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养为一名健康专业人员，成为一名独立的研究者。为了实现这一目标，一个为期五年，有指导的培训计划，其中包括大量的流行病学和生物统计学教学课程，将导致流行病学博士学位。六名导师分别在流行病学、生物统计学、临床研究、白内障和屈光手术以及理论光学方面具有专业知识。本研究的第二个目的是研究目前在接受近视屈光手术并需要白内障摘除和人工晶状体植入术的患者中角膜度数估计和人工晶状体度数计算的不准确性。目前用于计算非手术眼的人工晶状体度数的方法在屈光手术后是不准确的，并且在高达83-100%的白内障手术后眼睛中导致无意远视。历史临床数据，即评估屈光手术后角膜能量的“金标准”，很少有，尤其是几十年后需要白内障手术时。我们建议：a)使用横截面确定理论模型

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.