qvision), VITHAS Hospital, Almería, Spain.,Department of Ophthalmology, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Elisa Hueso
- Department of Ophthalmology (Qvision), VITHAS Hospital, Almería, Spain
| | - David Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante, Spain
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Lian H, Ma W, Wei Q, Yuan X. A comparative study on early vision quality after implantation of refractive segmental and diffractive multifocal intraocular lens. Pak J Med Sci 2020; 36:1607-1612. [PMID: 33235583 PMCID: PMC7674866 DOI: 10.12669/pjms.36.7.3364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Objectives: To compare early subjective and objective vision quality of postoperative patients undergoing phacoemulsification cataract surgery combined with implantation of refractive segmental multifocal intraocular lens (MIOL) SBL-3 and apodized diffractive MIOL SN6AD1. Methods: As a prospective study, it enrolled 53 patients (53 eyes) to undergo phacoemulsification cataract surgery combined with MIOL implantation. According to differences in MIOL implanted, patients were divided into a SBL-3 group (25 eyes) and a SN6AD1 group (28 eyes). Ophthalmological evaluation included uncorrected (UDVA) and corrected (CDVA) distance visual acuities, uncorrected intermediate (UIVA) and near (UNVA) visual acuities, distance-corrected intermediate (DCIVA) and near (DCNVA)visual acuities and corrected near(CNVA) visual acuity, contrast sensitivity, modulation transfer function (MTF) and high order aberration (4 mm pupil diameter) at three months postoperatively. Moreover, a questionnaire survey was carried out to assess near spectacle independence, patient satisfaction and symptoms of visual disturbance. Results: At three months after surgery, UIVA and UNVA in the SBL-3 group are statistically significantly superior to those of the SN6AD1 group (P>0.05). There was statistical difference in contrast sensitivity at four spatial frequencies (3, 6, 12, 18cycles/degree) under mesopic conditions and mesopic conditions with glare (P>0.05). The total ocular high order aberration, coma and trefoil were statistically significantly larger in the SBL-3 group than in the SN6AD1 group with 4.0 mm pupil diameters (P>0.05). Statistical differences were found in the MTF at spatial frequencies of 5, 10 and 15 cycles/degree between the groups. There were no significant differences in spectacle independence, patient satisfaction and visual disturbance between the groups (P>0.05). Conclusions: Both the two multifocal intraocular lens provided an excellent level of quality of vision three months postoperatively. However, the application effect of SBL-3 MIOL is superior to that of SN6AD1 MIOL as far as intermediate vision, near vision and contrast sensitivity are concerned.
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Affiliation(s)
- Huifang Lian
- Huifang Lian, Department of Ophthalmology, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, P.R. China. Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin, 300020, P.R. China, Baoding First Central Hospital, Hebei, Baoding 071000, P. R. China
| | - Weisong Ma
- Weisong Ma, Department of Orthopaedics, Baoding First Central Hospital, Hebei, Baoding First Central Hospital, Hebei, Baoding 071000, P. R. China
| | - Qiuhong Wei
- Qiuhong Wei, Department of Ophthalmology, Baoding First Central Hospital, Hebei, Baoding 071000, P. R. China
| | - Xiaoyong Yuan
- Xiaoyong Yuan, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, P.R. China. Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin, 300020, P.R. China
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Analysis of the Effect of Intraocular Lens Implantation on Retinal Nerve and Postoperative Nursing Outcome Based on Ultrasound Imaging. World Neurosurg 2020; 149:444-452. [PMID: 33217596 DOI: 10.1016/j.wneu.2020.11.052] [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: 09/28/2020] [Revised: 11/07/2020] [Accepted: 11/09/2020] [Indexed: 11/23/2022]
Abstract
Traumatic cataract is a common complication of ocular contusion. Caused by various forms of trauma, the course and prognosis of traumatic cataract are also different. Intraocular lens (IOL) implantation is the most effective treatment at the present time and can provide good visual quality and near, medium, and far vision. In this study, an adaptive medical ultrasound image denoising algorithm was constructed based on the biological vision mechanism and was applied to observe IOL implantation and postoperative care of 30 patients with traumatic cataract. Results showed that eyesight could be restored to the original healthy state after IOL implantation, and eyesight was close to normal 3 months after surgery. The corresponding noise pixel block of the noise reduction algorithm was obviously the lowest. A total of 30 patients (9 patients with contusion, 13 patients with intraocular foreign body, and 8 patients with perforation) were treated with aspheric and multifocal IOL to achieve the expected outcome. The noise reduction algorithm constructed in this study effectively reduced the speckle noise of ultrasound images, improved the clarity of ultrasound images, and achieved the effective observation of medical nursing outcome after traumatic cataract IOL implantation. After IOL implantation, the retinal nerves of patients with traumatic cataract were affected to different degrees.
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Wallace HB, Misra SL, Li SS, McKelvie J. Biomechanical changes in the cornea following cataract surgery: A prospective assessment with the Corneal Visualisation Scheimpflug Technology. Clin Exp Ophthalmol 2019; 47:461-468. [PMID: 30474314 DOI: 10.1111/ceo.13451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/02/2018] [Accepted: 11/09/2018] [Indexed: 01/26/2023]
Abstract
IMPORTANCE Intraocular pressure (IOP) is often reduced following cataract surgery. Postoperative changes in corneal stiffness are likely to be at least partly responsible for any reduction in IOP measured with applanation tonometry. BACKGROUND To determine the effect of cataract surgery and corneal incision size on corneal biomechanics. DESIGN Prospective randomized trial. PARTICIPANTS One hundred prospectively enrolled patients qualifying for cataract surgery. METHODS Participants were randomized to clear corneal incisions with a 2.20 or 2.85 mm keratome. Corneal Visualisation Scheimpflug Technology (Corvis-ST) tonometry and dynamic corneal response measurements were obtained preoperatively, and 3 mo postoperatively. Multiple regression analysis was completed using R software. MAIN OUTCOME MEASURES Corvis-ST biomechanical parameters. RESULTS Ninety-three eyes of 93 patients were included in the final analysis. Mean Corvis-ST biomechanically corrected IOP decreased by 3.63 mmHg postoperatively (95% confidence interval = 2.97-4.35, P ≤ 0.01), and central pachymetry increased by 6.96 μm (4.33-9.59, P ≤ 0.01). Independent of IOP and pachymetry changes, mean (±SE) corneal first applanation stiffness parameter reduced by 9.761 ± 3.729 (P = 0.01) postoperatively. First applanation velocity increased by 0.007 ± 0.002 ms, second applanation velocity increased by 0.012 ± 0.004 ms (P ≤ 0.01), the first applanation deformation amplitude increased by 0.008 ± 0.002 mm (P ≤ 0.01) and the deflection amplitude at highest concavity increased by 0.030 ± 0.069 (P ≤ 0.01). There were no significant differences between different incision size groups. CONCLUSIONS AND RELEVANCE Corneal stiffness is reduced 3 mo following cataract surgery and is associated with falsely low IOP measurements. This finding may be important for glaucoma patients and in particular when assessing the effectivity of minimally invasive glaucoma surgery devices.
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Affiliation(s)
- Henry B Wallace
- Department of Ophthalmology, Faculty of Medical and Health Sciences, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
| | - Stuti L Misra
- Department of Ophthalmology, Faculty of Medical and Health Sciences, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
| | - Sunny S Li
- Department of Ophthalmology, Faculty of Medical and Health Sciences, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
| | - James McKelvie
- Department of Ophthalmology, Faculty of Medical and Health Sciences, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
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Ferreira TB, Ribeiro FJ, Pinheiro J, Ribeiro P, O'Neill JG. Comparison of Surgically Induced Astigmatism and Morphologic Features Resulting From Femtosecond Laser and Manual Clear Corneal Incisions for Cataract Surgery. J Refract Surg 2018; 34:322-329. [PMID: 29738588 DOI: 10.3928/1081597x-20180301-01] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 02/16/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the surgically induced astigmatism (SIA) vector, flattening effect, torque, and wound architecture following femtosecond laser and manual clear corneal incisions (CCIs). METHODS In a double-armed, randomized, prospective case series, cataract surgery was performed for 600 eyes using femtosecond laser (300 eyes) or manual (300 eyes) 2.4-mm CCIs in temporal or superior oblique locations. SIA, flattening effect, torque, and the summated vector mean for SIA were calculated. Correlation with individual features was established and incision morphology was investigated by anterior segment optical coherence tomography at 3 months of follow-up. RESULTS The SIA, flattening effect, and torque were lower in the femtosecond laser group for both incision locations, although the differences were not significant (all P > .05). The femtosecond laser group showed less dispersion of SIA magnitude and flattening effect. Temporal and superior oblique incisions resulted in flattening effect values of -0.11 and -0.21 diopters (D), respectively, in the femtosecond laser group and -0.13 and -0.34 D, respectively, in the manual group. Significant correlations with individual features were only found in the femtosecond laser group, with preoperative astigmatism being the only significant SIA predictor by multiple regression analysis (P = .003). Femtosecond laser CCIs showed less deviation from the intended length, wound enlargement, endothelial misalignment, and Descemet membrane detachments (all P < .037). CONCLUSIONS Femtosecond laser CCIs were more reproducible. Although SIAs were smaller in femtosecond laser CCIs than in manual CCIs for both temporal and superior oblique incisions, the difference was not statistically significant. Association with individual features is highly variable. [J Refract Surg. 2018;34(5):322-329.].
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Garzón N, Rodríguez-Vallejo M, Carmona D, Calvo-Sanz JA, Poyales F, Palomino C, Zato-Gómez de Liaño MÁ, Fernández J. Comparing surgically induced astigmatism calculated by means of simulated keratometry versus total corneal refractive power. Eur J Ophthalmol 2018; 28:573-581. [DOI: 10.1177/1120672118757666] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To evaluate surgically induced astigmatism as computed by means of either simulated keratometry (KSIM) or total corneal refractive power (TCRP) after temporal incisions. Methods: Prospective observational study including 36 right eyes undergoing cataract surgery. Astigmatism was measured preoperatively during the 3-month follow-up period using Pentacam. Surgically induced astigmatism was computed considering anterior corneal surface astigmatism at 3 mm with KSIM and considering both corneal surfaces with TCRP from 1 to 8 mm (TCRP3 for 3 mm). The eyes under study were divided into two balanced groups: LOW with KSIM astigmatism <0.90 D and HIGH with KSIM astigmatism ≥0.90 D. Resulting surgically induced astigmatism values were compared across groups and measuring techniques by means of flattening, steepening, and torque analysis. Results: Mean surgically induced astigmatism was higher in the HIGH group (0.31 D @ 102°) than in the LOW group (0.04 D @ 16°). The temporal incision resulted in a steepening in the HIGH group of 0.15 D @ 90°, as estimated with KSIM, versus 0.28 D @ 90° with TCRP3, but no significant differences were found for the steepening in the LOW group or for the torque in either group. Differences between KSIM- and TCRP3-based surgically induced astigmatism values were negligible in LOW group. Conclusion: Surgically induced astigmatism was considerably higher in the high-astigmatism group and its value was underestimated with the KSIM approach. Eyes having low astigmatism should not be included for computing the surgically induced astigmatism because steepening would be underestimated.
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Affiliation(s)
| | | | - David Carmona
- Hospital Universitario Quironsalud Madrid, Madrid, Spain
| | | | | | | | | | - Joaquín Fernández
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería, Spain
- Department of Ophthalmology, Torrecárdenas Hospital Complex, Almería, Spain
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Fernández J, Rodríguez-Vallejo M, Martínez J, Tauste A, Piñero DP. Prediction of surgically induced astigmatism in manual and femtosecond laser-assisted clear corneal incisions. Eur J Ophthalmol 2018; 28:398-405. [DOI: 10.1177/1120672117747017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: To assess the surgically induced astigmatism with femtosecond laser-assisted and manual temporal clear corneal incisions and to evaluate the performance of a model for prediction of the surgically induced astigmatism based on the preoperative corneal astigmatism. Methods: Clinical data of 104 right eyes and 104 left eyes undergoing cataract surgery, 52 with manual incisions and 52 with femtosecond laser-assisted incisions in each eye group, were extracted and revised retrospectively. In all cases, manual incisions were 2.2 mm width and femtosecond incisions were 2.5 mm width, both at temporal location. A predictive model of the surgically induced astigmatism was obtained by means of simple linear regression analyses. Results: Mean surgically induced astigmatisms for right eyes were 0.14D@65° (manual) and 0.24D@92° (femtosecond) (p > 0.05) and for left eyes, 0.15D@101° (manual) and 0.19D@104° (femtosecond) (p > 0.05). The orthogonal components of the surgically induced astigmatism (XSIA, YSIA) were significantly correlated (p < 0.05) with the preoperative orthogonal components of corneal astigmatism (Xpreop, Ypreop) (r = −0.29 for X and r = −0.1 for Y). The preoperative astigmatism explained 8% of the variability of the XSIA and 3% of the variability of YSIA. The postoperative corneal astigmatism prediction was not improved by the surgically induced astigmatism obtained from the model in comparison with the simple vector subtraction of the mean surgically induced astigmatism. Conclusion: Temporal incisions induce similar astigmatism either for manual or for femtosecond procedures. This can be clinically negligible for being considered for toric intraocular lens calculation due to the great standard deviation in comparison with the mean. The usefulness of the prediction model should be confirmed in patients with high preoperative corneal astigmatism.
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Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería, Spain
- Department of Ophthalmology, Torrecárdenas Hospital Complex, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería, Spain
| | - Ana Tauste
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante, Spain
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Reinstein DZ, Archer TJ, Srinivasan S, Mamalis N, Kohnen T, Dupps WJ, Randleman JB. Standard for Reporting Refractive Outcomes of Intraocular Lens-Based Refractive Surgery. J Refract Surg 2017; 33:218-222. [PMID: 28407160 DOI: 10.3928/1081597x-20170302-01] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Park DY, Lim DH, Hwang S, Hyun J, Chung TY. Comparison of astigmatism prediction error taken with the Pentacam measurements, Baylor nomogram, and Barrett formula for toric intraocular lens implantation. BMC Ophthalmol 2017; 17:156. [PMID: 28836956 PMCID: PMC5571625 DOI: 10.1186/s12886-017-0550-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/16/2017] [Indexed: 12/02/2022] Open
Abstract
Background To evaluate and compare the astigmatism prediction errors taken with the Pentacam measurements, Baylor nomogram, and Barrett formula for toric intraocular lens (IOL) implantation. Methods Phacoemulsification with toric Precizon IOL implantation was performed in 41 eyes with corneal astigmatism (range, 1 to 5 diopters (D)) determined by IOLMaster and SimK on Pentacam. Preoperative corneal astigmatism measurements were obtained from IOLMaster readings (IOLMaster, Baylor-IOLMaster, and Barrett-IOLMaster) and Pentacam readings (SimK, Baylor-SimK, Barrett-SimK, wavefront, true net power, total corneal refractive power, and vector derived by manual vector summation using corneal front and back astigmatism). Prediction error and intraclass correlation coefficient (ICC) between the measured (or calculated) astigmatism by IOLMaster and Pentacam and the estimated corneal astigmatism estimated by IOL toricity power and residual astigmatism were determined. Results The centroid errors in prediction error with IOLMaster, SimK, Baylor-IOLMaster, Baylor-SimK, Barrett-IOLMaster, Barrett-SimK, wavefront, true net power, total corneal refractive power, and vector were 0.59@103, 0.61 @103, 0.37@161, 0.41@162, 0.24@171, 0.36@162, 0.42@106, 0.04@8, 0.07@82, and 0.03@82, respectively, in with-the-rule (WTR) astigmatism eyes at postoperative 3-month. They were 0.22@87, 0.20@74, 0.16@21, 0.54@10, 0.43@3, 0.33@19, 0.51@25, 0.31@58, 0.29@50, and 0.14@50 in against-the-rule (ATR) astigmatism eyes. Of the ten modalities, vector showed the lowest WTR astigmatism prediction error and the highest ICC between the predicted and the estimated corneal astigmatism for both WTR and ATR eyes. Conclusion Vector summation using anterior and posterior corneal surface power taken with the Pentacam yields the least astigmatism prediction error and is a promising tool for determining toric IOL cylinder power.
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Affiliation(s)
- Dae-Young Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.,Department of Preventive Medicine, Graduate School, The Catholic University of Korea, Seoul, South Korea
| | - Sungsoon Hwang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Joo Hyun
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.,Department of Ophthalmology, Saevit Eye Hospital, Goyang, South Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
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Reinstein DZ, Archer TJ, Srinivasan S, Mamalis N, Kohnen T, Dupps WJ, Randleman BJ. Standard for reporting refractive outcomes of intraocular lens–based refractive surgery. J Cataract Refract Surg 2017; 43:435-439. [DOI: 10.1016/j.jcrs.2017.04.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zhao Y, Li J, Yang K, Li X, Zhu S. Combined Special Capsular Tension Ring and Toric IOL Implantation for Management of Astigmatism and High Axial Myopia with Cataracts. Semin Ophthalmol 2016; 33:389-394. [PMID: 28005433 DOI: 10.1080/08820538.2016.1247181] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Yang Zhao
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jiaxin Li
- Medical School, Pingdingshan University, Pingdingshan, China
| | - Ke Yang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiao Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Siquan Zhu
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Choi EY, Kang HG, Kim TI, Kim EK, Lee HK. Effect of postoperative administration of nonsteroidal antiinflammatory drugs and steroids on the conformational changes in wound healing after cataract surgery. J Cataract Refract Surg 2016; 42:1804-1813. [DOI: 10.1016/j.jcrs.2016.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 09/22/2016] [Accepted: 10/05/2016] [Indexed: 11/25/2022]
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Czajka MP, Frajdenberg A, Johansson B. Comparison of 1.8-mm incision versus 2.75-mm incision cataract surgery in combined phacoemulsification and 23-gauge vitrectomy. Acta Ophthalmol 2016; 94:507-13. [PMID: 27009675 DOI: 10.1111/aos.12998] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 12/31/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare 1.8 mm micro-incision and 2.75 mm standard incision in coaxial cataract surgery combined with 23-Gauge (23G) vitrectomy with respect to intraoperative and postoperative complications and outcomes. METHODS In this prospective study 30 eyes of 30 patients planned for combined phacoemulsification and 23G vitrectomy were enrolled, and randomized to undergo either Standard 2.75 mm Incision Cataract Surgery (SICS, 15 eyes) or Coaxial 1.8 mm Micro-Incision Cataract Surgery (C-MICS, 15 eyes) followed by vitrectomy. Inclusion criteria were cataract and macular disorders including macular hole, epiretinal membrane and vitreomacular traction. Data were collected at preoperative evaluation and 1 and 12 months or more after surgery. RESULTS Incision leakage occurred in two eyes (7%: one per group), retinal break in nine (30%: four in C-MICS, five in SICS). Fibrin in anterior chamber (AC) occurred day 1 in three eyes (10%: two C- and one SICS). Posterior capsule opacification developed in 22 eyes (78%: 13 MICS, nine SICS, p = 0.1). A myopic shift of -0.63 ± 0.7 was noted (-0.59 ± 0.8 MICS, -0.68 ± 0.6 SICS, p = 0.74). Surgically induced astigmatism (SIA) was significantly smaller in C-MICS group (ΔKP, -0.019 ± 0.095 versus -0.141 ± 0.219, p = 0.0038) at 1 month but not at final follow-up (ΔKP, 0.0005 ± 0.16 in C-MICS versus -0.057 ± 0.12, p = 0.3 CONCLUSIONS: Both techniques were equally safe with respect to intraoperative and postoperative findings. Coaxial micro-incision cataract surgery (C-MICS) was associated with less surgically-induced astigmatism (SIA) 1 month after surgery but differences were not statistically significant at final follow-up indicating a faster refractive recovery with C-MICS than with SICS.
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Affiliation(s)
- Marcin Piotr Czajka
- Departments of Ophthalmology, Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Agata Frajdenberg
- Departments of Ophthalmology, Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Björn Johansson
- Departments of Ophthalmology, Clinical and Experimental Medicine; Linköping University; Linköping Sweden
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Abstract
PURPOSE OF REVIEW This article reviews current concepts in intraocular lens alignment strategies to maximize intraocular lens (IOL) positioning. RECENT FINDINGS A variety of strategies has been developed to maximize toric IOL position, including preoperative calculators to determine the appropriate IOL power and orientation, intraoperative alignment devices, and postoperative software to determine if IOL rotation would be beneficial for refractive outcomes. SUMMARY The combination of using multiple toric IOL calculators and intraoperative alignment devices has improved toric IOL outcomes. The relationship of the posterior corneal power and its effect on outcomes remains to be fully elucidated. Postoperative IOL rotation may be necessary even when the IOL is aligned as planned because of surgically induced astigmatism.
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Coaxial Microincision Cataract Surgery versus Standard Coaxial Small-Incision Cataract Surgery: A Meta-Analysis of Randomized Controlled Trials. PLoS One 2016; 11:e0146676. [PMID: 26745279 PMCID: PMC4706354 DOI: 10.1371/journal.pone.0146676] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 12/20/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND We conducted this meta-analysis to compare the outcomes of coaxial microincision cataract surgery (C-MICS) and standard coaxial small incision cataract surgery (C-SICS). METHODS The outcomes of randomized controlled trials (RCTs) reporting C-MICS and C-SICS were collected from PubMed, Web of Science, and The Cochrane Library in May 2015. The final meta-analysis was conducted on the following intraoperative and postoperative outcomes: ultrasound time (UST), effective phacoemulsification time (EPT), balanced salt solution use (BSS use), cumulative dissipated energy (CDE), mean surgery time, endothelial cell loss percentage (ECL%), best corrected visual acuity (BCVA), increased central corneal thickness (CCT), laser flare photometry values and surgically induced astigmatism (SIA). RESULTS A total of 15 RCTs, involving 1136 eyes, were included in the final meta-analysis. No significant between-group differences were detected in EPT, BSS use, CDE, BCVA, laser flare photometry values or increased CCT. However, the C-MICS group showed less SIA (at postoperative day 7: p<0.01; at postoperative day 30 or more: p<0.01) and greater ECL% (at postoperative day 60 or more: p<0.01), whereas the C-SICS group required a shorter UST (p<0.01). CONCLUSIONS The present meta-analysis suggested that the C-MICS technique was more advantageous than C-SICS in terms of SIA, but C-MICS required a longer UST and induced a higher ECL%. Further studies should be done to confirm our results.
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