Abstract: Objectives To evaluate degrees and percentages of cyclorotation in Chinese patients during femtosecond laser assisted cataract surgery performed by using LenSx femtosecond laser platform and to further sub-analyze bilateral cases to assess the congruency between both eyes. Methods This was a single-centre retrospective study(Beijing AIER-Intec Eye Hospital, Beijing, China)in which the records of 330 eyes of 274 patients who underwent femtosecond laser-assisted cataract surgery in 1 or two eyes(with placement of posterior chamber IOL)between May 2017 and July 2019 by using femtosecond laser platform(LenSx)were reviewed.LenSx Femtosecond Laser(Alcon Laboratories, Inc, Fort Worth, Texas, USA)was used to carry out corneal incisions, anterior capsulotomies and lens fragmentation in this procedure. All the patients were marked on corneal limbus(at 3 and 9 o’clock positions)by using sterile skin marker(Medplus.inc)while sitting upright preoperatively. Percentages of cyclorotation were calculated. Absolutes values were taken for all calculations. The cyclorotation data was tested to determine whether it followed a normal distribution. Descriptive statistics were applied to calculate percentile values of cyclorotation which is presented as(M [P25; P75). Results This retrospective study evaluated 330 eyes of 274 Chinese patients who had femtosecond laser-assisted cataract surgery using the femtosecond laser platform. Of the 330 eyes, there were 90 eyes(27.27%)that did not show cyclorotation. Out of 330 eyes that were analyzed, 72.72%(240 eyes)exhibited cyclorotation. The median value of cyclorotation was 3.0[0.0; 5.0](ranged between 0 to 19 degrees). Of the 330 eyes, there were 90 eyes(27.27%)that did not show cyclorotation. Overall anticlockwise rotation(172 eyes, 52.12%)was more common than clockwise rotation(68 eyes, 20.60%).The total numbers of right and left eyes were 169 and 161 respectively. In terms of laterality, 43.78% of right eyes(74 eyes out of 169)and 60.86% of left eyes(98 eyes out of 161)showed anticlockwise rotation. 25.44% of right eyes(43eyes)and 15.52% of left eyes(25 eyes)exhibited clockwise rotation. Therefore anticlockwise rotation was considered as common occurrence in both left and right eyes. In order to assess the congruency of cyclorotation between eyes in bilateral cases, a subanalysis of all the patients who underwent bilateral femtosecond laser-assisted cataract surgery(56 out of 274)was performed. In total, 17 patients exhibited incylorotation(both eyes moved nasally)and 4 patients showed motion of eyes temporally exhibiting excyclorotation. In rest of patients some of them showed no rotation and others exhibited the movement of both eyes in opposite direction(one eye nasally and other temporally and vice versa).There were no AK-related complications or complications during femtosecond laser-assisted cataract surgery. Among them 56 were bilateral cases. Conclusion Clinically significant cyclorotation can occur during femtosecond laser assisted cataract surgery causing axis misalignment which might influence the desired astigmatism correction outcomes. It is highly recommended to take crucial compensatory measures to address this problem.

Key words: Femtosecond Laser, Cataract, Cyclorotation, Clockwise rotation, Anticlockwise rotation

CLC Number: 

  • R772.2
[1] Ang RET, Quinto MMS, Cruz EM, et al. Comparison of clinical outcomes between femtosecond laser-assisted versus conventional phacoemulsification[J]. Eye Vis(Lond), 2018, 5: 8. doi:10.1186/s40662-018-0102-5.
[2] Yoo A, Yun S, Kim JY, et al. Femtosecond laser-assisted arcuate keratotomy versus toric IOL implantation for correcting astigmatism[J]. J Refract Surg, 2015, 31(9): 574-578. doi:10.3928/1081597X-20150820-01.
[3] Wang J, Zhao JY, Xu J, et al. Evaluation of the effectiveness of combined femtosecond laser-assisted cataract surgery and femtosecond laser astigmatic keratotomy in improving post-operative visual outcomes[J]. BMC Ophthalmol, 2018, 18(1): 161. doi:10.1186/s12886-018-0823-1.
[4] Baharozian CJ, Song C, Hatch KM, et al. A novel nomogram for the treatment of astigmatism with femtosecond-laser arcuate incisions at the time of cataract surgery[J]. Clin Ophthalmol, 2017, 11: 1841-1848. doi:10.2147/OPTH.S141255.
[5] Aristeidou A, Taniguchi EV, Tsatsos M, et al. The evolution of corneal and refractive surgery with the femtosecond laser[J]. Eye Vis(Lond), 2015, 2: 12. doi:10.1186/s40662-015-0022-6.
[6] Chan TC, Ng AL, Cheng GP, et al. Corneal astigmatism and aberrations after combined femtosecond-assisted phacoemulsification and arcuate keratotomy: two-year results[J]. Am J Ophthalmol, 2016, 170: 83-90. doi:10.1016/j.ajo.2016.07.022.
[7] Becker R, Krzizok TH, Wassill H. Use of preoperative assessment of positionally induced cyclotorsion: a video-oculographic study[J]. Br J Ophthalmol, 2004, 88(3): 417-421. doi:10.1136/bjo.2003.025783.
[8] Fea AM, Sciandra L, Annetta F, et al. Cyclotorsional eye movements during a simulated PRK procedure[J]. Eye(Lond), 2006, 20(7): 764-768. doi:10.1038/sj.eye.6701994.
[9] Chang J. Cyclotorsion during laser in situ keratomileusis[J]. J Cataract Refract Surg, 2008, 34(10): 1720-1726. doi:10.1016/j.jcrs.2008.06.027.
[10] Shen EP, Chen WL, Hu FR. Manual limbal markings versus Iris-registration software for correction of myopic astigmatism by laser in situ keratomileusis[J]. J Cataract Refract Surg, 2010, 36(3): 431-436. doi:10.1016/j.jcrs.2009.10.030.
[11] Lin HY, Chuang YJ, Lin PJ, et al. Novel method for preventing cyclorotation in Ziemer Femto LDV Z8 femtosecond laser-assisted cataract surgery with Verion image-guided system[J]. Clin Ophthalmol, 2019, 13: 415-419. doi:10.2147/OPTH.S177219.
[12] Chen P, Ye YM, Yu N, et al. Comparison of small incision lenticule extraction surgery with and without cyclotorsion error correction for patients with astigmatism[J]. Cornea, 2019, 38(6): 723-729. doi:10.1097/ICO.0000000000001937.
[13] Pajic B, Cvejic Z, Mijatovic Z, et al. Excimer laser surgery: biometrical Iris eye recognition with cyclorotational control eye tracker system[J]. Sensors(Basel), 2017, 17(6): E1211. doi:10.3390/s17061211.
[14] Liu YL, Yeh PT, Huang JY, et al. Pupil centroid shift and cyclotorsion in bilateral wavefront-guided laser refractive surgery and the correlation between both eyes[J]. Taiwan Yi Zhi, 2013, 112(2): 64-71. doi:10.1016/j.jfma.2012.02.028.
[15] Alió Del Barrio JL, Tiveron M, Plaza-Puche AB, et al. Laser-assisted in situ keratomileusis with optimized, fast-repetition, and cyclotorsion control excimer laser to treat hyperopic astigmatism with high cylinder[J]. Eur J Ophthalmol, 2017, 27(6): 686-693. doi:10.5301/ejo.5001051.
[16] Arba Mosquera S, Verma S. Effects of torsional movements in refractive procedures[J]. J Cataract Refract Surg, 2015, 41(8): 1752-1766. doi:10.1016/j.jcrs.2015.07.017.
[17] Mohammadpour M, Khorrami-Nejad M, Chini-Foroush N. Correlation between Iris-registered static and dynamic cyclotorsions with preoperative refractive astigmatism in PRK candidates[J]. J Curr Ophthalmol, 2019, 31(1): 36-42. doi:10.1016/j.joco.2018.10.006.
[18] Ganesh S, Brar S, Pawar A. Results of intraoperative manual cyclotorsion compensation for myopic astigmatism in patients undergoing small incision lenticule extraction(SMILE)[J]. J Refract Surg, 2017, 33(8): 506-512. doi:10.3928/1081597X-20170328-01.
[19] Ozulken K, Ilhan C. Effects of cyclotorsion orientation and magnitude in eyes with compound myopic astigmatism on the compensation capacity of WaveLight EX500 photorefractive keratectomy[J]. Korean J Ophthalmol, 2019, 33(5): 458-466. doi:10.3341/kjo.2019.0042.
[20] Lucena AR, Mota JA, Lucena DR, et al. Cyclotorsion measurement in laser refractive surgery[J]. Arq Bras Oftalmol, 2013, 76(6): 339-340. doi:10.1590/s0004-27492013000600003.
[21] Popp N, Hirnschall N, Maedel S, et al. Evaluation of 4 corneal astigmatic marking methods[J]. J Cataract Refract Surg, 2012, 38(12): 2094-2099. doi:10.1016/j.jcrs.2012.07.039.
[22] Hummel CD, Diakonis VF, Desai NR, et al. Cyclorotation during femtosecond laser-assisted cataract surgery measured using Iris registration[J]. J Cataract Refract Surg, 2017, 43(7): 952-955. doi:10.1016/j.jcrs.2017.04.034.
[23] Zhao FK, Li L, Zhou WK, et al. Correlative factors' analysis of postural-related ocular cyclotorsion with image-guided system[J]. Jpn J Ophthalmol, 2018, 62(2): 237-242. doi:10.1007/s10384-017-0544-7.
[24] Xiang W, Chen W, Liu RJ, et al. Ocular cyclorotation and corneal axial misalignment in femtosecond laser-assisted cataract surgery[J]. Curr Eye Res, 2019, 44(12): 1313-1318. doi:10.1080/02713683.2019.1638943.
[25] Terauchi R, Horiguchi H, Ogawa T, et al. Posture-related ocular cyclotorsion during cataract surgery with an ocular registration system[J]. Sci Rep, 2020, 10(1): 2136. doi:10.1038/s41598-020-59118-9.
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