Advances in ophthalmology practice and research · 2025
Efficacy of image-guided accurate limbal relaxing incisions for astigmatism correction during cataract surgery.
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Hu Xiaoxin, Qi Jiao, Cheng Kaiwen, He Wenwen, Du Yu, Zhang Keke, Lu Yi, Zhu Xiangjia
Аннотация
PURPOSE: To investigate the efficacy of image-guided accurate limbal relaxing incisions (LRIs) for astigmatism correction during cataract surgery.
METHODS: Consecutive cataract patients with regular corneal astigmatism ranging from 0.75 to 2.50 D, intended for cataract surgery with image-guided LRIs, were recruited in this prospective cohort study. The efficacy of astigmatism correction was evaluated 3 months after surgery, and compared among eyes with preoperative corneal with-the-rule (WTR), against-the-rule (ATR) and oblique astigmatism. Higher-order aberrations and visual quality indices obtained with iTrace were further compared between eyes with single and paired LRIs.
RESULTS: Totally, 108 eyes of 108 patients were analyzed. The mean total surgical induced astigmatism (tSIA) vector of all participants was 0.76 ± 0.38 D (range: 0.11-1.79 D, preoperative vs. postoperative astigmatism: 1.46 ± 0.41 vs. 0.78 ± 0.44 D, P < 0.001). Eyes with WTR astigmatism showed higher tSIA (0.89 ± 0.32 D vs. 0.42 ± 0.21 D vs. 0.48 ± 0.36 D, respectively, P < 0.001), as well as higher correction index and lower difference vector and index of success than ATR and oblique astigmatism groups (all P < 0.05). Eyes with paired LRIs exhibited better corneal average height of modulation transfer function, a better corneal performance index and a better quality of vision index than those with single LRI (all P < 0.05).
CONCLUSIONS: Image-guided LRIs can effectively correct low-to-moderate corneal astigmatism during cataract surgery, especially in eyes with WTR astigmatism.
METHODS: Consecutive cataract patients with regular corneal astigmatism ranging from 0.75 to 2.50 D, intended for cataract surgery with image-guided LRIs, were recruited in this prospective cohort study. The efficacy of astigmatism correction was evaluated 3 months after surgery, and compared among eyes with preoperative corneal with-the-rule (WTR), against-the-rule (ATR) and oblique astigmatism. Higher-order aberrations and visual quality indices obtained with iTrace were further compared between eyes with single and paired LRIs.
RESULTS: Totally, 108 eyes of 108 patients were analyzed. The mean total surgical induced astigmatism (tSIA) vector of all participants was 0.76 ± 0.38 D (range: 0.11-1.79 D, preoperative vs. postoperative astigmatism: 1.46 ± 0.41 vs. 0.78 ± 0.44 D, P < 0.001). Eyes with WTR astigmatism showed higher tSIA (0.89 ± 0.32 D vs. 0.42 ± 0.21 D vs. 0.48 ± 0.36 D, respectively, P < 0.001), as well as higher correction index and lower difference vector and index of success than ATR and oblique astigmatism groups (all P < 0.05). Eyes with paired LRIs exhibited better corneal average height of modulation transfer function, a better corneal performance index and a better quality of vision index than those with single LRI (all P < 0.05).
CONCLUSIONS: Image-guided LRIs can effectively correct low-to-moderate corneal astigmatism during cataract surgery, especially in eyes with WTR astigmatism.