Correction Of High Astigmatism By Autologous Astigmatic Lenticule Reshaping And Rotation
Published 2024 - 42nd Congress of the ESCRS
Reference: PP03.01 | Type: Free paper | DOI: 10.82333/etcr-tj35
Authors: Jia Huang* 1 , Jianmin Shang 1 , Xiaoying Wang 1 , Xingtao Zhou 1
1Department of Ophthalmology and Vision Science,Fudan University Eye & ENT Hospital,Shanghai,China
Purpose
To explore the use of autologous astigmatic lenticule reshaping and rotation surgery to correct high astigmatism in conjunction with excimer laser technology to correct residual refractive error.
Setting
This is a prospective study to investigate the safety, efficacy, stability, and predictability of autologous astigmatic lenticule reshaping and rotation for the correction of super-high astigmatism. The study subjects were patients with super-high astigmatism who visited the Optometry Center of the Eye, Ear, Nose and Throat Hospital of Fudan University since November 2022 and requested refractive error correction.
Methods
Six patients with high astigmatism (8 eyes, astigmatism <-5.0D) were enrolled and the following methods were used: fabrication of a customized lens using FLEX technology, lifting of the corneal flap and reshaping the autologous astigmatic lenticule in situ using an excimer laser, and rotation of the autologous astigmatic lenticule by 90c. Uncorrected distance visual acuity (UDVA), subjective refraction, corneal topography, and anterior segment optimal coherence tomography (OCT) were performed.
Results
The effective and safety indices at 6 months postoperatively were 0.93±0.18 and 1.06±0.11, respectively; the spherical equivalent remained stable and close to emmetropia (-0.13D±0.70D) from 1 to 6 months postoperatively; postoperative astigmatism was generally mildly undercorrected (-1.22D±0.43D), and the difference in corneal curvatures at 2mm from the apex of the cornea was significantly reduced compared to preoperatively (P< 0.05); however, the corresponding values at 1mm and 3mm showed no difference.
Conclusions
Correction of high astigmatism with autologous astigmatic lenticule reshaping and rotation surgery is tissue-sparing, predictable, and significantly improves postoperative visual acuity and quality. This method is feasible and safe, with predictability requiring further study. This novel surgical approach has potential for patients with high astigmatism that cannot be corrected by conventional refractive surgery.