Comparison of surgically induced astigmatism between femtosecond laser and manual clear corneal incisions for cataract surgery

Diakonis, Vasilios F.; Yeşilırmak, Nilüfer; Cabot, Florence; Kankariya, Vardhaman P.; Kounis, George A.; Warren, Daniel; Sayed-Ahmed, Ibrahim O.; Yoo, Sonia H.; Donaldson, Kendall E.

doi:10.1016/j.jcrs.2015.11.004

Cited by 36 publications

(34 citation statements)

References 19 publications

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“…25–29 To make such an evaluation, it is mandatory to perform a vectorial analysis. 30 However, we decided not to check this in our patients because this topic has been widely studied in the international literature, 25–29,31 and we could have added no new information.…”

Section: Discussionmentioning

confidence: 99%

Axial Length Shortening After Cataract Surgery: New Approach to Solve the Question

Bernardo

Salerno

Cornetta

et al. 2018

Trans. Vis. Sci. Tech.

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PurposeTo check if optical biometry can detect eventual corneal power (Km) and axial length (AL) cataract surgery-related changes that could influence the refractive outcome.MethodsPatients scheduled for sequential bilateral cataract surgery between January and September 2017 were included in the present study. One hundred ninety-six eyes of 98 patients (48 males) were selected. Before surgery of the first eye, patients underwent a complete ophthalmic examination, including IOLMaster biometry; the same evaluations were repeated in both eyes the day before the fellow eye cataract surgery, performed at least 2 months after the first one. The differences in Km and AL in the first operated eyes were evaluated, and the fellow eyes were used as controls.ResultsKm differences in the operated eyes ranged from −1.97 to +0.98 diopter (D) (mean = −0.02 ± 0.36 D) (P = 0.89); in the nonoperated eyes they ranged from −0.6 to +0.7 D (mean = 0 ± 0.20 D) (P = 0.91). The AL differences (pseudophakic option) in the operated eyes ranged from −0.35 to +0.15 mm (mean = −0.10 ± 0.08 mm) (P < 0.001); with the aphakic option they ranged from −0.24 to + 0.26 mm (mean = 0.01 ± 0.08 mm) (P= 0.38). In the nonoperated eyes, the AL differences ranged from −0.04 to +0.06 mm (mean= 0 ± 0.02 mm) (P = 0.02).ConclusionsThe modern phaco-technique seems not to induce changes in Km and AL, supporting the hypothesis that the differences in AL are due to an incorrect estimation in pseudophakic eyes.Translational RelevanceThe results of our study may improve the AL measurements in pseudophakic eyes.

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Section: Discussionmentioning

confidence: 99%

Axial Length Shortening After Cataract Surgery: New Approach to Solve the Question

Bernardo

Salerno

Cornetta

et al. 2018

Trans. Vis. Sci. Tech.

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“…In addition, there are some evidences that recovery of visual acuity is faster with FLACS than manual capsulorhexis [12, 16]. Importantly, FLACS is considered to be associated with a similar or perhaps lower incidence of intra-operative and post-operative complications than conventional phacoemulsification [17, 18]. Moreover, most investigations indicate that changes in corneal endothelial cell density, corneal thickness and/or central retinal thickness are similar or smaller for FLACS than for manual capsulorhexis [19–21].…”

Section: Introductionmentioning

confidence: 99%

Performance of femtosecond laser-assisted cataract surgery in Chinese patients with cataract: a prospective, multicenter, registry study

Zhang

et al. 2019

BMC Ophthalmol

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BackgroundThis study aimed to investigate the completion rate, visual performance, and adverse outcomes of femtosecond laser-assisted cataract surgery (FLACS) in Chinese patients.MethodsThis is a prospective, single-arm, multicenter registry study of 19 cataract surgery clinics in China. Chinese patients with cataract who underwent FLACS using the Alcon LenSx® laser system in single eye (n = 1140) or both eyes (n = 201) were enrolled and data were collected between March 2015 and August 2016. Clinical characteristics were recorded before surgery, and on postoperative days 1, 7, and 30. For surgery on both eyes, the second eye was included in the analysis only if it was operated within 30 days after the first eye surgery. The primary outcome was the completion rate of circular anterior capsulotomy. Secondary outcomes for lens fragmentation, corneal incision, and intraocular lens (IOL) implantation included best corrected distance visual acuity (BCDVA) and completion rates. Adverse events (AEs) were recorded.ResultsThe completion rates of circular anterior capsulotomy, lens fragmentation, corneal incision, and IOL implantation were 98.6% (95% CI: 97.8–99.1%), 99.5% (95% CI: 99.1–99.8%), 97.6% (95% CI: 96.7–98.3%), and 100% (95% CI: 99.8–100%), respectively. BCDVA preoperatively and at postoperative day 30 were 1.134 ± 0.831 logMAR and 0.158 ± 0.291 logMAR, respectively. The proportion of eyes with BCDVA of 20/20 or better was 1.6% at baseline and 41.3% at postoperative day 30. AE incidence was 0.32%, with posterior capsule rupture present in 0.19% of eyes.ConclusionFLACS using the LenSx® laser system can achieve satisfactory results in a real-world setting.Electronic supplementary materialThe online version of this article (10.1186/s12886-019-1079-0) contains supplementary material, which is available to authorized users.

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“…In former studies, the SIA has been usually measured as the only refraction parameter that change with corneal incision, although changes in sphere power could be also induced by the incisions. Small increments of positive power in sphere have been reported[12] at 1-month follow-up, but no previous works have measured the long-term changes of both refraction components: sphere and astigmatism. On the other hand, corneal incisions also increase the values of the root mean square (RMS) of higher order aberrations (HOA), some previous studies[15–18] have reported a significant change in trefoil aberration that increases as the corneal incision is larger[19,20].…”

Section: Introductionmentioning

confidence: 99%

One-year follow-up of changes in refraction and aberrations induced by corneal incision

et al. 2019

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PurposeTo evaluate the surgically induced changes in refraction (sphere and astigmatism) and higher order aberrations by corneal incision for one year.SettingUniversity Hospital “Virgen de la Arrixaca”, Murcia, Spain.DesignRetrospective interventional case series.MethodsCorneal power, astigmatism and higher order aberrations (HOA) were calculated from corneal topography measured in 27 eyes prior to surgery and at 2 weeks, 1, 2, 3 and 6 months and 1 year following cataract surgery with 3.2-mm corneal incision. At every stage, optical changes were calculated as the difference between pre- and post-surgery data (in each follow-up) using the formulas of obliquely crossed cylinders for the refraction and Zernikes coefficients for HOA.ResultsAt 2 weeks after surgery the mean corneal values of induced sphere, cylinder and the root mean square (RMS) of HOA were +0.54±0.27 D, -0.77±0.32 D and 0.15 microns respectively. These parameters decreased significantly (p-values between 0 and 0.01) at 3 months to +0.33±0.27 D sphere, -0.50±0.24 D cylinder and 0.10±0.05 microns HOA and were stable at the next follow-ups. Induced spherical equivalent was around zero at all visits. The changes in HOA were mainly due to trefoil aberration.ConclusionsLinear corneal incisions do not change the spherical power but can induce significant values of astigmatism and trefoil aberration in the cornea. However, these changes revert fully or partially to preoperative values by the third month after surgery and remain stable with time.

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Comparison of surgically induced astigmatism between femtosecond laser and manual clear corneal incisions for cataract surgery

Abstract: Drs. Yoo and Donaldson are speakers for and consultants to Alcon Surgical, Inc., and Abbott Medical Optics, Inc. No other author has a financial or proprietary interest in any material or method mentioned.

Cited by 36 publications

References 19 publications

Axial Length Shortening After Cataract Surgery: New Approach to Solve the Question

Axial Length Shortening After Cataract Surgery: New Approach to Solve the Question

Performance of femtosecond laser-assisted cataract surgery in Chinese patients with cataract: a prospective, multicenter, registry study

One-year follow-up of changes in refraction and aberrations induced by corneal incision

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