Clinical utility of femtosecond laser-assisted astigmatic keratotomy after cataract surgery
Tóm tắt
To examine the clinical utility of femtosecond laser-assisted astigmatic keratotomy (FSL-AK) for eyes after cataract surgery. Eight eyes of 6 patients with an intraocular lens and corneal astigmatism of 2.0 diopters (D) or more underwent FSL-AK. The mean preoperative manifest cylindrical refraction was 2.88 ± 0.64 D and the mean corneal astigmatism was 2.84 ± 0.83 D. Paired symmetrical arcuate incisions were created with the same settings, except for the incision depth. Uncorrected distance visual acuity (UDVA), manifest cylindrical power, and surgically induced astigmatism (SIA) were measured at 1 day, 1 week, and 1 month postoperatively. Fourier analysis of corneal topography and incision depths measured with anterior-segment optical coherence tomography were evaluated 1 month postoperatively. In all eyes, the UDVA improved at 1 week and 1 month postoperatively, and the manifest cylinder also decreased postoperatively, while the SIA showed overcorrections in 6 eyes. Fourier analysis showed decreases in spherical and regular astigmatic components and increases in higher-order irregularity. The mean incision depth was measured as 60 µm deeper than the intended depth. The FSL-AK effectively reduced corneal astigmatism and improved the UDVA, although it was demonstrated that the deeper incisions led to overcorrection.
Tài liệu tham khảo
Fouda S, Kamiya K, Aizawa D, Shimizu K. Limbal relaxing incision during cataract extraction versus photoastigmatic keratectomy after cataract extraction in controlling pre-existing corneal astigmatism. Graefes Arch Clin Exp Ophthalmol. 2010;248:1029–35.
Oshika T, Shimazaki J, Yoshitomi F, Oki K, Sakabe I, Matsuda S, et al. Arcuate keratotomy to treat corneal astigmatism after cataract surgery: a prospective evaluation of predictability and effectiveness. Ophthalmology. 1998;105:2012–6.
Soong HK, Malta JB. Femtosecond lasers in ophthalmology. Am J Ophthalmol. 2009;147:189–97.
Chen S, Feng Y, Stojanovic A, Jankov MR 2nd, Wang Q. IntraLase femtosecond laser vs mechanical microkeratomes in LASIK for myopia: a systematic review and meta-analysis. J Refract Surg. 2012;28:15–24.
Buratto L, Böhm E. The use of the femtosecond laser in penetrating keratoplasty. Am J Ophthalmol. 2007;143:737–42.
Bahar I, Levinger E, Kaiserman I, Sansanayudh W, Rootman DS. IntraLase-enabled astigmatic keratotomy for postkeratoplasty astigmatism. Am J Ophthalmol. 2009;147:897–904.
Hoffart L, Proust H, Matonti F, Conrath J, Ridings B. Correction of postkeratoplasty astigmatism by femtosecond laser compared with mechanized astigmatic keratotomy. Am J Ophthalmol. 2009;147:779–87.
Nubile M, Carpineto P, Lanzini M, Calienno R, Agnifili L, Ciancaglini M, et al. Femtosecond laser arcuate keratotomy for the correction of high astigmatism after keratoplasty. Ophthalmology. 2009;116:1083–92.
Ferrer-Blasco T, Montés-Micó R, Peixoto-de-Matos SC, González-Méijome JM, Cerviño A. Prevalence of corneal astigmatism before cataract surgery. J Cataract Refract Surg. 2009;35:70–5.
Miyake T, Kamiya K, Amano R, Iida Y, Tsunehiro S, Shimizu K. Corneal astigmatism before cataract surgery. Nihon Ganka Gakkai Zasshi. 2011;115:447–53 (in Japanese).
Bradley MJ, Coombs J, Olson RJ. Analysis of an approach to astigmatism correction during cataract surgery. Ophthalmologica. 2006;220:311–6.
Miyata K, Miyai T, Minami K, Bissen-Miyajima H, Maeda N, Amano S. Limbal relaxing incisions using a reference point and corneal topography for intraoperative identification of the steepest meridian. J Refract Surg. 2011;27:339–44.
Alpins NA. A new method of analyzing vectors for change in astigmatism. J Cataract Refract Surg. 1993;19:524–33.
Oshika T, Tomidokoro A, Maruo K, Tokunaga T, Miyata N. Quantitative evaluation of irregular astigmatism by Fourier series harmonic analysis of videokeratography data. Invest Ophthalmol Vis Sci. 1998;39:705–9.
Inoue T, Maeda N, Sasaki K, Watanabe H, Inoue Y, Nishida K, et al. Factors that influence the surgical effects of astigmatic keratotomy after cataract surgery. Ophthalmology. 2001;108:1269–74.
Kamburoglu G, Ertan A, Saraçbasi O. Measurement of depth of Intacs implanted via femtosecond laser using Pentacam. J Refract Surg. 2009;25:377–82.
Malandrini A, Martone G, Canovetti A, Menabuoni L, Balestrazzi A, Fantozzi C, et al. Morphologic study of the cornea by in vivo confocal microscopy and optical coherence tomography after bifocal refractive corneal inlay implantation. J Cataract Refract Surg. 2014;40:545–57.
Kohnen T, Bühren J. Corneal first-surface aberration analysis of the biomechanical effects of astigmatic keratotomy and a microkeratome cut after penetrating keratoplasty. J Cataract Refract Surg. 2005;31:185–9.
Kamiya K, Shimizu K, Ohmoto F, Amano R. Evaluation of corneal biomechanical parameters after simultaneous phacoemulsification with intraocular lens implantation and limbal relaxing incisions. J Cataract Refract Surg. 2011;37:265–70.
Denoyer A, Ricaud X, Van Went C, Labbé A, Baudouin C. Influence of corneal biomechanical properties on surgically induced astigmatism in cataract surgery. J Cataract Refract Surg. 2013;39:1204–10.
Venter J, Blumenfeld R, Schallhorn S, Pelouskova M. Non-penetrating femtosecond laser intrastromal astigmatic keratotomy in patients with mixed astigmatism after previous refractive surgery. J Refract Surg. 2013;29:180–6.
Rückl T, Dexl AK, Bachernegg A, Reischl V, Riha W, Ruckhofer J, et al. Femtosecond laser-assisted intrastromal arcuate keratotomy to reduce corneal astigmatism. J Cataract Refract Surg. 2013;39:528–38.
Nuzzo V, Aptel F, Savoldelli M, Plamann K, Peyrot D, Deloison F, et al. Histologic and ultrastructural characterization of corneal femtosecond laser trephination. Cornea. 2009;28:908–13.
Mayer WJ, Klaproth OK, Hengerer FH, Kook D, Dirisamer M, Priglinger S, et al. In vitro immunohistochemical and morphological observations of penetrating corneal incisions created by a femtosecond laser used for assisted intraocular lens surgery. J Cataract Refract Surg. 2014;40:632–8.