基于光学相干断层扫描的激光视力矫正术后角膜屈光力测量及人工晶状体屈光力计算（美国眼科学会论文）
Optical coherence tomography-based corneal power measurement and intraocular lens power calculation following laser vision correction (an American Ophthalmological Society thesis).
作者信息
Huang David, Tang Maolong, Wang Li, Zhang Xinbo, Armour Rebecca L, Gattey Devin M, Lombardi Lorinna H, Koch Douglas D
机构信息
Casey Eye Institute, Oregon Health & Science University, Portland, Oregon (Dr Huang, Dr Tang, Dr Zhang, Dr Armour, Dr Gattey, Dr Lombardi), and Cullen Eye Institute, Baylor College of Medicine, Houston, Texas (Dr Wang, Dr Koch).
出版信息
Trans Am Ophthalmol Soc. 2013 Sep;111:34-45.
PURPOSE
To use optical coherence tomography (OCT) to measure corneal power and improve the selection of intraocular lens (IOL) power in cataract surgeries after laser vision correction.
METHODS
Patients with previous myopic laser vision corrections were enrolled in this prospective study from two eye centers. Corneal thickness and power were measured by Fourier-domain OCT. Axial length, anterior chamber depth, and automated keratometry were measured by a partial coherence interferometer. An OCT-based IOL formula was developed. The mean absolute error of the OCT-based formula in predicting postoperative refraction was compared to two regression-based IOL formulae for eyes with previous laser vision correction.
RESULTS
Forty-six eyes of 46 patients all had uncomplicated cataract surgery with monofocal IOL implantation. The mean arithmetic prediction error of postoperative refraction was 0.05 ± 0.65 diopter (D) for the OCT formula, 0.14 ± 0.83 D for the Haigis-L formula, and 0.24 ± 0.82 D for the no-history Shammas-PL formula. The mean absolute error was 0.50 D for OCT compared to a mean absolute error of 0.67 D for Haigis-L and 0.67 D for Shammas-PL. The adjusted mean absolute error (average prediction error removed) was 0.49 D for OCT, 0.65 D for Haigis-L (P=.031), and 0.62 D for Shammas-PL (P=.044). For OCT, 61% of the eyes were within 0.5 D of prediction error, whereas 46% were within 0.5 D for both Haigis-L and Shammas-PL (P=.034).
CONCLUSIONS
The predictive accuracy of OCT-based IOL power calculation was better than Haigis-L and Shammas-PL formulas in eyes after laser vision correction.
目的
使用光学相干断层扫描（OCT）测量角膜屈光力，以改善激光视力矫正术后白内障手术中人工晶状体（IOL）屈光力的选择。
方法
来自两个眼科中心的曾接受过近视激光视力矫正的患者被纳入这项前瞻性研究。通过傅里叶域OCT测量角膜厚度和屈光力。通过部分相干干涉仪测量眼轴长度、前房深度和自动角膜曲率计。开发了基于OCT的IOL计算公式。将基于OCT的公式预测术后屈光不正的平均绝对误差与两种基于回归的IOL公式用于曾接受激光视力矫正的眼睛进行比较。
结果
46例患者的46只眼睛均进行了无并发症的白内障手术并植入了单焦点IOL。OCT公式术后屈光不正的平均算术预测误差为0.05±0.65屈光度（D），Haigis-L公式为0.14±0.83 D，无手术史的Shammas-PL公式为0.24±0.82 D。OCT的平均绝对误差为0.50 D，而Haigis-L和Shammas-PL的平均绝对误差分别为0.67 D和0.67 D。调整后的平均绝对误差（去除平均预测误差）OCT为0.49 D，Haigis-L为0.65 D（P = 0.031），Shammas-PL为0.62 D（P = 0.044）。对于OCT，61%的眼睛预测误差在0.5 D以内，而Haigis-L和Shammas-PL均为46%（P = 0.034）。
结论
在激光视力矫正术后的眼睛中，基于OCT的IOL屈光力计算的预测准确性优于Haigis-L和Shammas-PL公式。
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