Tomographic analysis of anterior and posterior surgically induced astigmatism after 2.2 mm temporal clear corneal incisions in femtosecond laser–assisted cataract surgery

Kohnen, Thomas; Löffler, Franziska; Herzog, Michael; Petermann, Kerstin; Böhm, Myriam

doi:10.1016/j.jcrs.2019.06.010

Cited by 11 publications

(10 citation statements)

References 30 publications

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“…Hayashi et al demonstrated mean SIA-P was 0,10D in short temporal CCI group but their study didn't compare postoperative posterior astigmatism with preoperative astigmatism [17]. In these studies concluded that changing posterior astigmatism after cataract surgery are clinically insigni cant and negligible [14][15][16][17]. In our study, AC-P is almost zero.…”

Section: Discussioncontrasting

confidence: 54%

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Tomographic Analysis of Incision Sequence on Anterior and Posterior Surgically Induced Astigmatism in Cataract Surgery

Adam

Sayın

Ağca

et al. 2021

Preprint

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Purpose: To evaluate of effect incision sequence on anterior and posterior astigmatism and SIA at cataract surgery using Scheimpflug tomography measurements.Methods: We evaluated 86 patients who had gone cataract surgery between October 2018 to March 2019. All eyes were measured with a Scheimpflug tomography system preoperatively and at 1 month after surgery which included anterior and posterior corneal surfaces. The surgery was begin with side incision in group 1 differently the main incision was done first in group 2. Student t test and Pearson’s correlation were performed. P values < 0.05 were considered statistically significant.Result: Surgically induced anterior astigmatism (SIA-A) 0.76±0.43, 0.67±0.38 and surgically induced posterior astigmatism(SIA-P) 0.27±0.19 0.23±0.19 respectively in group 1 and group 2. 1D or greater SIA-A was found 24.4 % and 15.6% and 0.5 D or greater SIA-P was found 14.6% and 12.2% respectively in group 1 and group 2. There was a significant increase in anterior astigmatism (p=0.002, 0.005 respectively in group 1 and 2), but not in the posterior astigmatism (p=0.471 and 0.247 respectively in group 1 and 2). In the subgroup analysis, group 2 has lower SIA-A then group 1 except oblique subgroup and group 2 has lower SIA-P for all subgroups but it wasn't statistically significant.Conclusion: Making the main incision first caused less SIA on both anterior and posterior surfaces however this difference was not significant.

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Section: Discussioncontrasting

confidence: 54%

“…Similarly Kohnen et all. showed that posterior corneal astigmatism didn't change postoperative in one months period after 2.2 mm temporal clear corneal incisions in femtosecond laser-assisted cataract surgery [14]. In the another study with 2.75 mm temporal corneal incision, posterior astigmatic values didn't change after the operation [15].…”

Section: Discussionmentioning

confidence: 99%

Tomographic Analysis of Incision Sequence on Anterior and Posterior Surgically Induced Astigmatism in Cataract Surgery

Adam

Sayın

Ağca

et al. 2021

Preprint

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“…Klijn et al [28] found that the incision effect on the posterior corneal surface was of the same order of magnitude as the test-retest effect and concluded that the contribution of the posterior cornea to astigmatic change is limited. Kohnen et al [29] also concluded that the SIA on the posterior corneal surface of a 2.2 mm femtosecond laser-assisted clear corneal incision was clinically insignificant. These results are contrary to the results of a recent study showing that posterior corneal astigmatism increased after the creation of a 1.8 mm steep meridian clear corneal incision [30].…”

Section: Discussionmentioning

confidence: 99%

Comparison of surgically induced astigmatism between anterior and total cornea in 2.2 mm steep meridian incision cataract surgery

Yoon

Whang

2021

BMC Ophthalmol

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Background This study aimed to compare surgically induced astigmatism (SIA) on the anterior and total cornea during cataract surgery through a 2.2 mm steep meridian incision. Methods The study included 69 left eyes of 69 patients who had undergone cataract surgery. The 69 eyes were classified into three subgroups according to the preoperative steep meridian. Following phacoemulsification, an intraocular lens was inserted into the bag. The keratometric measurements were taken 12 months postoperatively, on the anterior cornea (automated keratometer and anterior keratometry [K] from a rotating Scheimpflug camera) and total cornea (equivalent K reading [EKR] 3.0 mm, EKR 4.5 mm, total corneal refractive power (TCRP) 2.0 mm ring, TCRP 3.0 mm zone, TCRP 4.0 mm zone). The SIA was analyzed for each parameter. Results On the double-angle polar plot, the summated vector mean values of SIA determined by the automated keratometer and Scheimpflug anterior K were 0.28 diopter (axis: 177°) and 0.37 diopter (axis: 175°) in with-the-rule (WTR) astigmatism; 0.03 diopter (axis: 156°) and 0.18 diopter (axis: 177°) in oblique astigmatism; 0.15 diopter (axis: 96°) and 0.17 diopter (axis: 73°) in against-the-rule (ATR) astigmatism. The mean SIAs on the total cornea ranged from 0.31 to 0.42 diopter in WTR astigmatism; from 0.16 to 0.27 diopter in oblique astigmatism; from 0.04 to 0.11 diopter in ATR astigmatism. Mean magnitude SIA ranged from 0.41 to 0.46 diopter on anterior corneal surface and 0.50 to 0.62 diopter on total cornea. J0 and J45 of the posterior cornea showed no significant changes after cataract surgery, and the changes in J0 and J45 did not show any statistical differences between the anterior and total cornea (all p > 0.05). Conclusions There were no differences in the summed vector mean values of SIA between the anterior cornea and the total cornea.

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“…The combination of SIA derived from total cornea and these algorithms should be also evaluated in future studies because latest research suggests that corneal SIA differs between the derived from anterior cornea and total cornea [27,28]. Kohnen et al [29] reported differences in the percentage of eyes with anterior corneal SIA < 0.25 D in WTR and ATR cases but these differences were completely reduced when total cornea was considered suggesting that these incisions can be considered as neutral due to the minimal induced astigmatism. In our opinion, some caution should be borne in mind by surgeons using estimated anterior corneal SIA and PCA algorithms until future studies provide evidence if the combination improves or aggravates the results.…”

Section: Discussionmentioning

confidence: 99%

Toric Intraocular Lens Results Considering Posterior Corneal Astigmatism with Online Calculators: Phacoemulsification vs. Femtosecond

Fernández¹,

Rodríguez‐Vallejo²,

Burguera³

et al. 2021

Optics

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To evaluate the prediction error (PE) obtained in Phacoemulsification (Phaco) or Femtosecond (Femto) surgeries without considering posterior corneal astigmatism correction (non-PCA) versus the correction based on Abulafia-Koch + Medicontur (AK) and Barrett calculators in toric intraocular lens (IOL) power calculation. 58 right eyes were retrospectively retrieved from our database. Two groups formed by 28 and 30 eyes depending on the surgery type, Phaco or Femto respectively, were defined. Astigmatism PE were evaluated considering the approach used for calculation of the implanted IOL power (AK) versus the estimation of PEs in non-PCA and Barrett formula. A doubly-multivariate analysis was conducted to assess the differences between-surgery types, within-methods of calculation, and interaction. Mean centroid PE was significantly different between non-PCA, AK and Barrett approaches (p < 0.0005), and neither differences (p < 0.239) nor interaction (p = 0.672) between Phaco or Femto were found. Post-hoc univariate analysis showed a higher PE for the x-component of the non-PCA method versus AK (0.15 D, p < 0.0005) and non-PCA versus Barrett (0.18 D, p < 0.0005), though no differences were found between AK and Barrett (0.03 D, p = 0.93). Against-the-rule under-correction and with-the-rule overcorrection were found in both arms when PCA was not considered. Both calculators provide comparable clinical results.

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Tomographic analysis of anterior and posterior surgically induced astigmatism after 2.2 mm temporal clear corneal incisions in femtosecond laser–assisted cataract surgery

Cited by 11 publications

References 30 publications

Tomographic Analysis of Incision Sequence on Anterior and Posterior Surgically Induced Astigmatism in Cataract Surgery

Tomographic Analysis of Incision Sequence on Anterior and Posterior Surgically Induced Astigmatism in Cataract Surgery

Comparison of surgically induced astigmatism between anterior and total cornea in 2.2 mm steep meridian incision cataract surgery

Toric Intraocular Lens Results Considering Posterior Corneal Astigmatism with Online Calculators: Phacoemulsification vs. Femtosecond

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