Xiaoxin Hu , Jiao Qi , Kaiwen Cheng , Wenwen He , Yu Du , Keke Zhang , Yi Lu , Xiangjia Zhu
{"title":"影像引导下准确角膜缘松弛切口在白内障手术中矫正散光的效果","authors":"Xiaoxin Hu , Jiao Qi , Kaiwen Cheng , Wenwen He , Yu Du , Keke Zhang , Yi Lu , Xiangjia Zhu","doi":"10.1016/j.aopr.2025.06.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the efficacy of image-guided accurate limbal relaxing incisions (LRIs) for astigmatism correction during cataract surgery.</div></div><div><h3>Methods</h3><div>Consecutive cataract patients with regular corneal astigmatism ranging from 0.75 to 2.50 D, intended for cataract surgery with image-guided LRIs, were recruited in this prospective cohort study. The efficacy of astigmatism correction was evaluated 3 months after surgery, and compared among eyes with preoperative corneal with-the-rule (WTR), against-the-rule (ATR) and oblique astigmatism. Higher-order aberrations and visual quality indices obtained with iTrace were further compared between eyes with single and paired LRIs.</div></div><div><h3>Results</h3><div>Totally, 108 eyes of 108 patients were analyzed. The mean total surgical induced astigmatism (tSIA) vector of all participants was 0.76 ± 0.38 D (range: 0.11–1.79 D, preoperative vs. postoperative astigmatism: 1.46 ± 0.41 vs. 0.78 ± 0.44 D, <em>P</em> < 0.001). Eyes with WTR astigmatism showed higher tSIA (0.89 ± 0.32 D vs. 0.42 ± 0.21 D vs. 0.48 ± 0.36 D, respectively, <em>P</em> < 0.001), as well as higher correction index and lower difference vector and index of success than ATR and oblique astigmatism groups (all <em>P</em> < 0.05). Eyes with paired LRIs exhibited better corneal average height of modulation transfer function, a better corneal performance index and a better quality of vision index than those with single LRI (all <em>P</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>Image-guided LRIs can effectively correct low-to-moderate corneal astigmatism during cataract surgery, especially in eyes with WTR astigmatism.</div></div>","PeriodicalId":72103,"journal":{"name":"Advances in ophthalmology practice and research","volume":"5 3","pages":"Pages 212-219"},"PeriodicalIF":3.4000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of image-guided accurate limbal relaxing incisions for astigmatism correction during cataract surgery\",\"authors\":\"Xiaoxin Hu , Jiao Qi , Kaiwen Cheng , Wenwen He , Yu Du , Keke Zhang , Yi Lu , Xiangjia Zhu\",\"doi\":\"10.1016/j.aopr.2025.06.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>To investigate the efficacy of image-guided accurate limbal relaxing incisions (LRIs) for astigmatism correction during cataract surgery.</div></div><div><h3>Methods</h3><div>Consecutive cataract patients with regular corneal astigmatism ranging from 0.75 to 2.50 D, intended for cataract surgery with image-guided LRIs, were recruited in this prospective cohort study. The efficacy of astigmatism correction was evaluated 3 months after surgery, and compared among eyes with preoperative corneal with-the-rule (WTR), against-the-rule (ATR) and oblique astigmatism. Higher-order aberrations and visual quality indices obtained with iTrace were further compared between eyes with single and paired LRIs.</div></div><div><h3>Results</h3><div>Totally, 108 eyes of 108 patients were analyzed. The mean total surgical induced astigmatism (tSIA) vector of all participants was 0.76 ± 0.38 D (range: 0.11–1.79 D, preoperative vs. postoperative astigmatism: 1.46 ± 0.41 vs. 0.78 ± 0.44 D, <em>P</em> < 0.001). Eyes with WTR astigmatism showed higher tSIA (0.89 ± 0.32 D vs. 0.42 ± 0.21 D vs. 0.48 ± 0.36 D, respectively, <em>P</em> < 0.001), as well as higher correction index and lower difference vector and index of success than ATR and oblique astigmatism groups (all <em>P</em> < 0.05). Eyes with paired LRIs exhibited better corneal average height of modulation transfer function, a better corneal performance index and a better quality of vision index than those with single LRI (all <em>P</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>Image-guided LRIs can effectively correct low-to-moderate corneal astigmatism during cataract surgery, especially in eyes with WTR astigmatism.</div></div>\",\"PeriodicalId\":72103,\"journal\":{\"name\":\"Advances in ophthalmology practice and research\",\"volume\":\"5 3\",\"pages\":\"Pages 212-219\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-06-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Advances in ophthalmology practice and research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2667376225000307\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in ophthalmology practice and research","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2667376225000307","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
目的探讨图像引导下准确角膜缘松弛切口(LRIs)在白内障手术中矫正散光的效果。方法前瞻性队列研究招募了角膜散光在0.75 - 2.50 D范围内的常规白内障患者,这些患者拟接受图像引导下的LRIs白内障手术。术后3个月评估散光矫正效果,并与术前角膜顺位(WTR)、顺位(ATR)和斜向散光进行比较。用iTrace获得的高阶像差和视觉质量指数进一步比较了单眼和双眼LRIs。结果共分析108例患者108只眼。所有参与者的平均总手术性散光(tSIA)矢量为0.76±0.38 D(范围:0.11-1.79 D,术前与术后散光:1.46±0.41 vs 0.78±0.44 D, P <;0.001)。WTR散光组tSIA较高(分别为0.89±0.32 D、0.42±0.21 D、0.48±0.36 D);0.001),校正指数高于ATR和斜像散组,差矢量和成功指数低于斜像散组(P <;0.05)。配对LRI的眼比单LRI的眼表现出更好的角膜调制传递函数平均高度、更好的角膜性能指数和更好的视力质量指数(P <;0.05)。结论图像引导下的LRIs可有效矫正白内障手术中低、中度角膜散光,尤其对WTR型散光眼效果更好。
Efficacy of image-guided accurate limbal relaxing incisions for astigmatism correction during cataract surgery
Purpose
To investigate the efficacy of image-guided accurate limbal relaxing incisions (LRIs) for astigmatism correction during cataract surgery.
Methods
Consecutive cataract patients with regular corneal astigmatism ranging from 0.75 to 2.50 D, intended for cataract surgery with image-guided LRIs, were recruited in this prospective cohort study. The efficacy of astigmatism correction was evaluated 3 months after surgery, and compared among eyes with preoperative corneal with-the-rule (WTR), against-the-rule (ATR) and oblique astigmatism. Higher-order aberrations and visual quality indices obtained with iTrace were further compared between eyes with single and paired LRIs.
Results
Totally, 108 eyes of 108 patients were analyzed. The mean total surgical induced astigmatism (tSIA) vector of all participants was 0.76 ± 0.38 D (range: 0.11–1.79 D, preoperative vs. postoperative astigmatism: 1.46 ± 0.41 vs. 0.78 ± 0.44 D, P < 0.001). Eyes with WTR astigmatism showed higher tSIA (0.89 ± 0.32 D vs. 0.42 ± 0.21 D vs. 0.48 ± 0.36 D, respectively, P < 0.001), as well as higher correction index and lower difference vector and index of success than ATR and oblique astigmatism groups (all P < 0.05). Eyes with paired LRIs exhibited better corneal average height of modulation transfer function, a better corneal performance index and a better quality of vision index than those with single LRI (all P < 0.05).
Conclusions
Image-guided LRIs can effectively correct low-to-moderate corneal astigmatism during cataract surgery, especially in eyes with WTR astigmatism.