Predicting The Impact Of Femtosecond-Assisted Arcuate Keratotomy In Conjunction With Steep-Axis Triplanar Clear Corneal Incisions On Surgically Induced Astigmatism At Implantable Collamer Lens Surgery
Published 2023 - 41st Congress of the ESCRS
Reference: FP19.07 | Type: Free paper | DOI: 10.82333/v4xw-e627
Authors: Jihong Zhou* 1 , shaowei Li 2 , Guoli He 2 , Wenjuan Wang 2 , Fengju Zhang 3
1Refractive surgery,Beijing AierIntech Eye Hospital,Beijing,China;Eye Center,Beijing Tongren Hospital, Capital University,Beijing,China, 2Refractive surgery,Beijing AierIntech Eye Hospital,Beijing,China, 3Eye Center,Beijing Tongren Hospital, Capital University,Beijing,China
Purpose
To investigate the factors associated with and impact on surgically induced astigmatism (SIA) by using femtosecond-assisted (FS-assisted) arcuate keratotomy (AK) combined with the steep-axis triplanar clear corneal incision (TCCI) in patients undergoing Implantable Collamer Lens (ICL) surgery to reduce astigmatism.
Setting
The study was a retrospective case series conducted at Beijing AierIntech Eye Hospital. Patients with myopic from -4.50 to -17.0D and astigmatism from 0.75 to 3.00 D who underwent ICL between January 2017 and December 2020 and followed up 12 months were included.
Methods
The study reviewed patients with ICL surgery combined with FS-assisted AK paired with steep-axis TCCIs. Pearson correlation analysis examined the relationship between various independent variables, including preoperative characteristics, such as intraocular pressure, central or peripheral corneal thickness (CCT or PCT), axial length, et al.; the width, tunnel length, and position degree of TCCI; the diameter, depth, and angle of AK incision. Multiple linear regression (MLR) was used to identify factors that influence the magnitude of surgically induced astigmatism (SIA). The predictors of SIA were determined using individual-level analysis accounting for inter-eye correlation with the generalized estimating equation (GEE).
Results
55 right eyes and 59 left eyes from 67 patients were enrolled; the mean spherical equivalent was -10.29±2.99D and -9.99±2.72D, and the mean preoperative corneal astigmatism was −1.54±0.50D and −1.59±0.45D, respectively. After 12 months, correlations were revealed between SIA and intraocular pressure, TCCI position degree, PCT, AK depth, and angle. (P=0.046, 0.038, 0.040, 0.000, 0.000) Using the MLR model, axial length, PCT, AK incision depth, angle, and diameter affected SIA. (P=0.038, 0.005, 0.023, 0.000, 0.034). Finally, according to GEE analysis, only the axial length, AK incision diameter, and angle were predictors of SIA with exp(B) of 1.097, 1.456, and 1.019, respectively (P=0.002, 0.024, 0.000).
Conclusions
This study suggests that axial length, AK incision diameter, and angle significantly positively affect SIA in FS-assisted AK paired with steep-axis TCCI at ICL surgery in 12 months follow-up.