Management of Cataract in Patients with Irregular Astigmatism with Regular Central Component by Phacoemulsification Combined with Toric Intraocular Lens Implantation

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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Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

10.21203/rs.3.rs-54189/v1 ◽

2020 ◽

Author(s):

Da young Shin ◽

Ho Sik Hwang ◽

Hyun Seung Kim ◽

Man Soo Kim ◽

Eun Chul Kim

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Corneal Astigmatism ◽

Spherical Equivalent ◽

Toric Intraocular Lens ◽

Toric Iol ◽

Iol Implantation ◽

Monofocal Iol ◽

Target Refraction ◽

Better Than

Abstract Background: To analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is determined -3 diopter (D) in cataract patients with corneal astigmatism >1.5 diopters (D).Methods: We performed a retrospective chart review for patients with corneal astigmatism >1.5D who underwent cataract surgery and their target refraction is determined -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery.Results: The near UCVA of the toric IOL group (0.26±0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48±0.32) (p=0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). There were no significant intergroup differences in postoperative best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465). In the toric IOL group, postoperative refractive astigmatism was -0.80 ± 0.46D and postoperative corneal astigmatism was -1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were -1.65 ± 0.77D and -1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). Conclusions: When myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.

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Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

10.21203/rs.3.rs-54189/v2 ◽

2020 ◽

Author(s):

Da young Shin ◽

Ho Sik Hwang ◽

Hyun Seung Kim ◽

Man Soo Kim ◽

Eun Chul Kim

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Corneal Astigmatism ◽

Spherical Equivalent ◽

Toric Intraocular Lens ◽

Toric Iol ◽

Iol Implantation ◽

Monofocal Iol ◽

Target Refraction ◽

Better Than

Abstract Background: The aim of this study is to analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is determined -3 diopter (D) in cataract patients with corneal astigmatism >1.5 diopters (D).Methods: We performed a retrospective chart review for patients with corneal astigmatism >1.5D who underwent cataract surgery and their target refraction is determined -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery.Results: The near UCVA of the toric IOL group (0.26±0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48±0.32) (p=0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). There were no significant intergroup differences in postoperative best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465). In the toric IOL group, postoperative refractive astigmatism was -0.80 ± 0.46D and postoperative corneal astigmatism was -1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were -1.65 ± 0.77D and -1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). There were no postoperative complications and no adverse events were reported.Conclusions: When myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.

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Treatment of Stable Keratoconus by Cataract Surgery with Toric IOL Implantation

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1024 ◽

2012 ◽

Vol 1 (2) ◽

pp. 128-130

Author(s):

Tova Lifshitz ◽

Jaime Levy ◽

Anry Pitchkhadze

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraocular Lens ◽

Toric Intraocular Lens ◽

Toric Iol ◽

Iol Implantation ◽

Corrected Visual Acuity ◽

Uncorrected Visual Acuity ◽

Cylinder Power ◽

Best Corrected Visual Acuity

ABSTRACT We present the case of a 73-year-old patient who underwent successful phacoemulsification and toric intraocular lens (IOL) implantation to correct high stable astigmatism due to keratoconus and cataract. Preoperative refraction was −3.25 −4.0 × 98°. A toric IOL (Acrysof SN60T6) with a spherical power of 16.5 D and a cylinder power of 3.75 D at the IOL plane and 2.57 D at the corneal plane was implanted and aligned at an axis of 0°. Uncorrected visual acuity improved from 6/60 to 6/10. Postoperative best corrected visual acuity was 6/6, 6 months after the operation. In conclusion, phacoemulsification with toric IOL implantation can be performed in eyes with keratoconus and cataract. How to cite this article Levy J, Pitchkhadze A, Lifshitz T. Treatment of Stable Keratoconus by Cataract Surgery with Toric IOL Implantation. Int J Kerat Ect Cor Dis 2012;1(2):128-130.

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Rotational stability of modified toric intraocular lens

PLoS ONE ◽

10.1371/journal.pone.0247844 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0247844

Author(s):

Ryoko Osawa ◽

Tetsuro Oshika ◽

Masahiko Sano ◽

Takuma Yuguchi ◽

Tadayoshi Kaiya

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Corneal Astigmatism ◽

Rotational Stability ◽

Toric Intraocular Lens ◽

Toric Iol ◽

Iol Implantation ◽

Toric Iols ◽

Corrected Distance Visual Acuity ◽

One Way Anova

We evaluated the rotational stability of a new toric intraocular lens (IOL), HOYA XY-1 toric IOL that is an improved version of HOYA 355 toric IOL, with longer overall length (13.0 mm vs. 12.5 mm), shortened unfolding time, and texture processing of the surface of haptics. Data from 193 eyes of 165 patients (76.4 ± 8.3 years old) with preoperative corneal astigmatism exceeding 0.75 diopters who had undergone phacoemulsification and toric IOL implantation were collected and analyzed. Corneal astigmatism, refractive astigmatism, and uncorrected (UDVA) and corrected distance visual acuity (CDVA) were evaluated before and 1 day, 1 week, and 1 month after surgery. The degree of IOL decentration, IOL tilt, and toric axis misalignment was assessed at 1 day and 1 month postoperatively. Fifty eyes received AcrySof toric IOL, 51 eyes TECNIS toric IOL, 46 eyes HOYA 355 toric IOL, and 46 eyes HOYA XY-1 toric IOL. The amount of axis misalignment from the intended axis was significantly different among IOLs (p = 0.004, one-way ANOVA), and HOYA XY-1 showed significantly less amount of axis misalignment than TECNIS (p = 0.020, Tukey’s multiple comparison) and HOYA 355 (p = 0.010). The proportion of eyes that showed axis misalignment <10° at 1 month postoperatively was significantly higher with HOYA XY-1 toric IOL than with other toric IOLs (χ2 test, p = 0.020). HOYA XY-1 toric IOL, the modified version of HOYA 355 toric IOL, showed excellent rotational stability in comparison with other models of toric IOLs.

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Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

BMC Ophthalmology ◽

10.1186/s12886-021-01966-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Da Young Shin ◽

Ho Sik Hwang ◽

Hyun Seung Kim ◽

Man Soo Kim ◽

Eun Chul Kim

Keyword(s):

Visual Acuity ◽

Intraocular Lens ◽

Corneal Astigmatism ◽

Spherical Equivalent ◽

Toric Intraocular Lens ◽

Toric Iol ◽

Iol Implantation ◽

Monofocal Iol ◽

Target Refraction ◽

Better Than

Abstract Background The aim of this study is to analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is -3 diopter (D) in cataract patients with corneal astigmatism > 1.5 diopters (D). Methods We performed a retrospective chart review for patients with corneal astigmatism > 1.5D who underwent cataract surgery and their target refraction is -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery. Results The near UCVA of the toric IOL group (0.26 ± 0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48 ± 0.32) (p = 0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). Best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465) did not show significant differences between the toric IOL group and the monofocal IOL group. In the toric IOL group, postoperative refractive astigmatism was − 0.80 ± 0.46D and postoperative corneal astigmatism was − 1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were − 1.65 ± 0.77D and − 1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). There were no postoperative complications. Conclusions When myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.

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Comparison of Astigmatism Correction in Cataract Surgery Between Simultaneous Femtosecond Laser-Assisted Intrastromal Arcuate Keratotomy and Toric Intraocular Lens Implantation

10.21203/rs.3.rs-58747/v1 ◽

2020 ◽

Author(s):

Hye Ji Kwon ◽

Hun Lee ◽

Jin Ah Lee ◽

Jae Yong Kim ◽

Hungwon Tchah

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Intraocular Lens ◽

Tertiary Care ◽

Corneal Astigmatism ◽

Toric Intraocular Lens ◽

Toric Iol ◽

Iol Implantation ◽

Tertiary Care Medical Center ◽

Significant Difference

Abstract Objectives To compare the efficacy of astigmatic correction between simultaneous femtosecond laser-assisted intrastromal arcuate keratotomy (AK) combined with femtosecond laser-assisted cataract surgery (FLACS) and toric intraocular lens (IOL) implantation during cataract surgery in moderate astigmatism. Design: Retrospective observational study, tertiary care medical center Methods We retrospectively reviewed medical records of patients who underwent astigmatic correction via femtosecond laser-assisted intrastromal AK (AK group; 27 eyes of 27 patients) with FLACS or toric IOL implantation (toric IOL group; 21 eyes of 21 patients). All patients had senile cataracts with corneal astigmatism ranging from + 1.00 to + 2.00 diopters (D) before cataract surgery. We measured visual acuity, intraocular pressure, automated keratometry, manifest refraction and topography preoperatively and at 1-day, 1-month, 3-month, and 6-month postoperatively. Results Refractive astigmatism was significantly decreased in both groups. The mean preoperative and 6-month postoperative refractive astigmatism were 1.85 ± 1.07 and 0.99 ± 0.51 D, respectively, in the AK group (P = 0.028), and 1.84 ± 0.81 and 0.68 ± 0.21 D, respectively, in the toric IOL group (P < 0.001). There was no significant difference in refractive astigmatism between the two groups at 6-month postoperatively (0.99 ± 0.51 vs 0.68 ± 0.21 D, P = 0.057). At 6-month postoperatively, parameters for vector analysis of refractive astigmatism showed no statistical difference between the two groups. Corneal astigmatism was significantly decreased in the AK group. There was significant difference in corneal astigmatism from topography and automated keratometer between the two groups at 6-month postoperatively (0.94 ± 0.40 vs 1.53 ± 0.46 D, P = 0.018 for topography and 0.98 ± 0.69 vs 1.37 ± 0.41 D, P = 0.032 for automated keratometer). Conclusions Femtosecond laser-assisted intrastromal AK in FLACS could be an effective procedure for reducing astigmatism as well as toric IOL implantation in cataract surgery.

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Comparison of penetrating femtosecond laser-assisted astigmatic keratotomy and toric intraocular lens implantation for correction of astigmatism in cataract surgery

Scientific Reports ◽

10.1038/s41598-021-86763-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hoon Noh ◽

Young-Sik Yoo ◽

Kyoung Yoon Shin ◽

Dong Hui Lim ◽

Tae-Young Chung

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Intraocular Lens ◽

Safe Procedure ◽

Toric Intraocular Lens ◽

Toric Iol ◽

Iol Implantation ◽

Astigmatism Correction ◽

Correction Of Astigmatism ◽

Astigmatic Keratotomy

AbstractThis 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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Clinical Evaluation of Toric Intraocular Lens Implantation Based on iTrace Wavefront Keratometric Astigmatism

10.21203/rs.2.24137/v2 ◽

2020 ◽

Author(s):

Zhe Zhang ◽

Hui Li ◽

Jing Zhou ◽

Yaqin Zhang ◽

Suhua Zhang

Keyword(s):

Intraocular Lens ◽

Case Series ◽

Standard Technique ◽

Rotational Stability ◽

Toric Intraocular Lens ◽

Vector Method ◽

Toric Iol ◽

Iol Implantation ◽

Wavefront Aberrometry ◽

Prospective Case Series

Abstract Background: There was no standard technique for measuring corneal astigmatism. The iTrace wavefront aberrometry of cornea calculated steep power and axis based on the best Zernike mathematical fit from all topo data within 4 mm circle. It was supposed to be more accurate than iTrace simulated keratometry which was calculated based on only 4 points on the circle of 3 mm. This study evaluated visual outcomes, rotational stability after performing toric intraocular lens (IOL) implantation planning based on the wavefront aberrometry of the cornea with iTrace. Setting: Single site in China, Shanxi Eye Hospital, Shanxi, China.Design: Prospective case series.Methods: The study included 85 eyes of 63 patients undergoing phacoemulsification and toric IOL implantation. The IOL power and cylinders were chosen with the help of the iTrace toric planning program using wavefront keratometric astigmatism. Over a 3-month follow-up period, astigmatic changes were assessed using the Alpins vector method. Results: Preoperative mean corneal topographic astigmatism was 1.91 diopters (D) ± 0.69 (standard deviation). Postoperative mean refractive astigmatism decreased significantly to 0.48 D ± 0.34. Surgical induced astigmatism was 1.73 D ± 0.77 and the mean correction index was 0.89 ± 0.22, showing a slight undercorrection. The proportion of astigmatism ≤ 0.50 D increased from 0 to 71.8% postoperatively.Conclusions: This is the first study evaluating the clinical outcomes of using iTrace wavefront keratometric readings to plan a toric IOL implantation. The findings show that the iTrace built-in toric calculator with wavefront keratometric astigmatism for toric IOL planning is safe and effective.Trial registration: Current Controlled Trials ISRCTN94956424, Retrospectively registered (Date of registration: 05 February 2020). http://www.isrctn.com/ISRCTN94956424.

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Astigmatic correction of simultaneous femtosecond laser-assisted cataract surgery (FLACS) with intrastromal arcuate keratotomy (ISAK) versus Toric intraocular Lens Impantation with conventional phacoemulsification

BMC Ophthalmology ◽

10.1186/s12886-021-02059-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hye Ji Kwon ◽

Hun Lee ◽

Jin Ah. Lee ◽

Jae Yong Kim ◽

Hungwon Tchah

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Intraocular Lens ◽

Retrospective Chart Review ◽

Corneal Astigmatism ◽

Vector Analysis ◽

Toric Intraocular Lens ◽

Toric Iol ◽

Iol Implantation ◽

Significant Difference

Abstract Background To compare the efficacies in astigmatic correction of simultaneous femtosecond laser-assisted cataract surgery (FLACS) with intrastromal arcuate keratotomy (ISAK) versus toric intraocular lens (IOL) implantation with conventional phacoemulsification in moderate astigmatism. Methods A retrospective chart review was conducted for patients who had undergone cataract surgery by one surgeon. We identified patients with preoperative corneal astigmatism from + 0.75 to + 2.00 diopters (D) who had undergone astigmatic correction with FLACS with ISAK or toric IOL implantation with conventional phacoemulsification. We measured the visual acuity, intraocular pressure, automated keratometer, manifest refraction, and topography preoperatively and 1-day, 1-month, 3-month, and 6-month postoperatively. The vector analysis of refractive astigmatism was performed. Results Of a total of 48 eyes of 48 patients, 27 eyes of 27 patients had FLACS with ISAK (AK group), and 21 eyes of 21 patients had conventional cataract surgery with toric IOL implantation (toric IOL group). Refractive astigmatism was significantly decreased in both groups. The mean preoperative and 6-month postoperative refractive astigmatism were 1.85 ± 1.07 and 0.99 ± 0.51 D, respectively, in the AK group (P = 0.028), and 1.84 ± 0.81 and 0.68 ± 0.21 D, respectively, in the toric IOL group (P < 0.001). There was no significant difference in refractive astigmatism between the two groups at 6-month postoperatively (0.99 ± 0.51 vs 0.68 ± 0.21 D, P = 0.057). At 6-month postoperatively, parameters for vector analysis of refractive astigmatism showed no statistical difference between the two groups. Corneal astigmatism was significantly decreased in the AK group. Corneal astigmatism from topography and the automated keratometer were significantly lower in the AK group 6-month postoperatively compared to toric IOL group (0.94 ± 0.40 vs. 1.53 ± 0.46 D, P = 0.018 for topography; and 0.98 ± 0.69 vs. 1.37 ± 0.41 D, P = 0.032 for the automated keratometer). Conclusions FLACS with ISAK could be an effective procedure for reducing astigmatism as well as toric IOL implantation in cataract surgery.

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Refractive Outcomes of Femtosecond Laser-assisted Cataract Surgery with Arcuate Keratotomy and Standard Phacoemulsification with Toric Intraocular Lens Implantation

10.21203/rs.3.rs-142481/v1 ◽

2021 ◽

Author(s):

Meng-Yin Lin ◽

Yun-Dun Shen ◽

Hsin-Yuan Tan ◽

I-Jong Wang ◽

I-Chan Lin

Keyword(s):

Femtosecond Laser ◽

Cataract Surgery ◽

Intraocular Lens ◽

Postoperative Outcome ◽

Intraocular Lens Implantation ◽

Toric Intraocular Lens ◽

Toric Iol ◽

Iol Implantation ◽

Refractive Outcomes ◽

Lens Implantation

Abstract Background: Both femtosecond laser-assisted arcuate keratotomy (FS-AK) and toric intraocular lens (IOL) implantation were effective in correction for eyes with corneal astigmatism. The objective of this study was to evaluate the postoperative refractive outcomes of patients receiving femtosecond laser-assisted cataract surgery (FLACS) with FS-AK and patients receiving standard phacoemulsification with toric intraocular lens implantation Methods: This retrospective study reviewed the postoperative outcome of patients undergoing FLACS with FS-AK (FS-AK group) and patients undergoing standard phacoemulsification with toric IOL implantation (toric IOL group). The main outcome measures were bare and corrected visual acuities, keratometric and refractive astigmatism, and vector analysis.Results: The FL-AK group included 41 eyes with preoperative keratometric astigmatism of −1.64 diopters (D) ± 0.42 (standard deviation), and the toric IOL group included 53 eyes with preoperative keratometric astigmatism of −2.29 ± 0.91 D (P < 0.001). Postoperative refractive astigmatism was comparable between the two groups. Postoperative bare vision was significantly better (P = 0.005) and corrected visual acuity was marginally better in the toric IOL group than in the FS-AK group (P = 0.051). The absolute angles of error were 9.95 ± 9.57 degrees and 5.08 ± 4.94 degrees (P = 0.02) in the FS-AK and toric IOL groups, respectively.Conclusion: Both FLACS with FS-AK and standard phacoemulsification with toric IOL implantation represent safe and effective methods for astigmatism correction at the time of cataract surgery. Standard phacoemulsification with toric IOL implantation achieves better visual outcome than combined FLACS and FS-AK at 6-month follow up.

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