Corneal Refractive Power Post Refractive Surgery

描述（由申请人提供）：本提案的主要目标是将申请人培训为卫生专业人员，使其成为独立研究者。为了实现这一目标，一个为期五年的，辅导培训计划，在流行病学和生物统计学繁重的教学课程的描述，将导致在流行病学博士学位。 六名导师，在流行病学，生物统计学，临床研究，白内障和屈光手术，和理论光学的专业知识已被选中。 本提案的次要目标是调查目前在接受近视屈光手术并需要白内障摘除和IOL植入的眼睛中角膜屈光度估计和眼内透镜（IOL）屈光度计算的不准确性。 目前用于计算非手术眼IOL屈光度的方法在屈光手术后不准确，并在高达83-100%的白内障手术后眼睛中引起意外远视。 历史临床数据，估计角膜屈光手术后的“金标准”很少，特别是几十年后，当白内障手术是必要的。 我们建议：a）使用横截面确定理论模型 该研究将允许我们评估和改进接触透镜过屈光方法在不使用白内障眼睛的情况下估计角膜屈光力的准确度和精密度;以及B）我们将测试我们改进的接触透镜过屈光方法可用于计算已发生白内障的眼睛的IOL屈光力的假设。我们将使用一项前瞻性队列研究来比较屈光手术后患者与角膜正常的白内障患者之间的屈光并发症。 屈光手术是一种常见的视力矫正方法，2000年至少有150万例手术，在未来十几年内将有2650万例手术。 因此，开发一种准确、精确和简单的方法来估计角膜屈光力和计算IOL屈光力是至关重要的。本研究的长期目标是有助于屈光手术后患者IOL屈光度确定的知识。

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.