Điều chỉnh loạn thị giác mạc với đường rạch giác mạc hình cung trong phẫu thuật thể thủy tinh bằng laser femtosecond

Abstract

Objective: To evaluate the clinical efficacy and safety of corneal arcuate incisions for correcting corneal astigmatism during femtosecond laser assisted cataract surgery. Subject and method: In this prospective study, forty-five eyes with cataract and corneal astigmatism (> 0.50D) were treated with corneal arcuate incisions and femtosecond-laser assisted cataract surgery in Vietnam National Institute of Ophthalmology, from January 2017 to May 2018. The uncorrected and corrected distant visual acuity, subjective and objective refraction, corneal astigmatism were evaluated and recorded for all patients by using an OPD-Scan III topographer before, 1 week and 3 months after surgery. Some features of corneal arcuate incisions (quantity, depth, length and morphology), spectacle independence at distance and complications were recorded. Result: The rate of postoperative uncorrected distant visual acuity was 20/40 or more at 1 week and 3 months were 86.7%, 97.8%, respectively. The rate of postoperative refraction spherical equivalent was within ±0.50D and ±1.0D at 3 months (in 75.5% and 100% of the eyes respectively). Mean length of corneal arcuate incisions was 53.78^o ± 17.683^o (range: 20^o to 85^o). The average of preoperative corneal astigmatism was 1.65 ± 0.83D, corneal astigmatism was decreased to 0.60 ± 0.55D at third month after surgery. Surgically induced astigmatism was 1.05 ± 0.449D and lower than preoperative corneal astigmatism (1.65 ± 0.83D), thereby this indicated undercorrection. However, rate of spectacle independence at distance was 82.3% and no complications were recorded. Conclusion: Laser femtosecond is effective and safe for correcting corneal astigmatism in cataract surgery and improves the quality of vision outcomes.