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近视眼LASIK术后人工晶体测算中建立矫正角膜屈光力的回归公式[J]. 中山大学学报(医学科学版), 2012,33(2).
A new Regression Formula for Correcting Corneal Power in IOL Power Calculation after Myopic LASIK Surgery[J]. Journal of Sun Yat-sen University (Medical Sciences), 2012, 33(2).
【目的】探讨近视眼LASIK屈光手术后测算人工晶体(IOL)屈光度时不需要其术前资料的方法。【方法】本研究分为两部分,研究的第一部分是通过对97例(193眼)接受LASIK屈光手术的病人,记录其术前及术后3个月的等效球镜以及由IOLMaster测量的平均角膜曲率(Km)和术后平均角膜曲率半径(rm),并应用临床病史法计算出术后3个月时的实际角膜曲率(Kchm),建立Kchm对Km的回归公式。研究的第二部分选取另外67例(132眼)拟接受LASIK屈光手术病人,在LASIK手术前及术后3个月后将等效球镜设定为目标屈光度,应用在研究第一部分中建立的回归公式来矫正LASIK术后角膜曲率,应用IOLmaster不同的IOL屈光度计算公式计算测算IOL屈光度并进行分析比较。【结果】 研究的第一部分中建立Kchm对Km的的回归模型为:Kchm=1.033×post-Km-2.192,模型可决系数R2=0.916。研究的第二部分分析比较将由此回归公式矫正的术后角膜曲率输入不同IOL屈光度计算公式的计算结果,对于选定的三种IOL类型,与术前“等值人工晶体屈光度”差别在±1.0D内者,应用Holladay I 和SRK-T公式的准确性优于Haigis、Hoffer-Q、Haigis-L公式,将矫正的术后角膜曲率输入Haigis公式计算LASIK术后IOL屈光度与专用于近视眼LASIK/PRK/LASEK术后IOL屈光度计算的Haigis-L公式效能几乎相同。【结论】本研究建立了不需要术前数据的矫正近视眼LASIK术后角膜曲率的回归公式,这将对以后该类病人因白内障需要行人工晶体植入而又缺失LASIK术前数据时会有用。
【Objective】 To investigate a method of calculating intraocular lens (IOL) power that may be independent of prerefractive surgery data in eyes that have previously undergone myopic laser in situ keratomileusis (LASIK). 【Methods】 In 193 eyes of 97 patients
before and 3 months after LASIK
th spherical equivalent(SE)
mean corneal power(Km)and postoperative mean corneal radius(rm) measured by IOLMaster were recorded in the first part of this study.On the basis of above data
A regression model was established between the the actual postoperative corneal power calculated by clinical history method(Kchm) and postoperative mean corneal power(Km)directly measured by the IOLMaster.In the second part of this study
before and 3 months after LASIK
intraocular lens(IOL) calculation with the SE as the target refraction by the IOLMaster was done in another set of 67 post-LASIK patients(132 eyes). The postoperative corneal power corrected by the regression fomula obtained from the first part of this study was used for IOL calculation after LASIK surgery. 【Results】 The regression model(Kchm=1.033×post-Km-2.192) was established and the model R square was 0.916 in the first part of this study. In the second part of this study
IOL calculation with Holladay I or SRK-T formula by using corrected postoperative corneal power was more accurate than that with Haigis
Hoffer-Q or Haigis-L formula within ±1.0D of preoperative equivalent IOL power by comparing above five IOL calculation formulas for three selected IOL types. In addition
it showed that IOL calculation with Haigis formula by entering corrected postoperative corneal power achieved almost the same efficacy compared with Haigis-L formula exclusivly used for IOL calculation after myopic LASIK/PRK/LASEK.【Conclusion】 This study presents a new regression model for correcting postoperative corneal power independent of preoperative data and it will be useful in myopic post-LASIK patients requiring cataract surgery but without pre-LASIK data.
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