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. 2023 Jan;261(1):247-256.
doi: 10.1007/s00417-022-05775-7. Epub 2022 Jul 27.

Clinical results of topography-guided laser-assisted in situ keratomileusis using the anterior corneal astigmatism axis and manifest refractive astigmatism axis

Chunlei Liu #  1   2   3 , Tian Luo #  4 , Xuejun Fang  3 , Ming Hu  5 , Yun Su  3 , Jing Li  6 , Yan Wang  7   8
Affiliations

Clinical results of topography-guided laser-assisted in situ keratomileusis using the anterior corneal astigmatism axis and manifest refractive astigmatism axis

Chunlei Liu et al. Graefes Arch Clin Exp Ophthalmol. 2023 Jan.

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.

Keywords: Astigmatism; LASIK; Topography-guided; Vector analysis.

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References

    1. Alpins N (2017) Practical Astigmatism: Planning and Analysis. Slack Incorporated, New Jersey
    1. Wallerstein A, Gauvin M, Qi SR, Cohen M (2020) Effect of the vectorial difference between manifest refractive astigmatism and anterior corneal astigmatism on topography-guided LASIK outcomes. J Refract Surg 36:449–458. https://doi.org/10.3928/1081597X-20200609-01 - DOI
    1. Kanellopoulos AJ (2016) Topography-modified refraction (TMR): adjustment of treated cylinder amount and axis to the topography versus standard clinical refraction in myopic topography-guided LASIK. Clin Ophthalmol 10:2213–2221. https://doi.org/10.2147/OPTH.S122345 - DOI
    1. Motwani M (2017) The use of WaveLight® Contoura to create a uniform cornea: the LYRA Protocol. Part 3: the results of 50 treated eyes. Clin Ophthalmol 11:915–921. https://doi.org/10.2147/OPTH.S133841 - DOI
    1. Lobanoff M, Stonecipher K, Tooma T, Wexler S, Potvin R (2020) Clinical outcomes after topography-guided LASIK: comparing results based on a new topography analysis algorithm with those based on manifest refraction. J Cataract Refract Surg 46:814–819. https://doi.org/10.1097/j.jcrs.0000000000000176 - DOI

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