[Clinical analysis of real-time iris recognition guided LASIK with femtosecond laser flap creation for myopic astigmatism].
OBJECTIVE
To assess the safety, efficacy, stability and changes in cylindrical degree and axis after real-time iris recognition guided LASIK with femtosecond laser flap creation for the correction of myopic astigmatism.


METHODS
Retrospective case series. This observational case study comprised 136 patients (249 eyes) with myopic astigmatism in a 6-month trial. Patients were divided into 3 groups according to the pre-operative cylindrical degree: Group 1, -0.75 to -1.25 D, 106 eyes;Group 2, -1.50 to -2.25 D, 89 eyes and Group 3, -2.50 to -5.00 D, 54 eyes. They were also grouped by pre-operative astigmatism axis:Group A, with the rule astigmatism (WTRA), 156 eyes; Group B, against the rule astigmatism (ATRA), 64 eyes;Group C, oblique axis astigmatism, 29 eyes. After femtosecond laser flap created, real-time iris recognized excimer ablation was performed. The naked visual acuity, the best-corrected visual acuity, the degree and axis of astigmatism were analyzed and compared at 1, 3 and 6 months postoperatively.


RESULTS
Static iris recognition detected that eye cyclotorsional misalignment was 2.37° ± 2.16°, dynamic iris recognition detected that the intraoperative cyclotorsional misalignment range was 0-4.3°. Six months after operation, the naked visual acuity was 0.5 or better in 100% cases. No eye lost ≥ 1 line of best spectacle-corrected visual acuity (BSCVA). Six months after operation, the naked vision of 227 eyes surpassed the BSCVA, and 87 eyes gained 1 line of BSCVA. The degree of astigmatism decreased from (-1.72 ± 0.77) D (pre-operation) to (-0.29 ± 0.25) D (post-operation). Six months after operation, WTRA from 157 eyes (pre-operation) decreased to 43 eyes (post-operation), ATRA from 63 eyes (pre-operation) decreased to 28 eyes (post-operation), oblique astigmatism increased from 29 eyes to 34 eyes and 144 eyes became non-astigmatism.


CONCLUSIONS
The real-time iris recognition guided LASIK with femtosecond laser flap creation can compensate deviation from eye cyclotorsion, decrease iatrogenic astigmatism, and provides more precise treatment for the degree and axis of astigmatism .It is an effective and safe procedure for the treatment of myopic astigmatism.
Xiamen Eye Center of Xiamen University, Xiamen 361001, China. Email: jieliming@sina.cn.
Li-ming
LM
Jie
Qian
Q
Wang
Lin
L
Zheng
D000293:Adolescent; D000328:Adult; D001251:Astigmatism / Q000601:surgery*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D008297:Male; D009216:Myopia / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult