Albert Einstein College of Medicine, Montefiore Medical Center, Department of Ophthalmology and Visual Sciences, Bronx, NY, USA.
Curr Opin Ophthalmol. 2013 Jul;24(4):275-80. doi: 10.1097/ICU.0b013e3283622955.
Since its introduction in the 1980s, more than 40 million people worldwide have undergone some form of kerato-refractive surgery. Many of these individuals are now candidates for cataract surgery and pose the challenge of attaining first-rate refractive outcomes in nonvirgin eyes. Numerous approaches have been developed to estimate intraocular lens (IOL) power in eyes postrefractive surgery. This review highlights the most practical, relevant options for accurate IOL power determination in these cases.
With refined techniques and advances in instrumentation, more accurate assessments of true corneal power and thus, IOL power, are possible in postrefractive eyes. Optical coherence tomography and other corneal tomography instruments have markedly improved accuracy in this process. However, when expensive, modern equipments are not readily available, and online IOL calculators such as the American Society of Cataract and Refractive Surgery (ASCRS) calculator have become efficient, reliable options. Recent evidence confirms the accuracy of these online calculators.
Emerging literature supports the use of methods that do not rely on prior refractive data in IOL power determination. Online IOL calculators provide user-friendly, efficient options that greatly facilitate accurate IOL power determination for cataract surgery in eyes that have undergone prior kerato-refractive surgery.
目的综述：自 20 世纪 80 年代问世以来，全球已有超过 4000 万人接受了某种形式的角膜屈光手术。这些患者中有许多人现在是白内障手术的候选者，他们的眼睛是非初次手术眼，这给实现一流的屈光手术效果带来了挑战。为了在屈光手术后的眼中估算人工晶状体（IOL）的屈光力，已经开发了许多方法。本文重点介绍了在这些情况下准确确定 IOL 屈光力的最实用、最相关的选择。
最新发现：随着技术的改进和仪器的进步，在屈光手术后的眼中，对真实角膜屈光力（进而对 IOL 屈光力）进行更精确的评估成为可能。光学相干断层扫描和其他角膜断层成像仪器在这一过程中显著提高了准确性。然而，当昂贵的现代设备不易获得时，美国白内障和屈光手术学会（ASCRS）计算器等在线 IOL 计算器已成为高效、可靠的选择。最近的证据证实了这些在线计算器的准确性。
总结：新出现的文献支持使用不依赖于先前屈光数据的方法来确定 IOL 屈光力。在线 IOL 计算器提供了用户友好、高效的选择，极大地促进了在先前接受过角膜屈光手术的眼中进行白内障手术时准确确定 IOL 屈光力。
