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AIM:To compare the curative effect of different surgical methods combined with Toric intraocular lens(IOL)implantation on age-related hard nuclear cataract.METHODS:According to retrospective study, 104 patients(104 eyes)with age-related hard nuclear cataract confirmed in the hospital between January 2020 and December 2021 were enrolled. They were divided into phacoemulsification group(52 eyes, phacoemulsification combined with Toric IOL implantation)and small-incision group(52 eyes, small-incision split nuclear technique in horizontal space combined with Toric IOL implantation)according to different surgical methods. The best corrected distance visual acuity(BCDVA), corneal astigmatism, number of corneal endothelial cells, proportion of normal hexagonal cells, tear film function and complications were compared between the two groups.RESULTS:There was no significant difference in BCDVA(LogMAR)between the two groups before and at 3mo after surgery(all P>0.05), while BCDVA(LogMAR)was better in small-incision group than phacoemulsification group at 1wk after surgery(0.15±0.04 vs. 0.20±0.05, P<0.001). The corneal astigmatism of the patients in both groups was lower at 1wk and 3mo after surgery than that before surgery, and it was lower at 3mo than 1wk after surgery(all P<0.05), while there was no significant difference in corneal astigmatism between the two groups before and after surgery(all P>0.05). At 1wk and 3mo after surgery, number of corneal endothelial cells in small-incision group was more than that in phacoemulsification group(1wk after surgery: 2363.8±315.3 vs. 2231.4±326.4 cells/mm2, P<0.05; 3mo after surgery: 2414.6±245.7 vs. 2322.9±221.0 cells/mm2, P<0.05). Before and at 1wk after surgery, there was no significant difference in the proportion of normal hexagonal cells between the two groups(all P>0.05). At 3mo after surgery, proportion of normal hexagonal cells in small-incision group was higher than that in phacoemulsification group(21.77%±1.91% vs. 20.59%±1.65%, P<0.001). Before and at 3mo after surgery, there was no difference in break up time(BUT)or ocular surface disease index(OSDI)score between the two groups(P>0.05). At 1wk after surgery, BUT in small-incision group was longer than that in phacoemulsification group(6.8±0.8 vs. 5.9±1.0s, P<0.001)and OSDI score was lower than that in phacoemulsification group(17.62±5.47 vs. 20.34±6.18 points, P<0.05). The incidence of postoperative complications in small-incision group was lower than that in phacoemulsification group(3.9% vs. 17.3%, P<0.05).CONCLUSION: Small-incision split nuclear technique in horizontal space combined with Toric IOL implantation can significantly improve visual acuity and astigmatism in patients with age-related cataract, with slight damage to corneal endothelium and tear film function.
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AIM: To investigate the visual quality of LENTIS Comfort Toric intraocular lens implantation in cataract surgery.METHODS: A retrospective controlled clinical study was conducted on 40 patients(40 eyes)who received phacoemulsification combined with intraocular lens implantation assisted by digital navigation, with LENTIS Comfort Toric(MF15T)implanted in group A(24 eyes)and monofocal Toric intraocular lens implanted in group B(16 eyes). The visual acuity at different distances, the postoperative astigmatism center of mass value, the lens loss rate, the change of defocus curve and the stability of intraocular lens were observed at 3mo after surgery.RESULTS: There were no serious complications in both groups, and there was no significant difference in distance vision between group A and group B at 3mo after surgery(P>0.05); the visual acuity and near vision in group A were significantly better than those in group B(P<0.01); the postoperative lens loss rate in group A was 99%, and it was 45% in group B(P<0.05); the value of astigmatism center of mass in 3mo after surgery was improved compared with that before surgery, and there was no significant difference between groups(P>0.05); the defocus curve of group A peaked at +0.50 and -1.75D at 3mo after surgery, forming plateau and gently declining, while group B showed a steep decline after peaks at +0.25 and -0.25D. One eye(4%)in group A had the axial rotation of intraocular lens greater than 10° at 1d after surgery; In group B, 6 eyes(38%)had axial rotation of intraocular lenses greater than 10°, 2 eyes(33%)rotated clockwise, and 4 eyes(67%)rotated counterclockwise. No intraocular lens displacement occurred in either group.CONCLUSION: Both kinds of intraocular lenses can correct astigmatism, among which LENTIS Comfort Toric intraocular lens can provide personalized choices for people with cataract and astigmatism, solve astigmatism and obtain full visual acuity at the same time, with low incidence of postoperative optical interference, better stability, high visual quality and satisfaction.
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@#AIM:To analyze the effect of phacoemulsification and astigmatism corrected multifocal intraocular lens(IOL)implantation on corneal astigmatism and visual quality in cataract patients. <p>METHODS:Ninety-five patients who underwent ophthalmic surgery in our hospital for cataract disease between December 2016 and February 2018 were studied. All subjects were randomized and compared. Both groups were treated with phacoemulsification. The control group was treated with astigmatism-corrected monofocal intraocular lens implantation. The observation group was combined with astigmatism-corrected multifocal intraocular lens implantation. The differences in corneal astigmatism, visual quality, and vision improvement were compared between the two groups.<p>RESULTS: Uncorrected distance vision, best corrected distance vision, uncorrected near vision and best corrected near vision were significantly improved in the two groups after treatment at 3mo after operation. The degree of improvement in the observation group was significantly higher than that in the control group(<i>P</i><0.05). The corneal astigmatism of the two groups was significantly improved after treatment(<i>P</i><0.05). There was no significant difference between the two groups(<i>P</i>>0.05). After the treatment,the visual contrast sensitivity was significantly increased(<i>P</i><0.05). The visual contrast at the 18 cpd spatial frequency in the observation group was significantly lower than that in the control group(<i>P</i><0.01).One day after surgery, only two eyes in the observation group showed corneal endothelial edema, and only one eye in the control group showed corneal endothelial edema. There was no significant difference in the incidence of complications between the observation group and the control group(<i>P</i>>0.05).<p>CONCLUSION: The treatment of cataract patients with phacoemulsification and astigmatism-corrected multifocal IOL implantation can effectively correct vision, reduce corneal astigmatism, and improve visual contrast. The entire surgical procedure is safe and has fewer postoperative complications.
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PURPOSE: To compare the effect of astigmatism correction upon Mel 80 excimer laser surgery with or without an eye registration system. METHODS: This retrospective analysis investigates a group (eye registration group) of surface laser ablation surgeries for myopic astigmatism correction, with operation on 27 eyes from 15 patients with guidance of the eye registration system and 40 eyes from 29 patients without guidance from the eye registration system. The evaluation of astigmatism correction was performed by the Alpins method, measuring the amount and axis of astigmatism before and after the operations. RESULTS: The average of the correction index (the ratio of the surgically induced amount of astigmatism correction to the intended amount of astigmatism correction) for the eye registration group was calculated to be 0.94+/-0.30 and, for non-eye registration group, was 0.92+/-0.41, showing no statistical significant difference between the two groups (p=0.762). However, the comparison of the index of success (the ratio of the difference vector to the intended amount of astigmatism correction) favorably demonstrated the effectiveness of eye registration (0.23+/-0.34 for eye registration group, 0.47+/-0.54 for non-eye registration group, p=0.03). The absolute angle of error (AE), a measure of difference in angle between the ablated axis of astigmatism correction and the desired axis of astigmatism correction, was lower on average for the eye registration group than for the non-eye registration group (3.52+/-7.69 to 12.5+/-20.69 degrees, p=0.015). CONCLUSIONS: Eye registration-guided surface laser ablation is suggested to be beneficial for the reduction of errors in astigmatism correction.
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Humans , Astigmatism , Axis, Cervical Vertebra , Eye , Laser Therapy , Lasers, Excimer , Retrospective StudiesABSTRACT
Transverse incision astigmatic keratotomy procedures were performed, combined with radial keratotomy, in 16 eyes for correction of astigmatism and coexisting myopia. We used a transverse incision technique in which T-incisions vertically intersected radial incisions of the steepest corneal meridian. After a mean follow-up period of 10 months with a range of six to 27 months, an average 1.92 diopters of the cylinder was corrected. In comparison with 2.11 diopters of the cylinder corrected at postoperative one day, there was a 22.8% decrease in the effect of astigmatism correction after a postoperative period averaging 10 months.