Rao S K, Cheng A C, Fan D S, Leung A T, Lam D S
Medical and Vision Research Foundations, Sankara Nethralaya, (Rao), Chennai, India.
J Cataract Refract Surg. 2001 Feb;27(2):297-302. doi: 10.1016/s0886-3350(00)00746-x.
To evaluate the effect of preoperative keratometry on the refractive outcome after laser in situ keratomileusis (LASIK) for myopia.
University Eye Clinic, Prince of Wales Hospital, Hong Kong, China.
In this retrospective study, the records of patients who had LASIK for myopia greater than -6.0 diopters (D) using the Chiron Automated Corneal Shaper and the Schwind Keratome-F excimer laser were reviewed.
Laser in situ keratomileusis was performed in 167 eyes of 103 patients (mean age 34.7 years +/- 7.5 [SD]). Preoperative myopic spherical equivalent (SE) refraction was -9.0 +/- 2.0 D (range -6.0 to -13.9 D). Three months after surgery, SE refraction was -0.04 +/- 1.1 D (range +2.3 to -3.3 D); uncorrected visual acuity > or = 20/40 was present in 91.8% of 110 eyes in which emmetropia was the postoperative goal. Mean preoperative keratometry was 43.9 +/- 1.5 D (range 40.3 to 48.1 D). When eyes were stratified by the degree of preoperative myopia in 1.0 D steps, a trend toward greater undercorrection was noted in eyes with preoperative keratometry < 43.5 D than in those with steeper keratometry (> 44.5 D) in all myopia groups except the -7.0 to -7.9 D group. This difference was statistically significant in eyes with a preoperative SE of -10.0 to -10.9 D and -11.0 to -11.9 D.
Preoperative keratometry appeared to influence the refractive outcome after myopic LASIK. Eyes with flatter corneas tended to have greater undercorrection than eyes with similar myopia and steeper corneas. Validation of these findings in larger data sets using the methodology described may improve the predictability of current LASIK nomograms, particularly in eyes with high myopia.
评估术前角膜曲率测量对近视患者准分子原位角膜磨镶术（LASIK）术后屈光效果的影响。
中国香港威尔士亲王医院大学眼科诊所。
在这项回顾性研究中，回顾了使用Chiron自动角膜板层刀和Schwind Keratome-F准分子激光对近视度数大于-6.0屈光度（D）的患者进行LASIK手术的记录。
对103例患者（平均年龄34.7岁±7.5[标准差]）的167只眼进行了准分子原位角膜磨镶术。术前近视等效球镜（SE）屈光度为-9.0±2.0 D（范围为-6.0至-13.9 D）。术后3个月，SE屈光度为-0.04±1.1 D（范围为+2.3至-3.3 D）；在以正视眼为术后目标的110只眼中，91.8%的未矫正视力≥20/40。术前平均角膜曲率为43.9±1.5 D（范围为40.3至48.1 D）。当按术前近视度数以1.0 D步长对眼睛进行分层时，在除-7.0至-7.9 D组外的所有近视组中，术前角膜曲率<43.5 D的眼睛比角膜曲率更陡（>44.5 D）的眼睛有更大的欠矫趋势。在术前SE为-10.0至-10.9 D和-11.0至-11.9 D的眼睛中，这种差异具有统计学意义。
术前角膜曲率测量似乎会影响近视LASIK术后的屈光效果。与近视程度相似但角膜曲率更陡的眼睛相比，角膜较平的眼睛往往有更大的欠矫。使用所述方法在更大的数据集中验证这些发现可能会提高当前LASIK手术图谱的可预测性，尤其是在高度近视眼中。
