Chunlei Liu1,2,3, Tian Luo4, Xuejun Fang3, Ming Hu5, Yun Su3, Jing Li6, Yan Wang7,8. 1. Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China. 2. Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China. 3. Refractive Surgery Department, Shenyang Aier Eye Hospital, Shenyang, China. 4. Pathology Department, Jinan Maternal and Child Health Hospital, Jinan, China. 5. Refractive Surgery Department, Yantai Aier Eye Hospital, Yantai, China. 6. Refractive Surgery Department, Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, China. 7. Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China. wangyan7143@vip.sina.com. 8. Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China. wangyan7143@vip.sina.com.
Abstract
PURPOSE: To evaluate the clinical results of primary topography-guided femtosecond laser-assisted in situ keratomileusis (TG-FS-LASIK) using the Pentacam-measured anterior corneal astigmatism axis (ACA) or manifest refractive astigmatism axis (MRA). METHODS: In this prospective cohort study, all eyes were treated with primary TG-FS-LASIK using the manifest cylinder. Thirty-two right eyes were treated using ACA with axis disparity > 5° in the experimental group, and 32 right eyes were treated using MRA with axis disparity ≤ 5° in the control group. Visual, refractive outcomes, and corneal higher-order aberrations were evaluated. Vector analysis of astigmatism was performed using Alpins method with the ASSORT software. RESULTS: The mean logMAR UDVA in the experimental group was - 0.12 ± 0.06, - 0.05 ± 0.08, and - 0.08 ± 0.08 at 1-week, 1-month, and 3-month follow-up, whereas - 0.05 ± 0.06, - 0.12 ± 0.06, and - 0.14 ± 0.06 in the control group (p = 0.017, p < 0.001, and p = 0.003). At 3-month follow-up, 79% eyes achieved a UDVA of 20/16 or better, 9% gained one line of corrected distance visual acuity, the mean manifest cylinder was - 0.375 ± 0.254 D, 84% showed a manifest cylinder within ± 0.50 D, the mean magnitude of difference vector was 0.41 ± 0.35 D, the mean absolute angle of error (AE) was 7.36 ± 6.21°, and 41% exhibited an arithmetic AE within ± 5° in the experimental group, whereas 94%, 19%, - 0.203 ± 0.148 D, 100%, 0.21 ± 0.15 D, 3.39 ± 3.68°, and 69% in the control group (all p < 0.05). The postoperative and preoperative corneal spherical aberrations were comparable in both groups (p > 0.05). CONCLUSION: Primary topography-guided FS-LASIK using Pentacam-measured anterior corneal astigmatism axis exhibited slightly inferior clinical results to that using the manifest refractive astigmatism axis. Both methods achieved comparable postoperative and preoperative corneal spherical aberrations.
PURPOSE: To evaluate the clinical results of primary topography-guided femtosecond laser-assisted in situ keratomileusis (TG-FS-LASIK) using the Pentacam-measured anterior corneal astigmatism axis (ACA) or manifest refractive astigmatism axis (MRA). METHODS: In this prospective cohort study, all eyes were treated with primary TG-FS-LASIK using the manifest cylinder. Thirty-two right eyes were treated using ACA with axis disparity > 5° in the experimental group, and 32 right eyes were treated using MRA with axis disparity ≤ 5° in the control group. Visual, refractive outcomes, and corneal higher-order aberrations were evaluated. Vector analysis of astigmatism was performed using Alpins method with the ASSORT software. RESULTS: The mean logMAR UDVA in the experimental group was - 0.12 ± 0.06, - 0.05 ± 0.08, and - 0.08 ± 0.08 at 1-week, 1-month, and 3-month follow-up, whereas - 0.05 ± 0.06, - 0.12 ± 0.06, and - 0.14 ± 0.06 in the control group (p = 0.017, p < 0.001, and p = 0.003). At 3-month follow-up, 79% eyes achieved a UDVA of 20/16 or better, 9% gained one line of corrected distance visual acuity, the mean manifest cylinder was - 0.375 ± 0.254 D, 84% showed a manifest cylinder within ± 0.50 D, the mean magnitude of difference vector was 0.41 ± 0.35 D, the mean absolute angle of error (AE) was 7.36 ± 6.21°, and 41% exhibited an arithmetic AE within ± 5° in the experimental group, whereas 94%, 19%, - 0.203 ± 0.148 D, 100%, 0.21 ± 0.15 D, 3.39 ± 3.68°, and 69% in the control group (all p < 0.05). The postoperative and preoperative corneal spherical aberrations were comparable in both groups (p > 0.05). CONCLUSION: Primary topography-guided FS-LASIK using Pentacam-measured anterior corneal astigmatism axis exhibited slightly inferior clinical results to that using the manifest refractive astigmatism axis. Both methods achieved comparable postoperative and preoperative corneal spherical aberrations.
Authors: Mark Lobanoff; Karl Stonecipher; Tom Tooma; Stephen Wexler; Richard Potvin Journal: J Cataract Refract Surg Date: 2020-06 Impact factor: 3.351