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Effectiveness and confounding factors of penetrating astigmatic keratotomy in clinical practice: Case report
RATIONALE: Penetrating astigmatic keratotomy (penetrating AK) is a well-known method to correct corneal astigmatism but rarely be performed nowadays. This article reevaluated the clinical effectiveness and confounding factors of penetrating AK. PATIENT CONCERNS: Penetrating AK has been introduced to...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794384/ https://www.ncbi.nlm.nih.gov/pubmed/29369200 http://dx.doi.org/10.1097/MD.0000000000009709 |
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author | Yen, Chu-Yu Tseng, Gow-Lieng |
author_facet | Yen, Chu-Yu Tseng, Gow-Lieng |
author_sort | Yen, Chu-Yu |
collection | PubMed |
description | RATIONALE: Penetrating astigmatic keratotomy (penetrating AK) is a well-known method to correct corneal astigmatism but rarely be performed nowadays. This article reevaluated the clinical effectiveness and confounding factors of penetrating AK. PATIENT CONCERNS: Penetrating AK has been introduced to serve as one alternative operation for astigmatism correction, and is thought to have the potential advantage of being more affordable and easy to perform. The purpose of our study is to evaluate the effectiveness and confounding factors of penetrating AK. DIAGNOSES: The chart of 95 patients with corneal astigmatism (range: 0.75–3.25 diopters [D]) who received penetrating AK from January 2014 to December 2016 was collected. The corneal astigmatism were measured by an autokeratometer (Topcon KR8100PA topographer-autorefractor), and repeated with manual keratometer in low reproducibility cases. INTERVENTIONS: All patients received penetrating AK by an experienced ophthalmologist (Dr. Gow-Lieng Tseng, MD, PHD) in the operation room. Among which, 66 patients received penetrating AK with phacoemulsification simultaneously (group A), whereas 29 patients received penetrating AK at least 3 months after phacoemulsification (group B). After excluding the patients combined with other procedures or lost followed up, 79 patients are remaining for analysis. The outcome was evaluated by net correction, the difference between preoperative corneal astigmatism (PCA) and residual corneal astigmatism (RCA). Two sample t tests and Pearson test were used for effectiveness evaluation. For confounding factors, multivariate linear regression was used for statistical analysis. OUTCOMES: The mean preoperative and postoperative refractive cylinders were 1.97 ± 0.77 and 1.08 ± 0.64 D, respectively, in group A and 2.62 ± 1.05 and 1.51 ± 0.89 D in group B. There were no statistically significant differences in net correction between these two groups (0.9 ± 0.66 vs. 1.1 ± 0.69, P = .214). Higher PCA were associated with higher net correction in both group A (P = .002) and group B (P = .019). Compound myopic astigmatism caused less net correction than others only in group A (P = 0.031). LESSONS: Penetrating AK is an accessible, affordable, and effective way to correct corneal astigmatism. The results of this procedure are comparable to modern methods in patients with low to moderate corneal astigmatism. |
format | Online Article Text |
id | pubmed-5794384 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-57943842018-02-07 Effectiveness and confounding factors of penetrating astigmatic keratotomy in clinical practice: Case report Yen, Chu-Yu Tseng, Gow-Lieng Medicine (Baltimore) 5800 RATIONALE: Penetrating astigmatic keratotomy (penetrating AK) is a well-known method to correct corneal astigmatism but rarely be performed nowadays. This article reevaluated the clinical effectiveness and confounding factors of penetrating AK. PATIENT CONCERNS: Penetrating AK has been introduced to serve as one alternative operation for astigmatism correction, and is thought to have the potential advantage of being more affordable and easy to perform. The purpose of our study is to evaluate the effectiveness and confounding factors of penetrating AK. DIAGNOSES: The chart of 95 patients with corneal astigmatism (range: 0.75–3.25 diopters [D]) who received penetrating AK from January 2014 to December 2016 was collected. The corneal astigmatism were measured by an autokeratometer (Topcon KR8100PA topographer-autorefractor), and repeated with manual keratometer in low reproducibility cases. INTERVENTIONS: All patients received penetrating AK by an experienced ophthalmologist (Dr. Gow-Lieng Tseng, MD, PHD) in the operation room. Among which, 66 patients received penetrating AK with phacoemulsification simultaneously (group A), whereas 29 patients received penetrating AK at least 3 months after phacoemulsification (group B). After excluding the patients combined with other procedures or lost followed up, 79 patients are remaining for analysis. The outcome was evaluated by net correction, the difference between preoperative corneal astigmatism (PCA) and residual corneal astigmatism (RCA). Two sample t tests and Pearson test were used for effectiveness evaluation. For confounding factors, multivariate linear regression was used for statistical analysis. OUTCOMES: The mean preoperative and postoperative refractive cylinders were 1.97 ± 0.77 and 1.08 ± 0.64 D, respectively, in group A and 2.62 ± 1.05 and 1.51 ± 0.89 D in group B. There were no statistically significant differences in net correction between these two groups (0.9 ± 0.66 vs. 1.1 ± 0.69, P = .214). Higher PCA were associated with higher net correction in both group A (P = .002) and group B (P = .019). Compound myopic astigmatism caused less net correction than others only in group A (P = 0.031). LESSONS: Penetrating AK is an accessible, affordable, and effective way to correct corneal astigmatism. The results of this procedure are comparable to modern methods in patients with low to moderate corneal astigmatism. Wolters Kluwer Health 2018-01-26 /pmc/articles/PMC5794384/ /pubmed/29369200 http://dx.doi.org/10.1097/MD.0000000000009709 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-nc-sa/4.0 |
spellingShingle | 5800 Yen, Chu-Yu Tseng, Gow-Lieng Effectiveness and confounding factors of penetrating astigmatic keratotomy in clinical practice: Case report |
title | Effectiveness and confounding factors of penetrating astigmatic keratotomy in clinical practice: Case report |
title_full | Effectiveness and confounding factors of penetrating astigmatic keratotomy in clinical practice: Case report |
title_fullStr | Effectiveness and confounding factors of penetrating astigmatic keratotomy in clinical practice: Case report |
title_full_unstemmed | Effectiveness and confounding factors of penetrating astigmatic keratotomy in clinical practice: Case report |
title_short | Effectiveness and confounding factors of penetrating astigmatic keratotomy in clinical practice: Case report |
title_sort | effectiveness and confounding factors of penetrating astigmatic keratotomy in clinical practice: case report |
topic | 5800 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794384/ https://www.ncbi.nlm.nih.gov/pubmed/29369200 http://dx.doi.org/10.1097/MD.0000000000009709 |
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