Corneal Refractive Power Post Refractive Surgery

描述(由申请者提供)：本提案的主要目标是培训申请者成为一名健康专业人员，使其成为一名独立的调查员。为了实现这一目标，描述了一个为期五年的指导培训计划，其中包括大量的流行病学和生物统计学课程教学，这将导致流行病学博士学位的获得。已选出6名导师，他们具有流行病学、生物统计学、临床研究、白内障和屈光外科以及理论眼科方面的专业知识。这项建议的第二个目标是调查目前近视屈光手术后需要白内障摘除和人工晶状体植入术的眼的角膜屈光度估计和人工晶状体(IOL)屈光度计算的不准确性。目前用于计算非手术眼人工晶状体屈光度的方法是不准确的，并在高达83%-100%的白内障手术后导致非故意远视。根据历史的临床数据，评估屈光手术后角膜屈光力的“黄金标准”很少，特别是几十年后需要白内障手术的时候。我们建议：a)使用横截面来确定理论模型 这项研究将使我们能够评估和完善隐形眼镜过屈光度方法在不使用白内障眼睛的情况下估计角膜屈光度的准确性和精密度；以及b)我们将测试我们改进的隐形眼镜过屈光度方法可以用于计算患有白内障的眼睛的IOL屈光度的假设。我们将使用前瞻性队列研究来比较屈光手术后患者和正常角膜的白内障患者术后的屈光并发症。屈光手术是一种常见的矫正视力的方法，2000年至少有150万例手术，在接下来的十几年里多达2650万例。因此，开发一种准确、准确、简便的方法来估算角膜屈光度和计算人工晶状体屈光度是非常关键的。这项研究的长期目标是帮助了解屈光手术后患者的人工晶状体屈光度测定。

DESCRIPTION (provided by applicant): The primary goal of this proposal is to train the applicant as a health professional to become an independent investigator. To achieve this goal, a five-year, mentored training program with heavy didactic coursework in epidemology and biostatistics is described that will lead to a PhD in epidemiology. Six mentors, with expertise in epidemiology, biostatistics, clinical research, cataract and refractive surgery, and theoretical opticas have been selected. The secondary goal of this proposal is to investigate the current inaccuracies of corneal power estimation and intraocular lens (IOL) power calculation in eyes that have undergone myopic refractive surgery and require cataract extraction and IOL placement. Current methods used to calculate IOL power in non-surgical eyes are inaccurate post-refractive surgery and cause unintentional hyperopia in up to 83-100% of eyes post-cataract surgery. Historical clinical data, the "gold standard" in estimating corneal power post-refractive surgery is rarely available, especially decades later when cataract surgery is necessary. We propose to: a) identify a theoretical model using a cross-sectional study that will allow us to evaluate and refine the accuracy and precision of a contact lens overrefraction method in estimating corneal refractive power without using cataractous eyes; and b) we will test the hypothesis that our refined contact lens over-refraction method can be used in calculating IOL power in eyes that have developed cataracts. We will use a prospective cohort study to compare refractive complications post-cataract surgery between post-refractive surgery patients and cataractous eyes with normal corneas. Refractive surgery is a common method of vision correction, with at least 1.5 million procedures in 2000, and as many as 26.5 million within the next dozen years. Hence, it is critical that an accurate, precise and simple method to estimate corneal power and calculate IOL power is developed. The long-term objective to this research is to contribute to the knowledge of IOL power determination in post-refractive surgery patients.