scholarly journals Comparison of magnitude and summated vector mean of surgically induced astigmatism vector according to incision site after phakic intraocular lens implantation

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Kazutaka Kamiya ◽  
Wakako Ando ◽  
Masahide Takahashi ◽  
Nobuyuki Shoji

Abstract Background To compare the arithmetic mean (M-SIA) and the summated vector mean of surgically induced astigmatism (SVM-SIA) according to the incision site after phakic intraocular lens (Visian implantable collamer lens (ICL), STAAR Surgical) implantation. Methods This study comprised 121 eyes of 121 consecutive patients undergoing ICL surgery through a 3.0-mm temporal or superior clear corneal incision. The magnitude and the axis of corneal astigmatism preoperatively and 3 months postoperatively were measured using an automated keratometer. The M-SIA and the SVM-SIA were determined according to the incision site. Results The magnitude of corneal astigmatism significantly increased from 1.23 ± 0.59 D preoperatively to 1.46 ± 0.72 D postoperatively in the temporal incision group (Wilcoxon signed-rank test, P < 0.001), but it significantly decreased from 1.09 ± 0.36 D preoperatively to 0.86 ± 0.41 D postoperatively in the superior incision group (P < 0.001). The M-SIA was 0.48 ± 0.30 D, and the SVM-SIA was 0.23 ± 0.52 D at a meridian of 82° in the temporal incision group. The M-SIA was 0.57 ± 0.30 D, and the SVM-SIA was 0.47 ± 0.45 D at a meridian of 1° in the superior incision group. Conclusions ICL implantation induces the M-SIA by approximately 0.5 D, but the SVM-SIA decreased to 50% and 80% of the M-SIA in magnitude through temporal and superior incisions, respectively. The direction of the SVM-SIA showed a tendency toward corneal flattening to the incisional site. It should be noted that the M-SIA is somewhat different from the SVM-SIA according to the incision site. Trial registration University Hospital Medical Information Network Clinical Trial Registry (000044269)

2021 ◽  
Vol 62 (12) ◽  
pp. 1592-1599
Author(s):  
Joon Kyo Chung ◽  
Gyu Le Han ◽  
Hoon Noh ◽  
Dong Hui Lim ◽  
Tae-Young Chung

Purpose: The purpose of this study was to compare corneal astigmatism correction between “wound open” and “wound intact” methods during femtosecond laser-assisted transepithelial arcuate keratotomy.Methods: From April 2016 to December 2018, a retrospective survey was conducted on patients undergoing femtosecond laser cataract surgery at the Ophthalmology Department of Samsung Medical Center. Size comparison and vector analysis of corneal astigmatism before and after surgery were performed in the wound open and wound intact groups.Results: In the wound open and wound intact groups, the target-induced astigmatism (TIA) was 1.28 ± 0.55; and 1.26 ± 0.29 diopters, the surgically induced astigmatism (SIA) was 0.80 ± 0.52; and 0.53 ± 0.32 diopters, and the correction index (CI) was 0.63 ± 0.28; and 0.43 ± 0.26, respectively. The astigmatism correction was superior in the wound open group (p = 0.048, p = 0.025). In a subgroup with TIA < 1.2 diopters, there were no significant differences in SIA or CI between the two groups; however, in the subgroup with a TIA > 1.2 diopters, the SIA was 1.09 ± 0.59; and 0.54 ± 0.37 diopters and the CI was 0.60 ± 0.28; and 0.36 ± 0.23 in the wound open and wound intact groups, respectively (p = 0.022, p = 0.047). Thus, astigmatism correction was superior in the wound open group.Conclusions: The wound open method during femtosecond laser-assisted transepithelial arcuate keratotomy was superior for astigmatism correction compared to the wound intact method.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Young-chae Yoon ◽  
Minji Ha ◽  
Woong-Joo Whang

Abstract Background This study aimed to compare surgically induced astigmatism (SIA) on the anterior and total cornea during cataract surgery through a 2.2 mm steep meridian incision. Methods The study included 69 left eyes of 69 patients who had undergone cataract surgery. The 69 eyes were classified into three subgroups according to the preoperative steep meridian. Following phacoemulsification, an intraocular lens was inserted into the bag. The keratometric measurements were taken 12 months postoperatively, on the anterior cornea (automated keratometer and anterior keratometry [K] from a rotating Scheimpflug camera) and total cornea (equivalent K reading [EKR] 3.0 mm, EKR 4.5 mm, total corneal refractive power (TCRP) 2.0 mm ring, TCRP 3.0 mm zone, TCRP 4.0 mm zone). The SIA was analyzed for each parameter. Results On the double-angle polar plot, the summated vector mean values of SIA determined by the automated keratometer and Scheimpflug anterior K were 0.28 diopter (axis: 177°) and 0.37 diopter (axis: 175°) in with-the-rule (WTR) astigmatism; 0.03 diopter (axis: 156°) and 0.18 diopter (axis: 177°) in oblique astigmatism; 0.15 diopter (axis: 96°) and 0.17 diopter (axis: 73°) in against-the-rule (ATR) astigmatism. The mean SIAs on the total cornea ranged from 0.31 to 0.42 diopter in WTR astigmatism; from 0.16 to 0.27 diopter in oblique astigmatism; from 0.04 to 0.11 diopter in ATR astigmatism. Mean magnitude SIA ranged from 0.41 to 0.46 diopter on anterior corneal surface and 0.50 to 0.62 diopter on total cornea. J0 and J45 of the posterior cornea showed no significant changes after cataract surgery, and the changes in J0 and J45 did not show any statistical differences between the anterior and total cornea (all p > 0.05). Conclusions There were no differences in the summed vector mean values of SIA between the anterior cornea and the total cornea.


2019 ◽  
Vol 30 (6) ◽  
pp. 1320-1327
Author(s):  
Yi-Ju Ho ◽  
Chi-Chin Sun ◽  
Jiahn-Shing Lee ◽  
Ken-Kuo Lin ◽  
Chiun-Ho Hou

Purpose: To compare corneal astigmatism estimation from Barrett toric calculator, with measurement from Galilei Dual Scheimpflug Analyzer G4 in low corneal cylinder patients. Methods: Preoperative corneal astigmatism was measured using Auto Kerato-Refractometer (AutoKM), IOL Master, and Galilei G4 (combined Placido-dual Scheimpflug analyzer) and was processed by Barrett toric calculator with measurements obtained from Auto Kerato-Refractometer and from IOL Master. A total of 42 eyes undergoing cataract surgery with nontoric intraocular lens implantation were included. Corneal astigmatism was calculated based on manifest refractive astigmatism with implications of surgically induced astigmatism. Errors in predicted residual astigmatism were calculated by the difference between postoperative manifest cylindrical refractive error and preoperative corneal cylinder using vector analysis. Results: Centroid error in predicted residual astigmatism was with-the-rule 0.36 D for AutoKM and 0.48 D for IOL Master, was lower at 0.24 D for the Barrett–IOL Master, and was lowest at 0.21 D for the Barrett–AutoKM ( p < .001). The Galilei G4 demonstrated the highest centroid error for SimK (0.53 D) and lower for total corneal power (0.49 D). The Barrett toric calculator obtained the lowest median absolute error in predicted residual astigmatism for AutoKM (0.43 D) and IOL Master (0.54 D). The Barrett–IOL Master demonstrated that 61% and 76% of eyes were within 0.50 and 0.75 D of the predicted residual astigmatism, respectively. Conclusion: The Barrett–IOL Master had more accurate prediction of residual astigmatism for low astigmatism eyes before cataract surgery compared to Galilei Dual Scheimpflug Analyzer G4 in this study.


2018 ◽  
Vol 28 (4) ◽  
pp. 398-405 ◽  
Author(s):  
Joaquín Fernández ◽  
Manuel Rodríguez-Vallejo ◽  
Javier Martínez ◽  
Ana Tauste ◽  
David P Piñero

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.


2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Paul Ernest ◽  
Warren Hill ◽  
Richard Potvin

Purpose. To compare the surgically induced astigmatism from clear corneal and square posterior limbal incisions at the time of cataract surgery.Methods. Surgically induced astigmatism was calculated for a set of eyes after cataract surgery using a temporal 2.2 mm square posterior limbal incision. Results were compared to similar available data from surgeons using clear corneal incisions of similar size.Results. Preoperative corneal astigmatism averaged 1.0 D and was not significantly different between the incision types. Surgically induced astigmatism with the 2.2 mm posterior limbal incision averaged0.25±0.14 D, significantly lower in magnitude than the aggregate surgically induced astigmatism produced by the 2.2 mm clear corneal incision (0.68±0.49 D).Conclusion. The 2.2 mm square posterior limbal incision induced significantly less, and significantly less variable, surgically induced astigmatism relative to a similar-sized clear corneal incision. This is likely to improve refractive outcomes, particularly important with regard to premium intraocular lenses.


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