AIMTo determine the surgically induced astigmatism (SIA) in Straight, Frown and Inverted V shape (Chevron) incisions in manual small incision cataract surgery (SICS).
To compare surgically induced astigmatism (SIA) of different surgeons, who perform the same main incision. Two hundred and seventy eyes underwent cataract surgery with phacoemulsification by four different surgeons ...To compare surgically induced astigmatism (SIA) of different surgeons, who perform the same main incision. Two hundred and seventy eyes underwent cataract surgery with phacoemulsification by four different surgeons (A, B, C, and D). A 3-step, 3.0 mm, superotemporal for the right eye and superonasa! for the left eye clear corneal incision was performed. A comparison in SlA among A, B, C and D surgeon was made. No significant difference was found in SlA at both first and sixth postoperative month between different surgeons (P〉0.05). SIA is more dependent on incisional characteristics and preoperative astigmatism and less on the surgeon.展开更多
We compared surgically induced astigmatism (SIA) by a superior incision with a temporal incision in manual small incision cataract surgery (MSICS), in patients with bilateral direct (regular) preoperative corneal asti...We compared surgically induced astigmatism (SIA) by a superior incision with a temporal incision in manual small incision cataract surgery (MSICS), in patients with bilateral direct (regular) preoperative corneal astigmatisms. Patients and method: We carried out a prospective study from July 1st 2018 to September 30th 2019 in the department of ophthalmology at the University Hospital of Brazzaville. Keratometric readings were recorded before surgery to assess preoperative corneal astigmatisms. Keratometric evaluation was done 45 days post-operatively. Patients were followed 90 days after surgery in order to assess the healing of the surgical site. The surgically induced astigmatism (SIA) is the difference in the magnitude vectors between the preoperative and postoperative astigmatism. The result was positive if the postoperative astigmatism was greater than the preoperative astigmatism and negative if the postoperative astigmatism was less than the preoperative astigmatism. Results: Our study sample included 48 eyes from 24 patients, including 24 operated on temporal incision and 24 in superior incision. The average SIA for superior incisions was 0.33 ± 1.55 diopters (D), versus 0.33 ± 1.44 for temporal incisions. For superior incisions the SIA was 0.81 for astigmatisms lower than 2D, against 0.16D for the temporal incisions. On the other hand, for preoperative astigmatisms greater than 2D, the surgically induced astigmatism was ±0.62D, marking a decrease in preoperative astigmatism for the superior incisions against an increase of 0.5D for the temporal incisions. The healing was delayed for the temporal incisions responsible for discomfort persisting beyond 45 days. Conclusion: The temporal incision had better results than the superior incision for astigmatisms lower than 2D, and less good for astigmatisms higher than 2D. The temporal incision healed less well.展开更多
BackgroundTo 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 ...BackgroundTo 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.MethodsThis 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.ResultsThe 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.ConclusionsICL 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.展开更多
Aim: To study the surgically induced astigmatism (SIA) caused by two different type main incisions in phacoemulsification. Methods: Sixty-eight eyes of 65 patients who underwent phacoemul-sification were randomly divi...Aim: To study the surgically induced astigmatism (SIA) caused by two different type main incisions in phacoemulsification. Methods: Sixty-eight eyes of 65 patients who underwent phacoemul-sification were randomly divided into two groups according to main incision type: 2.8 mm superior limbal incision (in Group 1) and 2.8 mm upper clear corneal incision (in Group 2). Surgical techniques did not differ between the groups except for the main incisions. All patients received detailed ophthalmological examination in addition to keratometry at the pre- and post-operatively. The preoperative and postoperative astigmatisms were calculated by the vector analysis method and the SIA was compared between the groups. Results: The mean SIA values were 1.3 ± 0.67 D, 0.89 ± 0.47 D, 0.77 ± 37 D in Group 1 and 1.42 ± 0.62 D, 1.15 ± 0.54 D, 0.94 ± 0.47 D in Group 2 on the first day, first week and first month postoperatively, respectively. According to the vector analysis, SIA was less in Group 1 than Group 2;although the difference was not statistically significant (p > 0.05). Conclusion: Although less astigmatism was detected in the superior limbal incision group, this difference was not statistically significant.展开更多
Purpose:.To investigate the occurrence of corneal incision-induced astigmatism following small incision extracapsular cataract extraction through a superotemporal incision combined with intraocular lens (IOL) implanta...Purpose:.To investigate the occurrence of corneal incision-induced astigmatism following small incision extracapsular cataract extraction through a superotemporal incision combined with intraocular lens (IOL) implantation. Methods:.A total of 255 cases (301 eyes) who received small incision extracapsular cataract extraction through a superotemporal incision with IOL implantation in the Department of Ophthalmology, Yuyan District Hospital of Guiyang were enrolled in this clinical trial..Postoperative best-corrected visual acuity and astigmatism were measured. The patients underwent 24-week follow-up. Results: In total, 166 patients (65.1%, 166 eyes) completed follow-up..Astigmatism gradually declined between 1 and 12-week postoperatively, and stabilized after 12 weeks. Among 166 patients,.125(75.3%).had astigmatism > 0.5 D at 24 weeks post-operatively,.showing mostly with-the-rule astigmatism. Visual acuity steadily improved up to 12 weeks, and tended to stabilize subsequently..Over the period of 24-week postoperatively,.visual acuity was negatively correlated with astigmatism (r=-0.691,P<0.05). Conclusion:Superotemporal small incision extracapsular extraction combined with IOL implantation is associated with modest astigmatism which declines over the post-operative period.展开更多
AIM: To examine the effects of one-handed phacoemulsification with steep-axis incision on corneal curvature and analyze surgically induced astigmatism(SIA) on the true net power, anterior and posterior corneal surface...AIM: To examine the effects of one-handed phacoemulsification with steep-axis incision on corneal curvature and analyze surgically induced astigmatism(SIA) on the true net power, anterior and posterior corneal surfaces. METHODS: Patients with cataracts underwent onehanded phacoemulsification with a 2.4-mm steep-axis of clear corneal incision(CCI) based on true net power. CCI was created under the guidance of Verion. Central corneal thickness(CCT), keratometry readings of the true net power and anterior and posterior corneal surface were obtained using Pentacam. Biometry, such as axial length, anterior chamber depth(ACD) and white-to-white(WTW) were performed using Lenstar pre-and 3 mo postoperatively. RESULTS: The study evaluated 68 eyes of 65 patients. The mean age was 65.93±9.40 y;CCT was 529.21±37.40 μm;WTW was 11.59±0.35 mm. Regarding true net power, keratometric value at the flattest corneal meridian for the 3-mm central zone(Ks) was significantly decreased postoperatively(P=0.031). Keratometric value at the steepest corneal meridian for the 3-mm central zone(Kf) was increased postoperatively(P>0.05). Astigmatism of true net power was 1.21±0.56 D preoperatively and significantly decreased to 1.02±0.58 D postoperatively(P=0.021). On the anterior corneal surface, no significant difference in Ks and Kf was noted pre-versus postoperatively. Anterior corneal astigmatism was 1.08±0.51 D preoperativelyand significantly decreased to 0.87±0.46 D postoperatively(P=0.002). On the posterior corneal surface, Ks and Kf were significantly increased postoperatively(all P<0.05), and posterior corneal astigmatism also increased(P=0.008). The SIA values of true net power and the anterior and posterior corneal surfaces at 3 mo postoperatively were 1.26±0.63 D(range: 0.11 to 2.80 D), 1.05±0.54 D(range: 0.23 to 2.40 D), and 0.21±0.17 D(range: 0.01 to 0.07 D), respectively. CONCLUSION: One-handed phacoemulsification with steep-axis incision can effectively decrease astigmatism of true net power and anterior corneal astigmatism. In the same surgery, the difference in personal SIA potentially originated from a difference in personal corneal thickness and diameter, both CCT and WTW distance should always be measured preoperatively when planning steep-axis phacoemulsification.展开更多
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)...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.展开更多
Objective:To explore the effect of phacoemulsification in combined with intraocular lens implantation incision site selection on the visual function, intraocular pressure, and corneal astigmatism in patients with cata...Objective:To explore the effect of phacoemulsification in combined with intraocular lens implantation incision site selection on the visual function, intraocular pressure, and corneal astigmatism in patients with cataract.Methods:A total of 72 patients (85 eyes) with cataract who were admitted in our hospital from April, 2015 to October, 2016 were included in the study. All the patients were performed with phacoemulsification in combined with intraocular lens implantation. The patients were divided into the observation group (n=36, 43 eyes) and the control group (n=36, 42 eyes) according to different surgical incision sites. A transparent corneal incision with a length of 3.0 mm was made along the meridian axial position with the maximum corneal refractive power in the observation, while a transparent corneal incision with a length of 3.0 mm was made above the temple or nose in the control group. Routine disposition and follow-up visit were given for the patients in the two groups after operation. BCVA, intraocular pressure, corneal astigmatism, and corneal endothelial cell count in the two groups before and after operation were compared.Results:BCVA after operation in the two groups was significantly elevated, while the corneal endothelial cell count was significantly reduced, but the comparison of BCVA and corneal endothelial cell count between the two groups was not statistically significant. The intraocular pressure after operation in the two groups was elevated first and reduced later. The intraocular pressure 2 h and 1 d after operation was significantly elevated when compared with before operation. The intraocular pressure 2 d after operation was not significantly different from that before operation. The comparison of intraocular pressure at each timing point after operation between the two groups was not statistically significant. The corneal astigmatism after operation in the two groups was elevated first and reduced later. The surgically induced astigmatism 7 d-6 months after operation was significantly reduced, and the average corneal astigmatism 7 d-6 months after operation in the observation group was significantly lower than that in the control group. The surgically induced astigmatism 1-6 months after operation in the observation group was significantly lower than that in the control group.Conclusions: Phacoemulsification in combined with intraocular lens implantation incision site selection including maximum corneal refractive power site and routine surgical incision can improve the patients' vision, but the maximum corneal refractive power site surgical incision can reduce the postoperative corneal astigmatism, and has a certain advantage.展开更多
Purpose:To investigate a simple method during extracapsular cataract extraction with posteior chamber intraocular lens implantation in order to reduce surgically induced corneal astig-matism.Methods:A modified scleral...Purpose:To investigate a simple method during extracapsular cataract extraction with posteior chamber intraocular lens implantation in order to reduce surgically induced corneal astig-matism.Methods:A modified scleral flap incision was used in the extracapsular cataract extraction with intraocular lens implantation and the postoperative changes in conreal astigmatism was observed.Results:The peak value of postoperative corneal astigmatism was3.60D,and the corneal astigmatism regression was 2.11D,surgically induced astigmatism was less significant in modified scleral flap incision group than that in convention-al limbal incison group(P<0.05).Conclusions:The modified scleral flap inciston is an ideal incision for cataract ex-traction with intraocular lens implantation when phacoemulsifier is not avaliable.Eye Science1995;11:136-139.展开更多
Objective To evaluate the efficacy of “straight scleral tunnel incision”-trabeculectomy with a releasable suture supplemented with mitomycin C (MMC) on reducing intraocular pressure (IOP), complications, and corneal...Objective To evaluate the efficacy of “straight scleral tunnel incision”-trabeculectomy with a releasable suture supplemented with mitomycin C (MMC) on reducing intraocular pressure (IOP), complications, and corneal astigmatism in patients with primary angle-closure glaucoma (PACG). Methods Totally 217 acute or chronic PACG patients with occludable angle above 180° and IOP above 21mmHg were divided into 3 groups. Patients in group A (98 cases, 128 eyes), B (71 cases, 95 eyes), and C (48 cases, 60 eyes) were treated with “straight scleral tunnel incision”-trabeculectomy with a releasable suture supplemented with MMC, releasable suture trabeculectomy with MMC, and trabeculectomy with MMC, respectively. IOP, complications, and surgically induced astigmatism (SIA) were evaluated preoperatively and up to 12 months postoperatively. [JP+2]Results IOP of 2 weeks after treatment was significantly lower than preoperative IOP in all the 3 groups (all P<0.001). Success rates (IOP≤20 mmHg) in group A, B, and C were 87.91%, 89.23%, and 83.72% respectively at 12 months after treatment (P=0.256). The incidence of shallow anterior chamber and hypotony had no significant difference between group A and B, but both of them were lower than that in group C (P<0.05). There were no significant differences in preoperative corneal astigmatism among the 3 groups. The corneal astigmatism after 2 weeks in group A (1.71±1.47D) was higher than that before operation (1.28±1.05D,P=0.126). With 12 months gone, the astigmatism almost returned to preoperative levels. The corneal astigmatisms after 2 weeks in group B and C (1.99±1.20D and 2.22±1.39D) were significantly higher than those before operation (1.20±0.85D and 1.18±0.93D,P=0.002, P=0.001), respectively. With 12 months gone, the mean astigmatisms in group B and C (1.87±0.91D and 1.90±1.16D) were still significantly higher than those before operation ( P=0.001, P=0.003). The highest astigmatic polar values in group A, B, and C (1.00D, 1.89D, and 1.77D) occurred after 2 weeks, 1 month, and 1 month postoperation, respectively, which were significantly higher than those before operation (0.19±1.32D, 0.12±1.22D, and 0.17±1.25D,P<0.01), respectively. With 12 months gone, they were 0.03D, -0.18D, and -0.13D higher than those before operation, respectively. The rates of function bleb and thin-wall bleb were 71.43% and 26.37% in group A, 75.38% and 29.23% in group B, 72.09% and 25.58% in group C, respectively at 12 months after treatment. There were no significant differences among the 3 groups.展开更多
目的:比较不同术式联合Toric IOL植入术治疗硬核年龄相关性白内障的疗效。方法:回顾性研究。选取2020-01/2021-12我院确诊为硬核年龄相关性白内障患者104例104眼,按照不同手术方式分为超声乳化组52眼采用超声乳化术联合Toric IOL植入术...目的:比较不同术式联合Toric IOL植入术治疗硬核年龄相关性白内障的疗效。方法:回顾性研究。选取2020-01/2021-12我院确诊为硬核年龄相关性白内障患者104例104眼,按照不同手术方式分为超声乳化组52眼采用超声乳化术联合Toric IOL植入术,小切口组52眼采用小切口水平空间劈核术联合Toric IOL植入术。比较两组患者手术前后最佳矫正远视力(BCDVA)、角膜散光、角膜内皮细胞数量和正常六边形细胞比例、泪膜功能及并发症情况。结果:术前和术后3mo两组患者BCDVA(LogMAR)比较均无差异(均P>0.05);术后1wk,小切口组患者BCDVA(LogMAR)优于超声乳化组(0.15±0.04 vs 0.20±0.05,P<0.001)。两组患者各组内术后1wk,3mo角膜散光均低于术前,术后3mo低于术后1wk(均P<0.05),而两组间手术前后角膜散光比较均无差异(均P>0.05)。术后1wk、3mo,小切口组患者角膜内皮细胞数量高于超声乳化组(术后1wk:2363.8±315.3 vs 2231.4±326.4cells/mm2,P<0.05;术后3mo:2414.6±245.7 vs 2322.9±221.0cells/mm2,P<0.05)。术前、术后1wk两组角膜正常六边形细胞比例比较均无差异(均P>0.05);术后3mo,小切口组正常六边形细胞比例高于超声乳化组(21.77%±1.91%vs 20.59%±1.65%,P<0.001)。术前、术后3mo时两组BUT和OSDI评分的比较无差异(P>0.05);术后1wk小切口组患者BUT长于超声乳化组(6.8±0.8 vs 5.9±1.0s,P<0.001),OSDI评分低于超声乳化组(17.62±5.47 vs 20.34±6.18分,P<0.05)。小切口组术后并发症发生率低于超声乳化组(3.9%vs 17.3%,P<0.05)。结论:小切口水平空间劈核术联合Toric IOL植入术可明显改善硬核年龄相关性白内障患者视力及散光,对角膜内皮和泪膜功能损伤轻微。展开更多
文摘AIMTo determine the surgically induced astigmatism (SIA) in Straight, Frown and Inverted V shape (Chevron) incisions in manual small incision cataract surgery (SICS).
文摘To compare surgically induced astigmatism (SIA) of different surgeons, who perform the same main incision. Two hundred and seventy eyes underwent cataract surgery with phacoemulsification by four different surgeons (A, B, C, and D). A 3-step, 3.0 mm, superotemporal for the right eye and superonasa! for the left eye clear corneal incision was performed. A comparison in SlA among A, B, C and D surgeon was made. No significant difference was found in SlA at both first and sixth postoperative month between different surgeons (P〉0.05). SIA is more dependent on incisional characteristics and preoperative astigmatism and less on the surgeon.
文摘We compared surgically induced astigmatism (SIA) by a superior incision with a temporal incision in manual small incision cataract surgery (MSICS), in patients with bilateral direct (regular) preoperative corneal astigmatisms. Patients and method: We carried out a prospective study from July 1st 2018 to September 30th 2019 in the department of ophthalmology at the University Hospital of Brazzaville. Keratometric readings were recorded before surgery to assess preoperative corneal astigmatisms. Keratometric evaluation was done 45 days post-operatively. Patients were followed 90 days after surgery in order to assess the healing of the surgical site. The surgically induced astigmatism (SIA) is the difference in the magnitude vectors between the preoperative and postoperative astigmatism. The result was positive if the postoperative astigmatism was greater than the preoperative astigmatism and negative if the postoperative astigmatism was less than the preoperative astigmatism. Results: Our study sample included 48 eyes from 24 patients, including 24 operated on temporal incision and 24 in superior incision. The average SIA for superior incisions was 0.33 ± 1.55 diopters (D), versus 0.33 ± 1.44 for temporal incisions. For superior incisions the SIA was 0.81 for astigmatisms lower than 2D, against 0.16D for the temporal incisions. On the other hand, for preoperative astigmatisms greater than 2D, the surgically induced astigmatism was ±0.62D, marking a decrease in preoperative astigmatism for the superior incisions against an increase of 0.5D for the temporal incisions. The healing was delayed for the temporal incisions responsible for discomfort persisting beyond 45 days. Conclusion: The temporal incision had better results than the superior incision for astigmatisms lower than 2D, and less good for astigmatisms higher than 2D. The temporal incision healed less well.
文摘BackgroundTo 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.MethodsThis 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.ResultsThe 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.ConclusionsICL 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.
文摘Aim: To study the surgically induced astigmatism (SIA) caused by two different type main incisions in phacoemulsification. Methods: Sixty-eight eyes of 65 patients who underwent phacoemul-sification were randomly divided into two groups according to main incision type: 2.8 mm superior limbal incision (in Group 1) and 2.8 mm upper clear corneal incision (in Group 2). Surgical techniques did not differ between the groups except for the main incisions. All patients received detailed ophthalmological examination in addition to keratometry at the pre- and post-operatively. The preoperative and postoperative astigmatisms were calculated by the vector analysis method and the SIA was compared between the groups. Results: The mean SIA values were 1.3 ± 0.67 D, 0.89 ± 0.47 D, 0.77 ± 37 D in Group 1 and 1.42 ± 0.62 D, 1.15 ± 0.54 D, 0.94 ± 0.47 D in Group 2 on the first day, first week and first month postoperatively, respectively. According to the vector analysis, SIA was less in Group 1 than Group 2;although the difference was not statistically significant (p > 0.05). Conclusion: Although less astigmatism was detected in the superior limbal incision group, this difference was not statistically significant.
文摘Purpose:.To investigate the occurrence of corneal incision-induced astigmatism following small incision extracapsular cataract extraction through a superotemporal incision combined with intraocular lens (IOL) implantation. Methods:.A total of 255 cases (301 eyes) who received small incision extracapsular cataract extraction through a superotemporal incision with IOL implantation in the Department of Ophthalmology, Yuyan District Hospital of Guiyang were enrolled in this clinical trial..Postoperative best-corrected visual acuity and astigmatism were measured. The patients underwent 24-week follow-up. Results: In total, 166 patients (65.1%, 166 eyes) completed follow-up..Astigmatism gradually declined between 1 and 12-week postoperatively, and stabilized after 12 weeks. Among 166 patients,.125(75.3%).had astigmatism > 0.5 D at 24 weeks post-operatively,.showing mostly with-the-rule astigmatism. Visual acuity steadily improved up to 12 weeks, and tended to stabilize subsequently..Over the period of 24-week postoperatively,.visual acuity was negatively correlated with astigmatism (r=-0.691,P<0.05). Conclusion:Superotemporal small incision extracapsular extraction combined with IOL implantation is associated with modest astigmatism which declines over the post-operative period.
基金Supported by the Jiangsu Province Science and Technology Department of Social Development Major Projects-Key Diseases Standardization Diagnosis and Treatment Projects(No.BE2016699)
文摘AIM: To examine the effects of one-handed phacoemulsification with steep-axis incision on corneal curvature and analyze surgically induced astigmatism(SIA) on the true net power, anterior and posterior corneal surfaces. METHODS: Patients with cataracts underwent onehanded phacoemulsification with a 2.4-mm steep-axis of clear corneal incision(CCI) based on true net power. CCI was created under the guidance of Verion. Central corneal thickness(CCT), keratometry readings of the true net power and anterior and posterior corneal surface were obtained using Pentacam. Biometry, such as axial length, anterior chamber depth(ACD) and white-to-white(WTW) were performed using Lenstar pre-and 3 mo postoperatively. RESULTS: The study evaluated 68 eyes of 65 patients. The mean age was 65.93±9.40 y;CCT was 529.21±37.40 μm;WTW was 11.59±0.35 mm. Regarding true net power, keratometric value at the flattest corneal meridian for the 3-mm central zone(Ks) was significantly decreased postoperatively(P=0.031). Keratometric value at the steepest corneal meridian for the 3-mm central zone(Kf) was increased postoperatively(P>0.05). Astigmatism of true net power was 1.21±0.56 D preoperatively and significantly decreased to 1.02±0.58 D postoperatively(P=0.021). On the anterior corneal surface, no significant difference in Ks and Kf was noted pre-versus postoperatively. Anterior corneal astigmatism was 1.08±0.51 D preoperativelyand significantly decreased to 0.87±0.46 D postoperatively(P=0.002). On the posterior corneal surface, Ks and Kf were significantly increased postoperatively(all P<0.05), and posterior corneal astigmatism also increased(P=0.008). The SIA values of true net power and the anterior and posterior corneal surfaces at 3 mo postoperatively were 1.26±0.63 D(range: 0.11 to 2.80 D), 1.05±0.54 D(range: 0.23 to 2.40 D), and 0.21±0.17 D(range: 0.01 to 0.07 D), respectively. CONCLUSION: One-handed phacoemulsification with steep-axis incision can effectively decrease astigmatism of true net power and anterior corneal astigmatism. In the same surgery, the difference in personal SIA potentially originated from a difference in personal corneal thickness and diameter, both CCT and WTW distance should always be measured preoperatively when planning steep-axis phacoemulsification.
文摘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.
文摘Objective:To explore the effect of phacoemulsification in combined with intraocular lens implantation incision site selection on the visual function, intraocular pressure, and corneal astigmatism in patients with cataract.Methods:A total of 72 patients (85 eyes) with cataract who were admitted in our hospital from April, 2015 to October, 2016 were included in the study. All the patients were performed with phacoemulsification in combined with intraocular lens implantation. The patients were divided into the observation group (n=36, 43 eyes) and the control group (n=36, 42 eyes) according to different surgical incision sites. A transparent corneal incision with a length of 3.0 mm was made along the meridian axial position with the maximum corneal refractive power in the observation, while a transparent corneal incision with a length of 3.0 mm was made above the temple or nose in the control group. Routine disposition and follow-up visit were given for the patients in the two groups after operation. BCVA, intraocular pressure, corneal astigmatism, and corneal endothelial cell count in the two groups before and after operation were compared.Results:BCVA after operation in the two groups was significantly elevated, while the corneal endothelial cell count was significantly reduced, but the comparison of BCVA and corneal endothelial cell count between the two groups was not statistically significant. The intraocular pressure after operation in the two groups was elevated first and reduced later. The intraocular pressure 2 h and 1 d after operation was significantly elevated when compared with before operation. The intraocular pressure 2 d after operation was not significantly different from that before operation. The comparison of intraocular pressure at each timing point after operation between the two groups was not statistically significant. The corneal astigmatism after operation in the two groups was elevated first and reduced later. The surgically induced astigmatism 7 d-6 months after operation was significantly reduced, and the average corneal astigmatism 7 d-6 months after operation in the observation group was significantly lower than that in the control group. The surgically induced astigmatism 1-6 months after operation in the observation group was significantly lower than that in the control group.Conclusions: Phacoemulsification in combined with intraocular lens implantation incision site selection including maximum corneal refractive power site and routine surgical incision can improve the patients' vision, but the maximum corneal refractive power site surgical incision can reduce the postoperative corneal astigmatism, and has a certain advantage.
文摘Purpose:To investigate a simple method during extracapsular cataract extraction with posteior chamber intraocular lens implantation in order to reduce surgically induced corneal astig-matism.Methods:A modified scleral flap incision was used in the extracapsular cataract extraction with intraocular lens implantation and the postoperative changes in conreal astigmatism was observed.Results:The peak value of postoperative corneal astigmatism was3.60D,and the corneal astigmatism regression was 2.11D,surgically induced astigmatism was less significant in modified scleral flap incision group than that in convention-al limbal incison group(P<0.05).Conclusions:The modified scleral flap inciston is an ideal incision for cataract ex-traction with intraocular lens implantation when phacoemulsifier is not avaliable.Eye Science1995;11:136-139.
文摘Objective To evaluate the efficacy of “straight scleral tunnel incision”-trabeculectomy with a releasable suture supplemented with mitomycin C (MMC) on reducing intraocular pressure (IOP), complications, and corneal astigmatism in patients with primary angle-closure glaucoma (PACG). Methods Totally 217 acute or chronic PACG patients with occludable angle above 180° and IOP above 21mmHg were divided into 3 groups. Patients in group A (98 cases, 128 eyes), B (71 cases, 95 eyes), and C (48 cases, 60 eyes) were treated with “straight scleral tunnel incision”-trabeculectomy with a releasable suture supplemented with MMC, releasable suture trabeculectomy with MMC, and trabeculectomy with MMC, respectively. IOP, complications, and surgically induced astigmatism (SIA) were evaluated preoperatively and up to 12 months postoperatively. [JP+2]Results IOP of 2 weeks after treatment was significantly lower than preoperative IOP in all the 3 groups (all P<0.001). Success rates (IOP≤20 mmHg) in group A, B, and C were 87.91%, 89.23%, and 83.72% respectively at 12 months after treatment (P=0.256). The incidence of shallow anterior chamber and hypotony had no significant difference between group A and B, but both of them were lower than that in group C (P<0.05). There were no significant differences in preoperative corneal astigmatism among the 3 groups. The corneal astigmatism after 2 weeks in group A (1.71±1.47D) was higher than that before operation (1.28±1.05D,P=0.126). With 12 months gone, the astigmatism almost returned to preoperative levels. The corneal astigmatisms after 2 weeks in group B and C (1.99±1.20D and 2.22±1.39D) were significantly higher than those before operation (1.20±0.85D and 1.18±0.93D,P=0.002, P=0.001), respectively. With 12 months gone, the mean astigmatisms in group B and C (1.87±0.91D and 1.90±1.16D) were still significantly higher than those before operation ( P=0.001, P=0.003). The highest astigmatic polar values in group A, B, and C (1.00D, 1.89D, and 1.77D) occurred after 2 weeks, 1 month, and 1 month postoperation, respectively, which were significantly higher than those before operation (0.19±1.32D, 0.12±1.22D, and 0.17±1.25D,P<0.01), respectively. With 12 months gone, they were 0.03D, -0.18D, and -0.13D higher than those before operation, respectively. The rates of function bleb and thin-wall bleb were 71.43% and 26.37% in group A, 75.38% and 29.23% in group B, 72.09% and 25.58% in group C, respectively at 12 months after treatment. There were no significant differences among the 3 groups.
文摘目的:比较不同术式联合Toric IOL植入术治疗硬核年龄相关性白内障的疗效。方法:回顾性研究。选取2020-01/2021-12我院确诊为硬核年龄相关性白内障患者104例104眼,按照不同手术方式分为超声乳化组52眼采用超声乳化术联合Toric IOL植入术,小切口组52眼采用小切口水平空间劈核术联合Toric IOL植入术。比较两组患者手术前后最佳矫正远视力(BCDVA)、角膜散光、角膜内皮细胞数量和正常六边形细胞比例、泪膜功能及并发症情况。结果:术前和术后3mo两组患者BCDVA(LogMAR)比较均无差异(均P>0.05);术后1wk,小切口组患者BCDVA(LogMAR)优于超声乳化组(0.15±0.04 vs 0.20±0.05,P<0.001)。两组患者各组内术后1wk,3mo角膜散光均低于术前,术后3mo低于术后1wk(均P<0.05),而两组间手术前后角膜散光比较均无差异(均P>0.05)。术后1wk、3mo,小切口组患者角膜内皮细胞数量高于超声乳化组(术后1wk:2363.8±315.3 vs 2231.4±326.4cells/mm2,P<0.05;术后3mo:2414.6±245.7 vs 2322.9±221.0cells/mm2,P<0.05)。术前、术后1wk两组角膜正常六边形细胞比例比较均无差异(均P>0.05);术后3mo,小切口组正常六边形细胞比例高于超声乳化组(21.77%±1.91%vs 20.59%±1.65%,P<0.001)。术前、术后3mo时两组BUT和OSDI评分的比较无差异(P>0.05);术后1wk小切口组患者BUT长于超声乳化组(6.8±0.8 vs 5.9±1.0s,P<0.001),OSDI评分低于超声乳化组(17.62±5.47 vs 20.34±6.18分,P<0.05)。小切口组术后并发症发生率低于超声乳化组(3.9%vs 17.3%,P<0.05)。结论:小切口水平空间劈核术联合Toric IOL植入术可明显改善硬核年龄相关性白内障患者视力及散光,对角膜内皮和泪膜功能损伤轻微。