Correction of Myopic Astigmatism with Topography-Guided Laser In Situ Keratomileusis (TOPOLINK).

Pei-Lun Wu,Hung-Yu Lin,Li-Ju Lai,Chia-Yi Lee,Han-Chih Cheng,Wei-Chi Wu,Hung-Chi Chen

doi:10.3390/healthcare8040477

Abstract

We aim to assess the feasibility of topography-guided laser in situ keratomileusis (TOPOLINK) for correcting pre-existing and surgical-induced astigmatism. A retrospective, single center cohort study was conducted. Patients with pre-existing irregular myopic astigmatism were recruited into the primary group and those with irregular myopic astigmatism following laser in situ keratomileusis (LASIK) were recruited into the enhancement group. The changes in uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), maximum astigmatism, spherical equivalent (SE) and patient satisfaction were recorded. The Chi-square test, Mann–Whitney U test and Generalized Linear Mixed Model were utilized for the analysis in the current study. A total of 18 eyes were studied in the primary group and 14 eyes were examined in the enhancement group. One year postoperatively, the UCVA, BCVA, maximum astigmatism and SE improved significantly in both the primary and the enhancement groups (all p < 0.05). The UCVA (p = 0.046) and SE (p = 0.003) were worse in the primary group preoperatively but became similar in both groups postoperatively, while the BCVA and maximum astigmatism remained identical between groups throughout the study period (all p < 0.05). In addition, the rate of high and moderate satisfaction reached 90.0% in the primary and the enhancement groups, without significant differences (p = 0.871). In conclusion, the TOPOLINK showed high predictability and will contribute to similar outcomes between primary and postoperative irregular myopic astigmatism concerning visual acuity, refractive status and subject satisfaction.

Highlights

Astigmatism, first described in the early 1880s, is a refractive condition that leads to the defocusing of images and is frequently encountered by ophthalmologists in clinical practice [1]
Irregular astigmatism refers to conditions with multiple prominent meridians of refractive power whereby refracted rays have no planes of symmetry, and irregular astigmatism may result from trauma, infection or postoperative status [6]
A total number of 32 eyes from 20 patients were examined, with 18 eyes from 10 patients assessed in the primary group and another 14 eyes from 10 subjects were assessed in the enhancement group

Summary

Introduction

Astigmatism, first described in the early 1880s, is a refractive condition that leads to the defocusing of images and is frequently encountered by ophthalmologists in clinical practice [1]. The causes of astigmatism include uneven curvature of the cornea and irregularity of the crystalline lens surface, and corneal astigmatism can be categorized into different types if the meridians of maximum and minimum refractive power exist, which is known as regular astigmatism [1]. The etiology of astigmatism is multifactorial and an association between astigmatism and myopia has been found [3,4], and the failure to correct astigmatism in childhood is known to lead to amblyopia [5]. Conventional forms of management, such as glasses, rigid gas permeable contact lenses and toric soft contact lenses, can generally reduce astigmatism, failure to correct astigmatism still occurs in some conditions [8]

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