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      Comparison of magnitude and summated vector mean of surgically induced astigmatism vector according to incision site after phakic intraocular lens implantation

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          Abstract

          Background

          To compare the arithmetic mean (M-SIA) and the summated vector mean of surgically induced astigmatism (SVM-SIA) according to the incision site after phakic intraocular lens (Visian implantable collamer lens (ICL), STAAR Surgical) implantation.

          Methods

          This study comprised 121 eyes of 121 consecutive patients undergoing ICL surgery through a 3.0-mm temporal or superior clear corneal incision. The magnitude and the axis of corneal astigmatism preoperatively and 3 months postoperatively were measured using an automated keratometer. The M-SIA and the SVM-SIA were determined according to the incision site.

          Results

          The magnitude of corneal astigmatism significantly increased from 1.23 ± 0.59 D preoperatively to 1.46 ± 0.72 D postoperatively in the temporal incision group (Wilcoxon signed-rank test, P < 0.001), but it significantly decreased from 1.09 ± 0.36 D preoperatively to 0.86 ± 0.41 D postoperatively in the superior incision group ( P < 0.001). The M-SIA was 0.48 ± 0.30 D, and the SVM-SIA was 0.23 ± 0.52 D at a meridian of 82° in the temporal incision group. The M-SIA was 0.57 ± 0.30 D, and the SVM-SIA was 0.47 ± 0.45 D at a meridian of 1° in the superior incision group.

          Conclusions

          ICL implantation induces the M-SIA by approximately 0.5 D, but the SVM-SIA decreased to 50% and 80% of the M-SIA in magnitude through temporal and superior incisions, respectively. The direction of the SVM-SIA showed a tendency toward corneal flattening to the incisional site. It should be noted that the M-SIA is somewhat different from the SVM-SIA according to the incision site.

          Trial registration University Hospital Medical Information Network Clinical Trial Registry (000044269)

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          Most cited references21

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          Posterior chamber phakic intraocular lens implantation: comparative, multicentre study in 351 eyes with low-to-moderate or high myopia

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            Toric Implantable Collamer Lens for moderate to high myopic astigmatism.

            To assess the efficacy of the Toric Implantable Collamer Lens (ICL) to treat moderate to high myopic astigmatism. Prospective nonrandomized clinical trial. Two hundred ten eyes of 124 patients with between 2.38 and 19.5 diopters (D) of myopia (spherical equivalent [SE]) and 1 to 4 D of astigmatism participating in the United States Food and Drug Administration clinical trial of the Toric ICL. Implantation of the Toric ICL. Uncorrected visual acuity (UCVA), refraction, best spectacle-corrected visual acuity (BSCVA), adverse events, and postoperative complications. At 12 months postoperatively, the proportion of eyes with 20/20 or better UCVA (83.1%) was identical to the proportion of eyes with preoperative 20/20 or better BSCVA (83.1%); 76.5% had postoperative UCVA better than or equal to preoperative BSCVA. The mean manifest refractive cylinder dropped from 1.93 D (+/-0.84) at baseline to 0.51 D (+/-0.48) postoperatively, a 73.6% decrease in astigmatism. Although only 21.0% of eyes had 1-D refractive cylinder preoperatively (none less), 91.4% of cases had or =2 lines of BSCVA after 12 months postoperatively, whereas 18.9% of cases improved by > or =2 lines. A total of 76.4% of cases gained > or =1 lines of BSCVA, whereas only 7.5% of cases lost the equivalent amount. Three ICL removals were performed without significant loss of BSCVA, and 1 clinically significant lens opacity was observed. The results support the efficacy and predictability of Toric ICL implantation to treat moderate to high myopic astigmatism. Important safety concerns were not identified.
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              Pursuing perfection in intraocular lens calculations

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                Author and article information

                Contributors
                kamiyak-tky@umin.ac.jp
                Journal
                Eye Vis (Lond)
                Eye Vis (Lond)
                Eye and Vision
                BioMed Central (London )
                2326-0254
                2 September 2021
                2 September 2021
                2021
                : 8
                Affiliations
                [1 ]GRID grid.410786.c, ISNI 0000 0000 9206 2938, Visual Physiology, School of Allied Health Sciences, , Kitasato University, ; 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0373 Japan
                [2 ]GRID grid.410786.c, ISNI 0000 0000 9206 2938, Department of Ophthalmology, School of Medicine, , Kitasato University, ; Sagamihara, Japan
                Article
                257
                10.1186/s40662-021-00257-z
                8411523
                34470645
                992d4f0d-666a-4730-8ce5-f5e27db860dd
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                Categories
                Research
                Custom metadata
                © The Author(s) 2021

                surgically induced astigmatism,corneal astigmatism,mean,summated vector mean,centroid,vector analysis,temporal incision,superior incision,icl implantation

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