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Kemal Ozulken,Cagri Ilhan 대한안과학회 2019 Korean Journal of Ophthalmology Vol.33 No.5
Purpose: To investigate the clinical effects of different orientation and magnitude of cyclotorsion on the compensationcapacity of the WaveLight EX500 photorefractive keratectomy (PRK) platform. Methods: This retrospective study comprised 400 eyes of 200 patients who underwent bilateral simultaneousPRK due to compound myopic astigmatism. The subjects were separated according to the orientation of cyclotorsioninto incyclotorsion and excyclotorsion groups, and by the magnitude of cyclotorsion into group 1 (0.50to 2.50 degrees), group 2 (3.00 to 5.00 degrees), group 3 (5.50 to 7.50 degrees), and group 4 (8.00 to 9.50 degrees). Results: The mean magnitude of cyclotorsion was 3.50 ± 2.4 degrees (0.50 to 9.50 degrees) in the incyclotorsiongroup and 3.32 ± 2.3 degrees (0.50 to 9.50 degrees) in the excyclotorsion group (p = 0.617). The postoperativerefractive outcomes of the incyclotorsion and excyclotorsion groups were similar (p > 0.05 for all). Thepostoperative mean cylindrical refractive error was -0.32 ± 0.3 diopters (D, -1.25 to 0.00 D) in group 1, -0.47 ± 0.2D (-2.00 to 0.00 D) in group 2, -0.62 ± 0.2 D (-1.00 to -0.25 D) in group 3, and -0.91 ± 0.2 D (-1.50 to -0.50 D) ingroup 4 (p < 0.001). Preoperative cylindrical refractive error was positively correlated with magnitude of cyclotorsion(r = 0.125 and p = 0.013), which was also positively correlated with postoperative cylindrical refractiveerror (r = 0.600 and p < 0.001). Conclusions: Incyclotorsion and excyclotorsion can be equally compensable in the WaveLight EX500 PRKplatform for compound myopic astigmatism. A value of ≤2.50 degrees cyclotorsion magnitude was observedto be more compensable than higher degrees of cyclotorsion magnitude. Preoperative high astigmatism wasassociated with high cyclotorsion magnitude, which was also associated with a high degree of postoperativeastigmatism.
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