Effects of Ocular Residual Astigmatism on Refractive Outcomes for Myopia Correction After Keratorefractive Lenticule Extraction Surgery.

IF 2.9 3区医学 Q1 OPHTHALMOLOGY Journal of refractive surgery Pub Date : 2024-12-01 DOI:10.3928/1081597X-20241016-02

Qing Su, Shuang Liang, Huazheng Cao, Mengyuan Shan, Yan Wang

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Abstract

Purpose: To evaluate the effects of ocular residual astigmatism (ORA) on refractive outcomes for patients with astigmatism after keratorefractive lenticule extraction (KLEx) and to identify the ratio of the ORA/manifest refractive cylinder at the corneal plane (MRC) resulting in a greater index of success (IOS).

Methods: In total, 892 right eyes that underwent KLEx surgery were included. Astigmatic changes were evaluated using Alpins' vector analysis. Surgical outcomes grouped by ORA/MRC and ORA were compared. In stage 1, eyes were divided into two groups with an ORA/MRC cutoff value of 1. In stage 2, patients with an ORA/MRC ratio of greater than 1 were divided into two groups: those with an ORA of 1.25 diopters (D) or greater and those with an ORA of less than 0.50 D. ORA/MRC thresholds leading to a high IOS were analyzed using receiver operating characteristic (ROC) curves.

Results: In stage 1, the mean IOS was 0.13 and 0.21 for the low and high ORA/MRC groups, respectively (P < .001). In stage 2, for high ORA/MRC, the IOS was significantly greater when the ORA was greater than 1.25 D than when the ORA was less than 0.50 D (0.27 versus 0.13, P < .001). ROC curves revealed that participants with an ORA/MRC ratio of greater than 1.8 were more likely to have a higher IOS (P < .001).

Conclusions: Patients with a smaller ORA can obtain better correction results. An ORA/MRC ratio of greater than 1.8 may increase the risk of poor astigmatism correction with KLEx. The application of vector planning may improve the refractive outcomes of KLEx. [J Refract Surg. 2024;40(12):e966-e973.].

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残余散光对屈光性角膜屈光体摘出术后近视矫正屈光效果的影响。

目的：评价残余散光（ORA）对散光患者角膜屈光体摘除（KLEx）术后屈光结果的影响，确定残余散光/明显屈光柱在角膜平面（MRC）的比例，从而获得更高的成功指数（IOS）。方法：选取892例行KLEx手术的右眼。采用Alpins矢量分析评价像散变化。比较ORA/MRC分组和ORA手术结果。在第一阶段，眼睛分为两组，ORA/MRC截止值为1。在第二阶段，将ORA/MRC比值大于1的患者分为两组：ORA为1.25屈光度(D)及以上的患者和ORA小于0.50 D的患者，采用受试者工作特征（ROC）曲线分析导致高IOS的ORA/MRC阈值。结果：在第一阶段，ORA/MRC低组和高组的平均IOS分别为0.13和0.21 （P < 0.001）。在第二阶段，对于高ORA/MRC，当ORA大于1.25 D时，IOS显著大于ORA小于0.50 D时（0.27 vs 0.13, P < 0.001）。ROC曲线显示，ORA/MRC比值大于1.8的参与者更有可能有更高的IOS （P < 0.001）。结论：ORA越小，矫正效果越好。ORA/MRC比值大于1.8可能会增加使用KLEx矫正散光不良的风险。矢量规划的应用可以改善屈光效果。[J].中华眼科杂志，2014;35(6):559 - 563。

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来源期刊

$Journal of refractive surgery$

Journal of refractive surgery 医学-外科

CiteScore

5.10

自引率

12.50%

发文量

160

审稿时长

4-8 weeks

期刊介绍： The Journal of Refractive Surgery, the official journal of the International Society of Refractive Surgery, a partner of the American Academy of Ophthalmology, has been a monthly peer-reviewed forum for original research, review, and evaluation of refractive and lens-based surgical procedures for more than 30 years. Practical, clinically valuable articles provide readers with the most up-to-date information regarding advances in the field of refractive surgery. Begin to explore the Journal and all of its great benefits such as: • Columns including “Translational Science,” “Surgical Techniques,” and “Biomechanics” • Supplemental videos and materials available for many articles • Access to current articles, as well as several years of archived content • Articles posted online just 2 months after acceptance.