Total keratometry in intraocular lens power calculations in eyes with previous laser refractive surgery
Total keratometry in intraocular lens power calculations in eyes with previous laser refractive surgery
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DOI：
10.1111/ceo.13760
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发表时间：
2020-04-27
影响因子：
4
通讯作者：
Barrett, Graham
中科院分区：
文献类型：
--
作者：
Lawless, Michael;Jiang, James Y.;Barrett, Graham
重要性 屈光后病例中人工晶状体 (IOL) 的计算仍然是一个问题。我们的研究为外科医生确定了改进的选择。 背景 使用标准角膜曲率 (SK)、测量的后角膜散光 (PCA) 和总角膜曲率 (TK) 评估和比较既往激光屈光手术后 IOL 屈光度计算方法的预测准确性。设计回顾性连续队列。参与者总共 50 名在私人机构接受过既往激光屈光手术的白内障手术的连续患者（72 只眼）。方法使用 SK 的方法包括 ASCRS 平均值、Barrett True-K 无历史、Haigis-L 和 Shammas IOL 公式。还评估了使用后验值 (True K TK) 的 Barrett True-K、使用 TK 的 Haigis 和 Holladay 1 Double-K 方法。手术后至少 3 周进行术后验光。主要结果测量算术和绝对 IOL 屈光预测误差、平均算术 IOL 预测误差的方差以及屈光预测误差在 +/- 0.25D、+/- 0.50D、+/- 0.75D 和 +/- 1.00D 范围内的眼睛百分比。结果 Barrett True-K (TK) 提供最低的平均屈光预测误差(RPE) 和既往接受白内障手术的近视眼和远视眼的方差。与先前近视患者的其他公式相比，Barrett True-K (TK) 表现出最高的 RPE +/- 0.50D、+/- 0.75D 和 +/- 1.00D 范围内的眼睛百分比。结论和相关性 通过添加 IOLMaster 700 测量的后角膜值，可以提高激光术后眼睛 IOL 度数计算的准确性。在没有结果的情况下，使用总角膜曲率测量可以补充结果。先前的屈光史是已知的。
Importance Intraocular lens (IOL) calculations in post-refractive cases remain a concern. Our study identifies improved options for surgeons.Background To evaluate and compare the prediction accuracy of IOL power calculation methods after previous laser refractive surgery using standard keratometry (SK), measured posterior corneal astigmatism (PCA) and total keratometry (TK).Design Retrospective consecutive cohort.Participants A total of 50 consecutive patients (72 eyes) at a private institution who underwent cataract surgery with prior laser refractive procedures.Methods Methods using SK included ASCRS mean, Barrett True-K no history, Haigis-L and Shammas IOL formulae. Barrett True-K using posterior values (True K TK), Haigis and Holladay 1 Double-K methods using TK were also assessed. Post-surgery refraction was undertaken at minimum 3 weeks following surgery.Main Outcome Measures Arithmetic and absolute IOL refractive prediction errors, variances in mean arithmetic IOL prediction error, and percentage of eyes within +/- 0.25D, +/- 0.50D, +/- 0.75D and +/- 1.00D of refractive prediction errors were compared.Results The Barrett True-K (TK) provided the lowest mean refractive prediction error (RPE) and variance for both prior myopes and hyperopes undergoing cataract surgery. The Barrett True-K (TK) exhibited the highest percentages of eyes within +/- 0.50D, +/- 0.75D and +/- 1.00D of the RPE compared to other formulae for prior myopic patients.Conclusions and Relevance Accuracy of IOL power calculations in post-laser eyes can be improved by the addition of posterior corneal values as measured by the IOLMaster 700. The use of total keratometry may supplement outcomes when no prior refraction history is known.