1
|
Balparda K, Silva-Quintero LA, Acevedo-Urrego A, Herrera-Chalarca T. Ocular residual astigmatism (ORA) does not seem to correlate with baseline refractive error among refractive surgery candidates. Int Ophthalmol 2023; 43:4087-4096. [PMID: 37548824 DOI: 10.1007/s10792-023-02826-8] [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: 01/23/2022] [Accepted: 07/09/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE Ocular residual astigmatism (ORA) is defined as the difference between refractive astigmatism and anterior corneal astigmatism. A high ORA may be correlated with poorer results in patients undergoing corneal-based laser surgery. Is a high baseline refractive error related to a higher degree of ORA? METHODS This was a retrospective analytical study including 181 right eyes of an equal number of refractive surgery candidates. Manifest subjective refraction was measured, along with a Pentacam AXL Wave corneal tomography. Via a vector analysis with this methodology, subjective cylinder was translated into the corneal plane and a vectorial subtraction was performed in order to measure ORA. Spearman's rank order test, one-way ANOVA and Chi-square were used to determine whether different levels of baseline refractive error correlate with different levels of ORA. RESULTS Mean age was 28.33 ± 4.71 years with a female preponderance (65.7%). Mean ORA was 0.74 ± 0.39 D, with 33.1% of eyes having an ORA ≥ 0.90 D. There was not a correlation between ORA and level of myopia (rho = - 0.022; p = 0.764), nor between ORA and spherical equivalent (rho = 0.009; p = 0.903). Refractive astigmatism did not demonstrate to be correlated with ORA level either (rho = 0.078; p = 0.329). One-way ANOVA tests failed to demonstrate an association between different classifications of refractive error and level of ORA. CONCLUSIONS In the studied population, ORA is not correlated with baseline refractive error. Every patient presenting for possible corneal-based laser refractive surgery should be evaluated for a possible high level of ORA, irrespective of their baseline ametropia level.
Collapse
Affiliation(s)
- Kepa Balparda
- Black Mammoth Surgical, Carrera 43 # 29 - 35, Office 712., Medellín, Colombia.
| | | | | | | |
Collapse
|
2
|
Elshahat A, Hamed AM, El Habbak AH, Tabl MA. Evaluation of Ocular Residual Astigmatism in Eyes with Myopia and Myopic Astigmatism and Its Interaction with Other Forms of Astigmatism. Clin Ophthalmol 2022; 16:4179-4190. [PMID: 36544897 PMCID: PMC9762676 DOI: 10.2147/opth.s393477] [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: 10/19/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose To evaluate the prevalence, magnitude, and direction of ocular residual astigmatism (ORA) in eyes with myopia and myopic astigmatism, and its interaction with refractive, anterior corneal, posterior corneal, and true net power astigmatism. Patients and Methods Refractive surgery candidates with myopia and myopic astigmatism were studied. Refractive astigmatism (RA) was measured using the Nidek® AR-310A autorefractometer. Anterior corneal astigmatism (ACA), posterior corneal astigmatism (PCA), and true net power astigmatism (TNP) were measured using the Wavelight® Oculyzer II. Astigmatism was converted from polar to vector notation. ORA was calculated by vector subtraction of ACA from RA vertexed to corneal plane. Compensation factor (CF) was calculated as the ratio of ORA that compensates ACA for both J0 and J45. Results 154 eyes of 88 patients (mean age 31.7±7.1 years) were included. With-the-rule (WTR) astigmatism was the most common for both RA (55.6%) and ACA (74%), while against-the-rule (ATR) was the most common for PCA (87.7%) and ORA (74.0%). The axes of RA and ACA were within 10° of each other in 46.8% of the eyes, and within 30° of each other in 76.0%. The mean difference in value between the axis of RA and ACA was 25.6°. 71.4% of eyes in the study had an ORA ≥ 0.5D, 44.1% had ORA ≥ 0.75D and 26% had ORA ≥ 1D. There was a statistically significant difference between ACA and each of RA and TNP. Using TNP to calculate ORA instead of ACA reduced its magnitude. RA is positively correlated to ACA and more strongly to TNP. The most common pattern of compensation between ORA and ACA was under-compensation for J0 (49%) and same-axis-augmentation for J45 (35%). Conclusion ORA, PCA, and the interaction between ORA and ACA can affect results during refractive planning.
Collapse
Affiliation(s)
- Ahmed Elshahat
- Department of Ophthalmology, Benha Faculty of Medicine, Benha University, Benha, Qalyopia, Egypt
| | - Abdelmonem M Hamed
- Department of Ophthalmology, Benha Faculty of Medicine, Benha University, Benha, Qalyopia, Egypt,Correspondence: Abdelmonem M Hamed, Email
| | - Ashraf H El Habbak
- Department of Ophthalmology, Benha Faculty of Medicine, Benha University, Benha, Qalyopia, Egypt
| | - Marwa Abdelshafy Tabl
- Department of Ophthalmology, Benha Faculty of Medicine, Benha University, Benha, Qalyopia, Egypt
| |
Collapse
|
3
|
Corneal and Whole-Eye Higher Order Aberrations Do Not Correlate With Ocular Residual Astigmatism in Prepresbyopic Refractive Surgery Candidates. Cornea 2022:00003226-990000000-00167. [PMID: 36730015 DOI: 10.1097/ico.0000000000003160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 08/18/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE Ocular residual astigmatism (ORA) is the proportion of manifest astigmatism that is not explained by anterior corneal astigmatism. The role of higher order aberrations (HOAs) in the level of ORA has not been profoundly studied. The purpose of this study was to evaluate the effect of different corneal and whole-eye HOAs on levels of ORA using a multivariate modeling approach. METHODS This is a retrospective analytical study including a sample of healthy refractive surgery candidates. One eye of every patient was randomly selected. A total of 294 eyes from an equal number of patients were included. Corneal and whole-eye HOAs were measured with a Pentacam AXL Wave, and subjective manifest refraction was taken. Astigmatism values were converted into power vectors and ORA was calculated. The Spearman rank-order correlation was initially used to explore correlation between HOA and ORA. All variables with a P value under 0.10 were included into a multiple linear regression model to explore this correlation adjusting for confounding variables. RESULTS The mean age was 28.81 ± 5.40 years. Simple bivariate correlation was significant for root mean square (RMS) total, RMS lower order aberrations, RMS HOAs, defocus, and vertical astigmatism. After being included into a multivariate regression model adjusting for confounding variables, the only variable that was significant was RMS total [F(3, 282) = 78.977; P < 0.001; adjusted R2 = 0.451]. For every μm increase in corneal RMS total, ORA increases by 0.135 diopters. About 45% of variability in ORA can be explained by corneal RMS total, corneal J0, and manifest J0. No individual HOA correlated with ORA in the multivariate regression model. CONCLUSIONS ORA increases with general corneal irregularity, especially regular astigmatism. Irregular astigmatism expressed by corneal and whole-eye HOAs does not seem to be a significant contributor of ORA in healthy refractive surgery candidates.
Collapse
|
4
|
Tang C, Du Z, Wu G, Tan X, Zang S, Yu H, Hu Y. The Distribution Pattern of Ocular Residual Astigmatism in Chinese Myopic Patients. Front Med (Lausanne) 2022; 9:763833. [PMID: 35685410 PMCID: PMC9171385 DOI: 10.3389/fmed.2022.763833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 04/12/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose We aimed to investigate the distribution of ocular residual astigmatism (ORA) and its associations with age, gender, manifest refraction, and other ocular indicators in Chinese patients with myopia. Design This is a multi-center retrospective cross-sectional study. Method The study included 7,893 patients with myopia (7,893 eyes) aged 18–40 years from five ophthalmic centers. Anterior segment biometrics of the eyes were collected from the Pentacam. ORA and its summated vector mean were calculated using Alpins vector analysis. Compensation factor (CF) was used to evaluate the relation between ORA and corneal astigmatism. ORA in different age, gender, and refraction groups was compared. The Spearman correlation was adopted to reveal multiple ocular indicators associated with ORA, which were integrated into a multiple linear regression model to predict ORA. Results Distribution of ORA was slightly positively skewed (Skewness= 2.111, Kurtosis = 19.660, KS P < 0.0001). Mean ORA was 0.74 ± 0.39 D (95% normal range: 0.14–1.54 D). Among all the subjects, 22.4% of the eyes had an ORA magnitude of 1.0 D or more. Undercompensation or full-compensation of anterior corneal astigmatism (ACA) by ORA prevailed in both J0 (76.99%) and J45 (58.48%). Women had higher ORA power than men (0.77 ± 0.36 D vs. 0.73 ± 0.41 D, P < 0.0001). Participants with less negative spherical equivalent (SE) or higher manifest astigmatism (MA) also had higher ORA (all P < 0.0001). ORA was significantly correlated with ACA (r = 0.405) and posterior corneal astigmatism (PCA, r = 0.356). The multivariate logistic regression analysis showed strong predictability of ORA magnitude >1.0 D using anterior segment parameters (area under the receiver operating characteristic curve: 0.739). Conclusion ORA is present in Chinese adults with myopia and is affected by multiple ocular factors. Our findings may provide valuable information about ORA distribution in candidates for refractive surgery, helping optimize the outcome of astigmatism correction.
Collapse
Affiliation(s)
- Changting Tang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Zijing Du
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Guanrong Wu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Xuanyun Tan
- Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Siwen Zang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Honghua Yu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Honghua Yu
| | - Yijun Hu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China
- Aier School of Ophthalmology, Central South University, Changsha, China
- *Correspondence: Yijun Hu
| |
Collapse
|
5
|
Yuan Y, Zhang Y, Sun T, Sun X, Zhao X, Chen Y. Topography-Guided FS-LASIK With PAE Algorithm and Sirius Tomography Data for Correction of Myopia and Myopic Astigmatism. J Refract Surg 2022; 38:235-242. [PMID: 35412929 DOI: 10.3928/1081597x-20220131-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the clinical outcomes after topography-guided and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) planned with the Phorcides Analytic Engine (PAE) algorithm system and Sirius tomography data for correction of myopia and myopic astigmatism when the ocular residual astigmatism (ORA) was great or not. METHODS In this retrospective study, a total of 163 eyes with myopia and myopic astigmatism (99 patients) were included. Eyes with myopic astigmatism and high ORA of 0.75 diopters (D) or greater were assigned to the high ORA group and the others to the low ORA group. All surgeries were performed by topography-guided FS-LASIK planned with a PAE algorithm system. PAE took anterior and posterior corneal negative cylinder of the 5-mm zone from the Sirius combined topography and tomography. Refractive and visual outcomes, vector analysis, and corneal aberrations were compared between the two groups. RESULTS At 6 months postoperatively, the uncorrected distance visual acuity of 20/16 or better was measured in 59% of eyes in the high ORA group and 66% of eyes in the low ORA group (P = .307). Postoperative corrected distance visual acuity, manifest refractive spherical equivalent, refractive astigmatism, target induced astigmatism, surgically induced astigmatism, and difference vector were similar between the two groups (P > .05). The postoperative corneal astigmatism was significantly higher in the high ORA group (P = .008), and the high ORA group over-corrected astigmatism with the rule and showed a higher correction index (P = .003) compared with the low ORA group. CONCLUSIONS Topography-guided FS-LASIK with PAE algorithm and Sirius combined topography and tomography data for correction of myopia and myopic astigmatism achieved the predicted surgical outcomes and there was a tendency to have a similar clinical outcome for PAE when the ORA was great or not. However, the PAE with high ORA overcorrected astigmatism with-the-rule and showed a higher correction index compared with the low ORA group. [J Refract Surg. 2022;38(4):235-242.].
Collapse
|
6
|
Li Y, LaHood BR. Peripheral Hypertrophic Subepithelial Corneal Degeneration on a Laser-Assisted In Situ Keratomileusis Flap. Eye Contact Lens 2022; 48:51-53. [PMID: 34310351 DOI: 10.1097/icl.0000000000000822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT We describe the first reported case of a patient developing peripheral hypertrophic subepithelial corneal degeneration (PHSCD) in the setting of previous femtosecond laser in situ keratomileusis (LASIK). Superficial keratectomy was performed successfully with the complete restoration of the visual acuity, no LASIK flap complications, and no recurrence of PHSCD at 1-year follow-up. Our case indicates that superficial keratectomy can be a safe and effective treatment for PHSCD in the setting of LASIK and raises awareness of the possibility of PHSCD developing in eyes that have undergone prior LASIK.
Collapse
Affiliation(s)
- Ye Li
- Princess Alexandra Hospital (Y.L.), Brisbane, Australia ; Ashford Advanced Eye Care (B.R.L.), Adelaide, Australia ; The Queen Elizabeth Hospital (B.R.L.), Adelaide, Australia ; South Australian Institute of Ophthalmology (B.R.L.), Adelaide, Australia; and University of Adelaide (B.R.L.), Adelaide, Australia
| | | |
Collapse
|
7
|
Optimized CorT Total to compare Scheimpflug vs dual Scheimpflug/Placido imaging devices. J Cataract Refract Surg 2021; 47:153-157. [PMID: 32826702 DOI: 10.1097/j.jcrs.0000000000000395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/03/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the manufacturer-provided measures of total corneal power (TCP) generated by Scheimpflug and dual Scheimpflug/Placido imaging compared with corneal topographic astigmatism calculated on the basis of measured TCP data (CorT Total). SETTING Emory University, Atlanta, Georgia, USA. DESIGN Retrospective case series. METHODS TCP values were exported from virgin 209 eyes that underwent imaging with both the Scheimpflug (Pentacam HR) and dual Scheimpflug-Placido (Galilei G4) imaging devices to compute an optimized CorT Total. The standard deviation of the ocular residual astigmatism (ORAsd), which serves as a value describing the vectoral difference between the corneal astigmatism measure and manifest refractive cylinder at the corneal plane, was evaluated for all eyes to compare manufacturer-provided measurements vs the optimized CorT Total. RESULTS The Scheimpflug CorT Total had the lowest ORAsd (0.306 diopter [D]; spherical equivalent [SE] 0.018) of all the parameters evaluated, although the difference was not statistically significant (P = .22) from the dual Scheimpflug/Placido CorT Total (0.32 2 D; SE 0.017). For the Scheimpflug device, the CorT Total had a statistically significant lower (P < .05) ORAsd in comparison to the best measure on the device (total corneal refractive power apex zone 2 mm: 0.324 D; SE 0.021). For dual Scheimpflug/Placido measurements, the CorT Total had the lowest ORAsd (0.322 D; SE 0.017), but the difference was not statistically significant (P = .43) from the lowest manufacturer-provided measure (TCP 2). CONCLUSIONS CorT Total generated with the Scheimpflug device corresponded better with the manifest refractive cylinder than all measures of total corneal astigmatism calculated by the software from both the Scheimpflug and the dual Scheimpflug/Placido devices.
Collapse
|
8
|
Jun I, Kang DSY, Arba-Mosquera S, Reinstein DZ, Archer TJ, Jean SK, Kim EK, Seo KY, Lee HK, Kim TI. Comparison of clinical outcomes between vector planning and manifest refraction planning in SMILE for myopic astigmatism. J Cataract Refract Surg 2021; 46:1149-1158. [PMID: 32347695 DOI: 10.1097/j.jcrs.0000000000000100] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare clinical outcomes of small-incision lenticule extraction (SMILE) between manifest refraction (MR) and vector planning for myopic astigmatism with high ocular residual astigmatism (ORA). SETTING Yonsei University College of Medicine and Eyereum Eye Clinic, Seoul, South Korea. DESIGN Prospective, randomized, comparative case series. METHODS Patients with myopic astigmatism and ORA of 0.75 diopters (D) or greater were randomized into the MR or vector planning group and underwent SMILE without applying any nomogram for cylinder correction. Visual acuity, MR, corneal topography, and corneal aberration were measured preoperatively and postoperatively. Outcomes at 6 months postoperatively were compared between the groups. RESULTS The study comprised 114 patients (114 eyes): 58 eyes in MR planning and 56 eyes in vector planning. The mean uncorrected and corrected distance visual acuity, safety and efficacy indices were comparable between the 2 groups. Postoperative refractive cylinder reached statistically significant differences between the groups (-0.22 ± 0.18 D and -0.14 ± 0.16 D in the MR and vector planning groups, respectively, P = .02). Postoperative corneal toricity and ORA reached statistically significant lower in the vector planning group. CONCLUSIONS In myopic astigmatism with high ORA, MR and vector planning in SMILE were effective with comparable visual outcomes; vector planning showed statistically significant lower postoperative refractive and corneal astigmatism and ORA. Use of vector planning may improve refractive outcomes in SMILE cases with high ORA. However, the results may have been different had a nomogram adjustment been applied, as is often used for cylinder corrections with SMILE.
Collapse
Affiliation(s)
- Ikhyun Jun
- From the Department of Ophthalmology (Jun, E. K. Kim, Seo, Lee, T.-i. Kim), The Institute of Vision Research, Department of Ophthalmology (Jun, E.K. Kim, T.-i. Kim), Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Eyereum Eye Clinic (Kang, Jean), Seoul, South Korea; Research and Development (Arba-Mosquera), Biomedical Engineering Office, SCHWIND eye-tech-solutions, Kleinostheim, Germany; London Vision Clinic (Reinstein, Archer), London, United Kingdom; Department of Ophthalmology (Reinstein), Columbia University Medical Center, New York, NY, USA; Centre Hospitalier National d'Ophtalmologie (Reinstein), Paris, France; Biomedical Science Research Institute, University of Ulster (Reinstein, Archer), Coleraine, Northern Ireland
| | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
The contribution of ocular residual astigmatism to anterior corneal astigmatism in refractive astigmatism eyes. Sci Rep 2021; 11:1018. [PMID: 33441809 PMCID: PMC7806660 DOI: 10.1038/s41598-020-80106-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/14/2020] [Indexed: 11/08/2022] Open
Abstract
To determine the distribution of ocular residual astigmatism (ORA) in astigmatic eyes and the influence on the anterior corneal (ACA) and refractive astigmatism (RA). A total of 165 children met the inclusion criteria. Right eyes' data were analyzed. Using Thibos vector analysis to calculate ORA. Spearman correlation analysis was used to obtain the correlation between the magnitude of ORA, ACA and RA. The median magnitude of ORA in astigmatic eyes was 0.57 D, with interquartile range was 0.42 D. And they were main against-the-rule (57.6-75.8%) and oblique astigmatism (13.9-34.5%) ORA. The ORA in 140 eyes (84.8%) acted as an offset to ACA, meanwhile, 25 eyes (15.2%) superimposed it. About 98% (97.9-98.4%) against-the-rule and 75% (73.9-82.5%) oblique ORA counteracted ACA, nevertheless, all with-the-rule ORA had a superimposed effect on ACA. For with-the-rule ACA, about 86% (85.4-85.9%) ORA worked to offset it. There was statistically correlations between ORA and ACA (r = 0.17, P = 0.03), ORA and RA (r = - 0.27, P = 0.001). The magnitude of ocular residual astigmatism was relatively small in children's astigmatic eyes. Both against-the-rule and oblique ORA can counteract with-the-rule ACA.
Collapse
|
10
|
Hu Y, Zhu S, Xiong L, Fang X, Liu J, Zhou J, Li F, Zhang Q, Huang N, Lei X, Jiang L, Wang Z. A multicenter study of the distribution pattern of posterior corneal astigmatism in Chinese myopic patients having corneal refractive surgery. Sci Rep 2020; 10:16151. [PMID: 32999411 PMCID: PMC7527519 DOI: 10.1038/s41598-020-73195-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 09/11/2020] [Indexed: 11/24/2022] Open
Abstract
Including posterior corneal astigmatism (PCA) into consideration may increase the accuracy of astigmatism correction after corneal refractive surgery. In the present study we aim to investigate the distribution pattern of PCA in a large number of myopic patients from multiple ophthalmic centers. There were 7829 eyes retrospectively included in the study. Pentacam data of the eyes were retrieved from the machine and only results with image quality labelled with ‘OK’ were included. Distribution of PCA was slightly positively skewed (Skewness = 0.419, Kurtosis = 0.435, KS P < 0.0001). Mean PCA was 0.34 ± 0.14 D (range: 0.00 D-0.99 D). PCA was ≥ 0.25 D in 74.91% of the eyes and was ≥ 0.50 D in 11.61% of the eyes. In 97.55% of the eyes the steep meridian of PCA was vertical (SMV). PCA magnitude was significantly higher in eyes with SMV PCA (P < 0.0001) or high manifest astigmatism (MA, P < 0.0001). There was a significant correlation between anterior corneal astigmatism (ACA) magnitude and PCA magnitude in all of the eyes (r = 0.704, P < 0.0001). There was also a trend of decreasing frequency and magnitude of SMV PCA with aging (both P < 0.0001). In conclusion, PCA is present in myopic patients having corneal refractive surgery and PCA magnitude is increased with higher MA or ACA. Consideration of the impact of PCA on laser astigmatism correction may be necessary.
Collapse
Affiliation(s)
- Yijun Hu
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China. .,Aier School of Ophthalmology, Central South University, Fourth Floor, New Century Mansion, 198 Middle Furong Road, Changsha, 410015, China.
| | - Shanqing Zhu
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Lu Xiong
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Xuejun Fang
- Aier School of Ophthalmology, Central South University, Fourth Floor, New Century Mansion, 198 Middle Furong Road, Changsha, 410015, China.,Refractive Surgery Center, Shenyang Aier Eye Hospital, Shenyang, China
| | - Jia Liu
- Refractive Surgery Center, Shenyang Aier Eye Hospital, Shenyang, China
| | - Jin Zhou
- Refractive Surgery Center, Chengdu Aier Eye Hospital, Chengdu, China
| | - Fangfang Li
- Refractive Surgery Center, Chengdu Aier Eye Hospital, Chengdu, China
| | - Qingsong Zhang
- Refractive Surgery Center, Wuhan Aier Eye Hospital, Wuhan, China
| | - Na Huang
- Refractive Surgery Center, Wuhan Aier Eye Hospital, Wuhan, China
| | - Xiaohua Lei
- Refractive Surgery Center, Hankou Aier Eye Hospital, Wuhan, China
| | - Li Jiang
- Refractive Surgery Center, Hankou Aier Eye Hospital, Wuhan, China
| | - Zheng Wang
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China. .,Aier School of Ophthalmology, Central South University, Fourth Floor, New Century Mansion, 198 Middle Furong Road, Changsha, 410015, China.
| |
Collapse
|
11
|
Five-Year Changes in Corneal Astigmatism After Combined Femtosecond-Assisted Phacoemulsification and Arcuate Keratotomy. Am J Ophthalmol 2020; 217:232-239. [PMID: 32437671 DOI: 10.1016/j.ajo.2020.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/26/2020] [Accepted: 05/01/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the long-term stability of corneal astigmatism after combined femtosecond (fs)-assisted phacoemulsification and arcuate keratotomy. DESIGN Retrospective, interventional case series. METHODS Surgery was performed using a Victus (Bausch & Lomb) platform. A single, 450-μm-deep arcuate keratotomy was paired at the 8-mm zone with the main phacoemulsification incision in the opposite meridian. The keratotomy incisions were not opened. Corneal astigmatism measurements obtained preoperatively and at 2 and 5 years postoperatively were analyzed using vector analysis. RESULTS A total of 44 eyes of 44 patients (mean age 66.0 ± 10.1 years) were included. The mean preoperative corneal astigmatism was 1.40 ± 0.66 diopters (D). This was reduced to 0.74 ± 0.54 D at 2 years and 0.70 ± 0.50 at 5 years postoperatively (P < .001). There were no statistically significant differences between postoperative corneal astigmatism at 2 years and at 5 years (P = .609). Both magnitude of error and absolute angle of error were comparable between the 2 postoperative time points (P > .805). At the end of 5 years, 65% of the eyes were within 15 degrees of the preoperative astigmatic meridian. Comparative analysis showed significantly higher surgically induced astigmatism, lower differences in vector and absolute angles of error for the eyes with preoperative with-the-rule (WTR) astigmatism than eyes with against-the-rule (ATR) astigmatism at 5 years (P < .004). CONCLUSIONS Our study showed the stability of femtosecond (fs)-assisted arcuate keratotomy was well-maintained over 5 years. There was a tendency of increasing overcorrection of preoperative WTR astigmatism and undercorrection of ATR astigmatism over time.
Collapse
|
12
|
Wallerstein A, Gauvin M, Qi SR, Cohen M. Effect of the Vectorial Difference Between Manifest Refractive Astigmatism and Anterior Corneal Astigmatism on Topography-Guided LASIK Outcomes. J Refract Surg 2020; 36:449-458. [DOI: 10.3928/1081597x-20200609-01] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/05/2020] [Indexed: 11/20/2022]
|
13
|
Gab-Alla AA. <p>Contributions of Anterior Corneal and Ocular Residual Astigmatism to Autorefraction Astigmatism in a Myopic Adult Sample</p>. Clin Ophthalmol 2020; 14:2125-2134. [PMID: 32801621 PMCID: PMC7386813 DOI: 10.2147/opth.s262167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/02/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Amr A Gab-Alla
- Ophthalmology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
- Correspondence: Amr A Gab-Alla Ophthalmology Department, Faculty of Medicine, Suez Canal University, Ring Road, Ismailia, EgyptTel +20 1222836261 Email
| |
Collapse
|
14
|
Woltsche N, Werkl P, Posch-Pertl L, Ardjomand N, Frings A. Astigmatismus. SPEKTRUM DER AUGENHEILKUNDE 2019. [DOI: 10.1007/s00717-019-00440-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Zusammenfassung
Der Astigmatismus ist der weltweit häufigste Refraktionsfehler vor Hypermetropie und Myopie. Man unterscheidet den äußeren vom inneren Astigmatismus. Der äußere Astigmatismus kann weiter in „mit der Regel“, „gegen die Regel“ und „schräg“ unterteilt werden. Die Summierung des äußeren und inneren Astigmatismus ergibt den refraktiven Zylinder. Astigmatismus wurde lange als zweidimensionales Phänomen gesehen, doch erst die dreidimensionale Betrachtung hat den Blick auf bestehende Analyseverfahren (Topo- und Tomographie) erweitert. Die Vektoranalyse nach Alpins ist hierbei eine bekannte Methode zur Therapieplanung. Zur Therapie des Astigmatismus stehen konservative Optionen wie Brille oder torische Kontaktlinse sowie unterschiedlichste chirurgische Verfahren wie photorefraktive Keratektomie, Femtosekundenlaser-assistierte Keratotomie, Laser-in-situ-Keratomileusis, „small-incision lenticule extraction“ und die Implantation torischer Intraokularlinsen zur Verfügung.
Collapse
|
15
|
Abstract
Astigmatism is the most frequent refractive error worldwide followed by hyperopia and myopia. Internal astigmatism has to be differentiated from external astigmatism. Furthermore, external astigmatism can be divided into "with the rule", "against the rule" and "oblique". The summation of internal and external astigmatism results in the refractive cylinder. Astigmatism has for a long time been regarded as a two-dimensional phenomenon; however, only a three-dimensional consideration expanded the view on existing analytical methods (topography and tomography). Alpins' vector analysis is a commonly used method for treatment planning. Multiple options exist for treatment of astigmatism with conservative approaches, such as eyeglasses or toric contact lenses as well as various surgical procedures, such as photorefractive keratectomy, femtosecond laser-assisted keratotomy, laser in-situ keratomileusis, small incision lenticule extraction and toric intraocular lens implantation.
Collapse
Affiliation(s)
- N Woltsche
- Univ.-Augenklinik Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich.
| | - P Werkl
- Univ.-Augenklinik Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich
| | - L Posch-Pertl
- Univ.-Augenklinik Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich
| | - N Ardjomand
- Sehzentrum für Augenlaser & Augenchirurgie, Leechgasse 58, 8010, Graz, Österreich
| | - A Frings
- Univ.-Augenklinik Düsseldorf, Heinrich-Heine-Universität, Moorenstr. 5, 40225, Düsseldorf, Deutschland.,UCL Institute of Ophthalmology, 11-43 Bath St, EC1V 9EL, London, Großbritannien.,Moorfields Eye Hospital NHS Foundation Trust, 162 City Rd, EC1V 2PD, London, Großbritannien
| |
Collapse
|
16
|
Arbelaez MC, Alpins N, Verma S, Stamatelatos G, Arbelaez JG, Arba-Mosquera S. Clinical outcomes of laser in situ keratomileusis with an aberration-neutral profile centered on the corneal vertex comparing vector planning with manifest refraction planning for the treatment of myopic astigmatism. J Cataract Refract Surg 2017; 43:1504-1514. [DOI: 10.1016/j.jcrs.2017.07.039] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 06/08/2017] [Accepted: 07/26/2017] [Indexed: 11/16/2022]
|
17
|
Investigation of a real-time location system of corneal astigmatic axis. EYE AND VISION 2017; 4:21. [PMID: 28920066 PMCID: PMC5597999 DOI: 10.1186/s40662-017-0086-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 08/30/2017] [Indexed: 11/10/2022]
Abstract
Background To construct a real-time computerized location system (RCLS) to analyze and display the axis of corneal astigmatism and to compare its accuracy with the Scheimpflug method. Methods Fifty-seven eyes of 39 volunteers with corneal astigmatism more than 1.00 diopter (D) were recruited. The RCLS was composed of a circular light-emitting diode (LED) light source, surgical microscope, surgical video system, computer and self-programming image analysis software. Scheimpflug imaging measurements (Pentacam HR, Oculus, Wetzlar, Germany) were performed on all subjects to determine the axis and power of corneal astigmatism. Thereafter, the axis of corneal astigmatism was analyzed in real-time and displayed by the RCLS on supine position, and videos were recorded. The MB-Ruler 4.0 software was used to measure the astigmatic axis. The accuracy of the RCLS was compared with the Scheimpflug method. Results The RCLS was able to display the axis of corneal astigmatism in real-time. The axial deviation of corneal astigmatism between the two methods was 0.63 ± 3.78° when astigmatism was 1.00 to 2.00 D and decreased to 0.06 ± 1.38° when astigmatism was greater than 2.00 D. A linear correlation of astigmatic axis was noted between the two methods: AxisRCLS = 1.01 × AxisScheimpflug − 1.02 (R2 = 0.998, P < 0.001). The Bland-Altman analysis revealed that the RCLS agreed sufficiently well with the Scheimpflug method. Conclusions The RCLS can accurately analyze and display the axis for corneal astigmatism greater than 1.00 D in real-time. The RCLS simplifies marking procedures and may have potential clinical application to improve the postoperative visual outcomes in surgical correction of corneal astigmatism.
Collapse
|
18
|
Peyman A, Dastborhan Z, Peyman M. Astigmatic treatment with photorefractive keratectomy: Investigations of non-keratometric ocular astigmatism. J Curr Ophthalmol 2017; 29:98-102. [PMID: 28626818 PMCID: PMC5463002 DOI: 10.1016/j.joco.2016.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/28/2016] [Accepted: 12/06/2016] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the effect of non-keratometric ocular astigmatisms on visual and refractive outcomes after photorefractive keratectomy (PRK) for correction of myopic astigmatisms. METHODS Seventy one eyes of 36 subjects were enrolled in this study. Patients underwent PRK for treatment of myopia. Subjects were evaluated for refractive error, keratometry, and visual acuity before and six months after surgery. Pre- and post-op non-keratometric astigmatisms were calculated by vectorial analysis of the difference between the corneal plane refractive astigmatism and keratometric astigmatism. Astigmatic analysis explored the contribution of non-keratometric astigmatisms. RESULTS The pre-op spherical equivalent (SE) was -6.27 ± 1.48 with 1.16 ± 1.02 diopters of corneal plane refractive astigmatism and 1.44 ± 0.47 diopters keratometric astigmatism. Post-op values were -0.60 ± 0.85, 0.56 ± 0.47, and 1.06 ± 0.57, respectively, 6 months after surgery. Pre- and post-op non-keratometric astigmatisms were 0.76 ± 0.41 and 0.76 ± 0.46, respectively, (P = 0.976) with significant correlation (r = 0.37, P = 0.002). Pre-op non-keratometric astigmatisms correlated to the pre-op SE (r = -0.25, P = 0.04). Pre-op non-keratometric astigmatisms had significant correlation with keratometric difference vector of astigmatic correction (r = 0.369, P = 0.002). Post-op non-keratometric astigmatisms correlated to keratometric induced astigmatism (r = 0.334, P = 0.006), keratometric index of success (r = 0.571, P < 0.001), and post-op keratometric astigmatism (r = 0.736, P < 0.001). CONCLUSIONS Higher or lower non-keratometric ocular astigmatisms did not have any effect on refractive and visual outcome after PRK. PRK effectively corrected total refractive astigmatism through correction of keratometric astigmatism and additional adjustment to compensate for non-keratometric ocular astigmatisms.
Collapse
Affiliation(s)
- Alireza Peyman
- Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Dastborhan
- Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Peyman
- Department of Ophthalmology, Faculty of Medicine Building, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
19
|
Sano M, Hiraoka T, Ueno Y, Itagaki H, Ogami T, Oshika T. Influence of posterior corneal astigmatism on postoperative refractive astigmatism in pseudophakic eyes after cataract surgery. BMC Ophthalmol 2016; 16:212. [PMID: 27905889 PMCID: PMC5134072 DOI: 10.1186/s12886-016-0391-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 11/24/2016] [Indexed: 11/29/2022] Open
Abstract
Background To examine the influence of posterior corneal astigmatism on postoperative refractive astigmatism in pseudophakic eyes after cataract surgery. Methods The study enrolled 64 pseudophakic eyes of 50 patients (71.8 ± 9.9 years old, mean ± standard deviation) who had undergone phacoemulsification with non-toric IOL implantation. Refractive astigmatism was measured using an auto ref-keratometer with a 0.01- diopter (D) scale. Two types of corneal astigmatism were calculated using anterior segment optical coherence tomography; keratometric and total corneal astigmatism. Keratometric astigmatism was obtained based on anterior corneal curvature alone and total corneal astigmatism was calculated using both anterior and posterior corneal curvatures. The difference between refractive and corneal astigmatism was computed as the vector difference using 1) refractive and keratometric astigmatism and 2) refractive and total corneal astigmatism. Results The mean refractive, keratometric, and total corneal astigmatism was 0.92 ± 0.48 D, 0.87 ± 0.44 D, and 0.94 ± 0.46 D, respectively. The difference between refractive and keratometric astigmatism (0.70 ± 0.40 D, mean vector of 0.30 D axis 164°) was significantly larger than the difference between refractive and total corneal astigmatism (0.63 ± 0.38 D, mean vector of 0.12 D axis 137°) (P = .019). Conclusions The difference between refractive and total corneal astigmatism, calculated using both anterior and posterior corneal curvatures, was significantly smaller than the difference between refractive and keratometric astigmatism using anterior corneal astigmatism alone, implying that the latter overestimates the true postoperative refractive astigmatism and can cause cylindrical inaccuracy after cataract surgery.
Collapse
Affiliation(s)
- Maki Sano
- Department of Ophthalmology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan. .,Hitachi General Hospital, 2-1-1 Jonancho, Hitachi, Ibaraki, 317-0077, Japan. .,Seinan Medical Center hospital, 2190 Sakaimachi, Sashimagun, Ibaraki, 306-0433, Japan.
| | - Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Yuta Ueno
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Hideo Itagaki
- Hitachi General Hospital, 2-1-1 Jonancho, Hitachi, Ibaraki, 317-0077, Japan
| | - Tomohiro Ogami
- Seinan Medical Center hospital, 2190 Sakaimachi, Sashimagun, Ibaraki, 306-0433, Japan
| | - Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| |
Collapse
|
20
|
Abstract
PURPOSE To examine internal astigmatism (IA) in myopes and non-myopes using a new method to assess compensation of corneal astigmatism (CA) by IA, to look for predictors of high IA in young adult myopes, and to determine if as CA changes IA changes to reduce refractive astigmatism (RA) in an active compensatory process in myopes. METHODS Right eye keratometry and cycloplegic autorefraction were measured annually over 14 years in 367 myopes and once in 204 non-myopes age- (mean 21.91 ± 1.47 years), gender-, and ethnicity-matched to myopes at year 12. CA and RA at the corneal plane were expressed as J0, J45. IA = RA - CA. Inverse power transformation provided cylinder power and axis of IA for the compensation factor (IA/CA). Analyses included (1) paired and unpaired t-tests (refractive data), (2) chi-square tests (distributions of compensation factor), (3) logistic regression analysis (predictors of high IA), and (4) linear mixed models (time effect on RA, CA, and IA). RESULTS The magnitude of IAJ0 varied by refractive error (myopes -0.25 ± 0.24 vs. non-myopes -0.32 ± 0.21, p < 0.001). Compensation of CA by IA was poorer in myopes than non-myopes (χ p < 0.001). When matched by CA, compensation remained poorer in myopes than non-myopes (χ all p ≤ 0.04). Within each refractive group, compensation was better when CA was low than high (χ p < 0.001). When CA was low in myopes, high IA (≥1.00D) was less likely (p = 0.01). Longitudinal follow-up of myopes found no evidence for an active compensatory role for IA as CA increased over time. There were differences in IAJ0 by ethnicity over time (p < 0.0001). CONCLUSIONS In myopic and non-myopic eyes with low amounts of CA, IA may reduce CA's contribution to RA, but IA is not a constant. However, there is no evidence for an active compensatory role for IA reducing CA in myopes.
Collapse
|
21
|
Mashige KP. Repeatability and reproducibility of horizontal corneal diameter and anterior corneal power measurements using the Oculus Keratograph 4. AFRICAN VISION AND EYE HEALTH 2016. [DOI: 10.4102/aveh.v75i1.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Purpose: To evaluate the repeatability and reproducibility of horizontal corneal diameter (HCD) and anterior corneal power (ACP) measurements obtained with the Oculus Keratograph 4 (OCULUS Optikgeräte GmbH).Methods: These parameters (HCD and ACP) were prospectively measured in quick succession three times in each of the right eyes of 40 healthy subjects, aged 18–28 years, with normal vision (6/6 or better visual acuity) in the first session by a single examiner. Measurements were then repeated in the second session scheduled 1 week later by the same examiner using the same instrument. Repeatability and reproducibility of HCD and ACP measurements was assessed based on the intra-session and intersession within-subject standard deviation (sw), repeatability (2.77sw), coefficient of variation (CoV) and intra-class correlation coefficient (ICC).Results: Intra-session repeatability and intersession reproducibility of all measured parameters showed a repeatability (2.77sw) of 0.35 mm or less for HCD and 0.35 D or less for ACP, a CoV of 0.30% or less and an ICC of more than 0.9.Conclusion: HCD and ACP measurements obtained using an Oculus Keratograph 4 show good repeatability and reproducibility in healthy eyes; therefore, these parameters can be used for longitudinal follow-up when measured with this device.
Collapse
|
22
|
Day AC, Stevens JD. Predictors of femtosecond laser intrastromal astigmatic keratotomy efficacy for astigmatism management in cataract surgery. J Cataract Refract Surg 2016; 42:251-7. [DOI: 10.1016/j.jcrs.2015.09.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/28/2015] [Accepted: 09/03/2015] [Indexed: 11/27/2022]
|
23
|
Archer TJ, Reinstein DZ, Piñero DP, Gobbe M, Carp GI. Comparison of the predictability of refractive cylinder correction by laser in situ keratomileusis in eyes with low or high ocular residual astigmatism. J Cataract Refract Surg 2015; 41:1383-92. [DOI: 10.1016/j.jcrs.2014.10.046] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 09/30/2014] [Accepted: 10/11/2014] [Indexed: 11/16/2022]
|
24
|
Frings A, Richard G, Steinberg J, Skevas C, Druchkiv V, Katz T, Linke SJ. LASIK for spherical refractive myopia: effect of topographic astigmatism (ocular residual astigmatism, ORA) on refractive outcome. PLoS One 2015; 10:e0124313. [PMID: 25875476 PMCID: PMC4398356 DOI: 10.1371/journal.pone.0124313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 03/11/2015] [Indexed: 11/23/2022] Open
Abstract
Purpose In eyes with a preoperative plano refractive cylinder, it would appear that there is no rationale for astigmatic treatment. The aim of this retrospective, cross-sectional data analysis was to determine the amount of topographic astigmatism in refractive plano eyes that results in reduced efficacy after myopic laser in situ keratomileusis (LASIK). Methods This study included 267 eyes from 267 consecutive myopic patients with a refractive plano cylinder. Receiver operating characteristic analysis was used to find the cut-off values of preoperative ocular residual astigmatism (= topographic astigmatism) that can best discriminate between groups of efficacy and safety indices in preoperative plano refractive cylinder eyes. Results Preoperative ocular residual astigmatism (ORA) (or topographic astigmatism) of ≤0.9 diopters (D) resulted in an efficacy index of at least 0.8 statistically significantly more frequently than eyes with a preoperative ORA of >0.9 D. Eyes with a high ORA preoperatively also had a high ORA postoperatively. Regression analysis showed that each diopter of preoperative ORA reduced efficacy by 0.07. Conclusion A preoperative corneal astigmatism of ≥0.9 D could (partially) be taken into account in the LASIK design, even if the subjective refractive astigmatism is neutral.
Collapse
Affiliation(s)
- Andreas Frings
- Department of Ophthalmology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Gisbert Richard
- Department of Ophthalmology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Johannes Steinberg
- Department of Ophthalmology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Christos Skevas
- Department of Ophthalmology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Vasyl Druchkiv
- Department of Ophthalmology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Toam Katz
- Department of Ophthalmology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Stephan J Linke
- Department of Ophthalmology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| |
Collapse
|
25
|
Alpins N, Ong JKY, Stamatelatos G. Corneal Topographic Astigmatism (CorT) to Quantify Total Corneal Astigmatism. J Refract Surg 2015; 31:182-6. [DOI: 10.3928/1081597x-20150224-02] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 01/15/2015] [Indexed: 11/20/2022]
|
26
|
Frings A, Linke SJ, Bauer EL, Druchkiv V, Katz T, Steinberg J. Effects of laser in situ keratomileusis (LASIK) on corneal biomechanical measurements with the Corvis ST tonometer. Clin Ophthalmol 2015; 9:305-11. [PMID: 25709393 PMCID: PMC4334333 DOI: 10.2147/opth.s76491] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose This study was initiated to evaluate biomechanical changes using the Corvis ST tonometer (CST) on the cornea after laser in situ keratomileusis (LASIK). Setting University Medical Center Hamburg-Eppendorf, Germany, and Care Vision Refractive Centers, Germany. Design Retrospective cohort study. Methods This retrospective study included 37 eyes of 37 refractive patients. All CST measurements were performed 1 day before surgery and at the 1-month follow-up examination. The LASIK procedure included mechanical flap preparation using a Moria SBK microkeratome and an Allegretto excimer laser platform. Results Statistically significant differences were observed for mean first applanation length, mean first and second deflection lengths, mean first and second deflection amplitudes, radius of curvature, and peak distance. Significant positive correlations were found between the change (Δ) of radius of curvature and manifest refraction spherical equivalent (MRSE), ablation depth, and Δintraocular pressure as well as between AD and ΔHC-time. Each diopter of myopic correction in MRSE resulted in an increase in Δradius of curvature of 0.2 mm. Conclusion Several CST parameters were statistically significantly altered by LASIK, thereby indicating that flap creation, ablation, or both, significantly change the ability of the cornea to absorb or dissipate energy.
Collapse
Affiliation(s)
- Andreas Frings
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Stephan J Linke
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany ; Care Vision Refractive Center, Hamburg, Germany
| | - Eva L Bauer
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Vasyl Druchkiv
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Toam Katz
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany ; Care Vision Refractive Center, Hamburg, Germany
| | - Johannes Steinberg
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany ; Care Vision Refractive Center, Hamburg, Germany
| |
Collapse
|
27
|
|
28
|
Huang J, Savini G, Chen H, Bao F, Li Y, Chen H, Lu W, Yu Y, Wang Q. Precision and agreement of corneal power measurements obtained using a new corneal topographer OphthaTOP. PLoS One 2015; 10:e109414. [PMID: 25559203 PMCID: PMC4283956 DOI: 10.1371/journal.pone.0109414] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 09/01/2014] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate repeatability and reproducibility of anterior corneal power measurements obtained with a new corneal topographer OphthaTOP (Hummel AG, Germany) and agreement with measurements by a rotating Scheimpflug camera (Pentacam HR, Oculus, Germany) and an automated keratometer (IOLMaster, Carl Zeiss Meditec, Germany). Methods The right eyes of 79 healthy subjects were prospectively measured three times with all three devices. Another examiner performed three additional scans with the OphthaTOP in the same session. Within one week, the first examiner repeated the measurements using the OphthaTOP. The flat simulated keratometry (Kf), steep K (Ks), mean K (Km), J0, and J45 were noted. Repeatability and reproducibility of measurements were assessed by within-subject standard deviation (Sw), repeatability (2.77 Sw), coefficient of variation (CoV), and intraclass correlation coefficient (ICC). Agreement between devices was assessed using 95% limits of agreement (LoA). Results Intraobserver repeatability and interobserver and intersession reproducibility of all measured parameters showed a 2.77 Sw of 0.29 diopter or less, a CoV of less than 0.24%, and an ICC of more than 0.906. Statistically significant differences (P<0.001) were found between the parameters analyzed by the three devices, except J0 and J45. The mean differences between OphthaTOP and the other two devices were small, and the 95% LoA was narrow for all results. Conclusions The OphthaTOP showed excellent intraobserver repeatability and interobserver and intersession reproducibility of corneal power measurements. Good agreements with the other two devices in these parameters were found in healthy eyes.
Collapse
Affiliation(s)
- Jinhai Huang
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Giacomo Savini
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Studio Oculistico d’Azeglio, Bologna, Italy
| | - Hao Chen
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fangjun Bao
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Yuanguang Li
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haisi Chen
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weicong Lu
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ye Yu
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Qinmei Wang
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
- * E-mail:
| |
Collapse
|