Martinez C E, Klyce S D
LSU Eye Center, Louisiana State University Medical Center School of Medicine, New Orleans, USA.
Curr Opin Ophthalmol. 1996 Feb;7(1):31-8. doi: 10.1097/00055735-199602000-00007.
Keratometry and corneal topography remain the most important means of evaluating induced corneal changes after surgery and have comparable sensitivities in the paracentral region of the cornea. However, keratometry gives no information about the peripheral cornea or about asymmetry of the cornea. Videokeratography should be performed after cataract surgery in cases in which best-corrected visual acuity is not adequate and there are no other obvious causes for poor vision to determine whether corneal irregularities are present. The recent literature on corneal topographic evaluation of induced astigmatism after cataract surgery suggests that in general, smaller, temporal incisions result in less astigmatism. Preoperatively, corneal topography can be used in the calculation of intraocular lens power as well as incision planning. Postoperatively, it can be used to detect tight sutures, torsion of the wound, internal wound gape, and irregular astigmatism, as well as to guide suture removal. In the future, corneal topography will become increasingly important in the determination of intraocular lens power in difficult cases such as patients undergoing combined cataract extraction and penetrating keratoplasty as well as patients with a history of radial keratotomy or photorefractive surgery.
角膜曲率测量和角膜地形图仍然是评估手术后诱发角膜变化的最重要手段，并且在角膜旁中央区域具有相当的敏感性。然而，角膜曲率测量无法提供有关周边角膜或角膜不对称性的信息。在白内障手术后，如果最佳矫正视力不佳且没有其他明显的视力低下原因，应进行视频角膜地形图检查，以确定是否存在角膜不规则。最近关于白内障手术后诱发散光的角膜地形图评估的文献表明，一般来说，较小的颞侧切口导致的散光较少。术前，角膜地形图可用于计算人工晶状体的屈光度以及切口规划。术后，它可用于检测缝线过紧、伤口扭转、内部伤口裂开和不规则散光，以及指导缝线拆除。未来，角膜地形图在确定复杂病例（如接受白内障摘除联合穿透性角膜移植术的患者以及有放射状角膜切开术或屈光性角膜切削术病史的患者）的人工晶状体屈光度方面将变得越来越重要。
