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Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 2/2024

19-09-2023 | Refractive Surgery | Refractive Surgery

Impact of the preoperative cylinder on astigmatism correction in femtosecond lenticule extraction (FLEX): a prospective observational study

Authors: Xiuyu Mao, Han Chen, Yinzhen Zhao, Shunmei Ji, Jinhui Dai

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 2/2024

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Abstract

Purpose

To explore the impact of the preoperative manifest cylinder on astigmatism correction via femtosecond lenticule extraction (FLEX), or small incision lenticule extraction (SMILE).

Methods

This was a prospective observational study. Eyes were categorized into mild (n = 88), moderate (n = 46), and severe (n = 53) astigmatism groups, based on the preoperative manifest cylinder. Vector analysis was conducted with the back vertex distance set at 12 mm. The primary outcome was the correction index (CI), with secondary outcomes including the safety, efficacy, predictability, and vectoral alterations related to FLEX.

Results

The average target-induced astigmatism was 0.45 ± 0.20 D, 0.95 ± 0.17 D, and 1.99 ± 0.65 D in the three groups (P < 0.001), and the average CI was 1.12± 0.05, 1.01 ± 0.03, and 0.95 ± 0.02 (P = 0.020), with the severe astigmatism group displaying a notably lower CI. The efficacy, safety, predictability, or stability of FLEX did not demonstrate any significant differences among the three groups. The CIs exhibited a significant difference in eyes with with-the-rule (WTR) astigmatism and against-the-rule (ATR) astigmatism from the mild to severe astigmatism group. In eyes with oblique astigmatism, the average CI exceeded one.

Conclusion

Patients with manifest cylinder exceeding 1.25 D have a heightened risk of under-correction in WTR and ATR astigmatism compared to those with mild astigmatism, and mild over-correction may occur in cases of oblique astigmatism.
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Metadata
Title
Impact of the preoperative cylinder on astigmatism correction in femtosecond lenticule extraction (FLEX): a prospective observational study
Authors
Xiuyu Mao
Han Chen
Yinzhen Zhao
Shunmei Ji
Jinhui Dai
Publication date
19-09-2023
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 2/2024
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-023-06211-0

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