CORRECTION OF CORNEAL ASTIGMATISM DURING SINGLE-STEP PHACOEMULSIFICATION: FEMTOLASER ARCHUAT INCISIONS AND IMPLANTATION OF TORIC INTRAOCULAR LENSES


Cite item

Full Text

Abstract

Objective: to compare the effectiveness of astigmatism correction achieved during cataract surgery using the implantation of toric intraocular lenses and peripheral femtolaser corneal incisions. Materials and methods. 60 patients (80 eyes) with lens pathology of different genesis accompanied by corneal astigmatism from 0.75 to 4.5D underwent the surgery. 40 toric intraocular lenses were implanted and femtosecond laser arcuate keratotomy was performed on 40 eyes. Results of the study. In the early postoperative period visual acuity was 0.8-1.0 in both groups. Keratometry, keratopogram in group 1 with toric intraocular lenses did not differ from the preoperative data. The position of the toric intraocular lenses completely coincided with the steep axes (100%). In femtolaser keratotomy group on the 1st day a spherical component from +1.0D to +2.5D remained in 10 cases (25%); a cylindrical component from 1,0D to 2,0D - in 20 cases (50%); and both components were observed in 10 cases (25%). 1 month after the surgery: in group 1 visual acuity remained high 0.8-1.0 in the majority of patients - 35 eyes (87.5%), it was 0.5-0.7 with the correction cylindrical component (±)1,0 in 5 cases; in group 2 visual acuity also remained high 0.8-1.0 in the majority of patients - 36 eyes (90%). 6 months after the surgery: in group 1 due to the rotation of the intraocular lenses without contracture of capsular bag visual acuity decreased in some patients up to 0.5-0.6 with a correction cylindrical component (±)1.0 ± 0.5 - 7 eyes (17.5%); due to fibrosis and capsule contracture it was 0,3-0,4 without correction in 5 eyes (12.5%). In group 2 visual acuity decreased due to fibrosis of the posterior capsule, which did not affect the astigmatism index - 0.5-0.6 without correction in 4 cases (10%), and 0.5-0,6 with correction cylindrical component (±)1.0 ± 0.5 in 4 cases (10%). Conclusion. Phacoemulsification with implantation of the toric intraocular lens and femtosecond laser arcuate keratotomy are effective, safe, controlled ways to correct corneal astigmatism. Femtosecond laser arcuate keratotomy is effective in correcting astigmatism up to 4.5D. Stability of the functional results is higher when corrected using limbal relaxing incisions (bibliography: 9 refs).

About the authors

A D Chuprov

Orenburg branch of the Academician S. Fyodorov Eye Microsurgery Federal State Institution

Orenburg, Russia

K V Mal’gin

Orenburg branch of the Academician S. Fyodorov Eye Microsurgery Federal State Institution

Orenburg, Russia

References

  1. Amesbury E. C., Miller K. M. Correction of astigmatism at the time of cataract surgery. Current Opinion in Ophthalmology. 2009; 20 (1): 19-24.
  2. Mamalis N. Correction of astigmatism during cataract surgery. J. Cataract Refract. Surg. 2009; 35 (3): 403-4.
  3. Негодина Д. А. Индивидуальная регистрационная карта пациента с исходным роговичным астигматизмом, оперируемого по поводу катаракты. Тихоокеанский медицинский журнал. 2014; 4: 86-8.
  4. Ahmed I. I., Rocha G., Slomovic A. R., Climenhaqa H., Gohill J., Greqoire A., Ma J. Visual function and patient experience after bilateral implantation of toric intraocular lenses. J. Cataract Refract. Surg. 2010; 36 (4): 609-16.
  5. Buckhurst P. J., Wolffsohn J. S., Davies L. N., Naroo S. A. Surgical correction of astigmatism during cataract surgery. Clinical and Experimental Optometry. 2010; 93 (6): 409-18.
  6. Poll J. T., Wang L., Koch D. D., Weikert M. P. Correction of astigmatism during cataract surgery: toric intraocular lens compared to peripheral corneal relaxing incisions. J. Cataract Refract. Surg. 2011; 27 (3): 165-71.
  7. Buckhurst P. J., Wolffsohn J. S., Naroo S. A., Davies L. N. Rotational and centration stability of an aspheric intraocular lens with a simulated toric design. J. Cataract Refract. Surg. 2010; 36 (9): 1523-8.
  8. Rozema J., Gobin L., Verbruggen K., Tassignon M. J. Changesin rotation after implantation of a bag-in-the-lens intraocular lens. J. Cataract Refract. Surg. 2009; 35 (8): 1385-8.
  9. Tsinopoulos I. T., Tsaousis K. T., Tsakpinis D., Ziakas N. G., Dimitrakos S. A. Acrylic toric intraocular lens implantation: a single center experience concerning clinical outcomes and postoperative rotation. Clinical Ophthalmology. 2010; 4 (3): 137-42.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2018 Chuprov A.D., Mal’gin K.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).