Comparison between the change in total corneal astigmatism and actual change in refractive astigmatism in transepithelial photorefractive keratectomy (tPRK), laser in situ keratomileusis (LASIK) and femtosecond laser assisted laser in situ keratomileusis (FsLASIK).

Autor: Bohac M; 448692Specialty Eye Hospital 'Svjetlost', Zagreb, Croatia, School of Medicine University of Rijeka, Croatia., Biscevic A; 448692Specialty Eye Hospital 'Svjetlost', Zagreb, Croatia, School of Medicine University of Rijeka, Croatia., Shijakova V; 448692Specialty Eye Hospital 'Svjetlost', Zagreb, Croatia, School of Medicine University of Rijeka, Croatia.; Eye Clinic Sistina Oftalmologija, Skopje, Republic of North Macedonia., Gabric I; 448692Specialty Eye Hospital 'Svjetlost', Zagreb, Croatia, School of Medicine University of Rijeka, Croatia., Gabric K; 448692Specialty Eye Hospital 'Svjetlost', Zagreb, Croatia, School of Medicine University of Rijeka, Croatia., Patel S; 448692Specialty Eye Hospital 'Svjetlost', Zagreb, Croatia, School of Medicine University of Rijeka, Croatia.
Jazyk: angličtina
Zdroj: European journal of ophthalmology [Eur J Ophthalmol] 2022 Sep; Vol. 32 (5), pp. 2638-2645. Date of Electronic Publication: 2021 Nov 11.
DOI: 10.1177/11206721211059327
Abstrakt: Purpose: To compare changes in astigmatism by refraction and total corneal astigmatism after tPRK, LASIK and FsLASIK.
Setting: Specialty Eye Hospital Svjetlost, Zagreb, Croatia.
Design: Partially masked, semi-randomized, prospective, case-by-case, interventional, clinical study.
Methods: Patients with a stable refraction (-0.75DS to -8.00DS, astigmatism ≤1.00DC) underwent tPRK, LASIK or FsLASIK without complication. Astigmatism was measured at both corneal surfaces over the central 3.2 mm zone (approximately using Pentacam HR TM ) preoperatively and 3 months postoperatively. Pentacam and refraction data were subjected to vector analysis to calculate the surgically induced changes in i) total corneal astigmatism (SIA TCA ) ii) any astigmatism by refraction (SIA R ) and the vectorial difference (DV) between SIA TCA and SIA R.
Results: Reporting key findings (p < .01), there was a significant difference between mean SIA TCA and SIA R powers after tPRK (75eyes) but not after LASIK (100eyes) or FsLASIK (100eyes). Mean (±sd,95% CIs) values for DV powers were, tPRK -1.13DC(±0.71, -1.29 to -0.97), LASIK -0.39DC(±0.23,-0.44 to -0.34), FsLASIK -0.55DC(±0.38,-0.62 to -0.47). The differences were significant. For the tPRK and FsLASIK cases, linear regression revealed significant associations between I) SIA TCA (x) &DV (z) powers (tPRK z = 1.586x-0.179, r  =  0.767, p < .01; FsLASIK z  =  0.442x-0.303, r  =  .484,p < .01), II) sines of SIA TCA (x 1 ) &DV (z 1 ) axes (tPRK, z 1  = 0.523 ×  1  + 0.394, r = .650,p < .01; FsLASIK z 1  = 0.460 ×  1 -0.308, r = .465,p < .01).
Conclusions: tPRK is more prone to unintended changes in astigmatism. The difference between SIA TCA & SIA R after tPRK or FsLASIK is mediated by SIA TCA . Photoablating deeper regions of the cornea reduces the gap between SIA TCA & SIA R .
Databáze: MEDLINE
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