ABSTRACT
Purpose: To evaluate the postoperative visual outcomes, that is, corneal higher?order aberrations (HOAs) and visual quality, of patients with an angle kappa greater than 0.30 mm who underwent angle kappa adjustment during small?incision lenticule extraction (SMILE) 2 years after surgery compared to eyes with an angle kappa less than 0.30 mm. Methods: This was a retrospective study and included 12 patients from October 2019 to December 2019 who underwent the SMILE procedure for correction of myopia and myopic astigmatism and had one eye with a large kappa angle and another eye with a small kappa angle. Twenty?four months after surgery, an optical quality analysis system (OQAS II; Visiometrics, Terrassa, Spain) was used to measure the modulation transfer function cutoff frequency (MTFcutoff), Strehl2D ratio, and objective scatter index (OSI). HOAs were measured with a Tracey iTrace Visual Function Analyzer (Tracey version 6.1.0; Tracey Technologies, Houston, TX, USA). Assessment of subjective visual quality was achieved using the quality of vision (QOV) questionnaire. Results: At 24 months postoperatively, the mean spherical equivalent (SE) refraction was ? 0.32 ± 0.40 and ? 0.31 ± 0.35 in the S?kappa group (kappa <0.3 mm) and the L?kappa group (kappa ?0.3 mm), respectively (P > 0.05). The mean OSI was 0.73 ± 0.32 and 0.81 ± 0.47, respectively (P > 0.05). There was no significant difference in MTFcutoff and Strehl2D ratio between the two groups (P > 0.05). Total HOA, coma, spherical, trefoil, and secondary astigmatism were not significantly different (P > 0.05) between the two groups. Conclusion: Adjustment of angle kappa during SMILE helps reduce the decentration, results in less HOAs, and promotes visual quality. It provides a reliable method to optimize the treatment concentration in SMILE.
ABSTRACT
PURPOSE: To compare the corneal first surface higher-order aberrations (HOAs) of normal subjects and patients with dry eye using KR-1W(R) (Topcon Corp., Tokyo, Japan) and Pentacam(R) HR (Oculus Inc., Dutenhofen, Germany). We analyzed the relationship between the aberrations and the diagnostic parameters of dry eye. METHODS: We evaluated anterior corneal HOAs in 71 normal eyes and 71 dry eyes using KR-1W(R) and Pentacam(R). Dry eye patients were examined for fluorescein staining, tear break-up time (TBUT), and Schirmer I test. Ocular Surface Disease Index (OSDI) was used for assessment of subjective symptoms in dry eye patients. RESULTS: HOAs measured by both instruments were greater in the dry eye group than in the control group, although HOAs using KR-1W(R) only achieved statistical significance. The anterior corneal HOAs measured by the 2 instruments were significantly correlated with superficial punctate keratitis. Moreover, TBUT and the Shirmer I test negatively correlated, and OSDI positively correlated, with anterior corneal HOAs. CONCLUSIONS: The HOAs in patients with dry eye were significantly different from controls and tended to increase with disease severity. KR-1W(R) might be more useful than Pentacam(R) to detect tear film instabilities.
Subject(s)
Humans , Fluorescein , Keratitis , TearsABSTRACT
PURPOSE: To assess the changes of corneal astigmatism and higher order aberrations (HOAs) of the anterior and posterior corneal surface after cataract surgery with on-axis clear corneal incision in eyes with-the-rule (WTR) astigmatism and against-the-rule (ATR) astigmatism. METHODS: This study included 50 patients who underwent phacoemulsification and IOL insertion through a 2.8-mm on-axis clear corneal incision. The eyes were divided into two groups: (1) 26 eyes with WTR astigmatism with a superior incision and (2) 24 eyes with ATR astigmatism with a temporal incision. During the follow-up period, visual acuity was measured, and the surgically induced astigmatism (SIA) and HOAs of the anterior and posterior corneal surface were measured with Pentacam(R) (Occlus, Wetzlar, Germany) preoperatively and 1 week, 1 month, and 2 months postoperatively. RESULTS: There were no significant differences in UCVA and BCVA between the two groups. HOAs increased in both groups 1 week after surgery, but no significant differences were found between the groups (p > 0.05). Surgically induced astigmatism was larger in the WTR group than in the ATR group (p < 0.05). At postoperative 2 months, there were significant differences in HOAs between the two groups, and there were statistically significant differences in HOAs, oblique trefoil at front side, and in HOAs, horizontal coma at rear side (p < 0.05). CONCLUSIONS: In conclusion, superior incision in eyes with WTR astigmatism resulted in higher SIA compared to temporal incision in eyes with ATR astigmatism. Moreover, HOAs was significantly decreased in eyes with WTR astigmatism with superior incision. Thus, superior incision could be more effective in reducing corneal astigmatism in eyes with WTR astigmatism.