Long-Term Clinical Study of Astigmatism Induced by Steep Axis Clean Corneal Incisions during Cataract Surgery
Haiwei Chen, Dongmei Liu, Hongsheng Bi, Yang Li
The Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Institute of Ophthalmology Disease Prevention and Control of Shandong, Key Laboratory of IntegratedTraditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong,Jinan 250002, China
Abstract：Objective: To observe the long-term changes of surgically induced astigmatism (SIA) in phacoemulsifcation surgery with steep axis clear corneal incision. Methods: Retrospective case analysis was used. The data was gathered from 56 patients (63 eyes, 32 right eyes, and 31 left eyes) who underwent cataract surgery at the Eye Hospital of Shandong University of Traditional Chinese Medicine from January 1 st, 2018, to March 1 st, 2021. In addition to intraocular lens implantation, all patients had their cataracts phacoemulsified. The same doctor conducted the procedure. During the most recent follow-up (follow-up period from October 1 st, 2021, to December 31 st, 2021) and prior, the IOL-Master 700's corneal curvature was assessed. Through the use of vector analysis, axial, SIAis determined. Corneal incisions in different eye types, in different directions (the incision group corresponding to the upper incision group in the compliant astigmatism group, the temporal incision group in the anti-regular astigmatism group,and the oblique axis incision group in the oblique axis astigmatism group) and different periods (from 36 months to 48 months after cataract surgery, 24 months to 36 months after cataract surgery, and 12 months to 24 months after cataract surgery) and SIAusing different calculation methods (vector analysis method and centroid method) were compared. The obtained data was analyzed by one-way homogeneity of variance test and independent-sample t test method. Results:Among 63 eyes, the SIAof different eyes was compared, the right eye was (0.45±0.19) D, the left eye was (0.48±0.34)D, and the difference was statistically signifcant (t=0.43, P=0.045); the incision comparison of SIAwas (0.44±0.36) D, (0.47±0.23) D,
(0.50±0.20) D respectively and the difference was not statistically significant (F=0.22, P=0.800); the difference of different periods was not statistically signifcant (F=0.28, P=0.756); there was no signifcant difference between the SIAcalculated by the vector analysis method and the centroid method (t=0.08,P=0.800). Conclusion: The SIAof the incision of the right eye was signifcantly smaller than that of the incision of the left eye by the vector analysis method, but therewas no signifcant change in the SIAof the incision in different steep axial directions, different periods, and different calculation methods in all patients.
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