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Effectiveness and confounding factors of penetrating astigmatic keratotomy in clinical practice: Case report.

Abstract 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.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29369200
OWN - NLM
STAT- MEDLINE
DCOM- 20180202
LR  - 20180208
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 4
DP  - 2018 Jan
TI  - Effectiveness and confounding factors of penetrating astigmatic keratotomy in
      clinical practice: Case report.
PG  - e9709
LID - 10.1097/MD.0000000000009709 [doi]
AB  - 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.
FAU - Yen, Chu-Yu
AU  - Yen CY
AD  - Department of Ophthalmology, Taipei City Hospital, Renai Branch, Taipei, Taiwan.
FAU - Tseng, Gow-Lieng
AU  - Tseng GL
LA  - eng
PT  - Comparative Study
PT  - Evaluation Studies
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Astigmatism/*surgery
MH  - Cornea/surgery
MH  - Corneal Diseases/*surgery
MH  - Female
MH  - Humans
MH  - Keratoplasty, Penetrating/*methods
MH  - Male
MH  - Middle Aged
MH  - Phacoemulsification/methods
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC5794384
EDAT- 2018/01/26 06:00
MHDA- 2018/02/03 06:00
CRDT- 2018/01/26 06:00
PHST- 2018/01/26 06:00 [entrez]
PHST- 2018/01/26 06:00 [pubmed]
PHST- 2018/02/03 06:00 [medline]
AID - 10.1097/MD.0000000000009709 [doi]
AID - 00005792-201801260-00033 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Jan;97(4):e9709. doi: 10.1097/MD.0000000000009709.