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| Clinical Observation on Correction of Corneal Astigmatism by Femtosceond Laser-AssistedArcuate Keratotomy during Cataract Surgery |
| Fan Zhang1, Shaowei Li1, Dongmei Huo2, Qiumei Li2, Yuan Miao1, Weiyan Liang2, Xinxin Li1 |
| 1Aier School of Ophthalmology, Central South University, Changsha 410009, China
2Beijing Aier-Intech Eye Hospital, Beijing 100021, China |
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Abstract Objective: To research the clinical effect of femtosceond laser-assisted arcuate keratotomy (FSAK) in the correction of preoperative corneal astigmatism during cataract surgery. Methods:This was a retrospective case control study. Eight-nine patients (89 eyes) with preoperative regular corneal astigmatism of 0.75 -2.00 D who underwent femtosecond laser-assisted cataract surgery from March 2017 to December 2021 in Beijing Aier-Intech Eye Hospital were continuously collected. Femtosecond laser assisted cataract surgery and arcuate keratotomy were performed on Lensx platform. All patients were divided into 3 subgroups according to the axis of preoperative astigmatism, with the rule astigmatism group (90°±30°),against the rule astigmatism group (180°±30°) and the oblique astigmatism group (45°±15° and 135°±15°). Femtosecond laser-assisted cataract surgery and arcuate incisions were performed on Lensx platform.Observe the changes and distribution of corneal astigmatism before and 3 months after surgery in the general and subgroups of with the rule and against the rule subgroups. Paired samples t-test or Wilcoxon signed-rank test were used to compare the preoperative and postoperative astigmatism differences between the whole and each subgroup. Independent samples t-test or Mann-Whitney U test were used to compare the differences between the with-the-rule and the against-the-rule astigmatism groups, astigmatism change analysis usingAlpins vector analysis method.Results: Eighty-nine patients (89 eyes) were included,there were 38 cases in with the rule group, 44 cases in against the rule group and 7 cases in oblique group. The corneal horizontal diameter was 11.48±0.57 mm and the vertical diameter was 10.66±0.60 mm.The post-operative uncorrected distance visual acuity and corrected distance visual acuity of the patients weresignifcantlyimprovedcomparedwithpre-operative.Totalmeancornealastigmatismbeforeoperation was1.28±0.33D,and the residual corneal astigmatism was 0.67±0.37 D at 3 months after operation, the correction magnitudle of astigmatism is 0.61±0.33 D. In with the rule and against the rule groups, the net changes of corneal astigmatism were 0.48±0.27 D, 0.74±0.34 D, respectively. The postoperative fat keratometric of the patients in the overall and with the rule, against the rule groups increased signifcantly, while the steep keratometric decreased significantly. Alpins vector analysis shows that the overall astigmatism correction index is 0.63±0.30, the fatting index is 0.58±0.30, the index of success is 0.51±0.25,and the angle of error is -1.83°±12.59°. Among two subgroups, the against the rule group has the best correction effect (correction index is 0.81±0.25, fatting index is 0.75±0.26, index of success is 0.40±0.24), the with the rule group takes the second place (correction index is 0.42±0.21, fatting index is 0.39±0.21, index of success is 0.63±0.21).Conclusions: FSAK during cataract surgery is effective and safe in the treatment of corneal astigmatism, the same arcuate incision design achieved better curative effect in the against the rule astigmatism group, and corneal diameter maybe an important factor affecting the amount of astigmatism correction.
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Received: 30 April 2022
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Corresponding Authors:
Shaowei Li, Aier School of Ophthalmology, Central South University, Changsha 410009, China (Email: lishaowei@csu.edu.cn)
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