角膜非球面性对白内障手术人工晶状体植入屈光结果的影响。
Influence of corneal asphericity on the refractive outcome of intraocular lens implantation in cataract surgery.
作者信息
Savini Giacomo, Hoffer Kenneth J, Barboni Piero
机构信息
From the Fondazione G.B. Bietti IRCCS (Savini), Rome, Studio Oculistico d'Azeglio (Barboni), Bologna, and the Scientific Institute San Raffaele (Barboni), Milan, Italy; the Stein Eye Institute (Hoffer), University of California, and St. Mary's Eye Center (Hoffer), Santa Monica, California, USA.
From the Fondazione G.B. Bietti IRCCS (Savini), Rome, Studio Oculistico d'Azeglio (Barboni), Bologna, and the Scientific Institute San Raffaele (Barboni), Milan, Italy; the Stein Eye Institute (Hoffer), University of California, and St. Mary's Eye Center (Hoffer), Santa Monica, California, USA.
出版信息
J Cataract Refract Surg. 2015 Apr;41(4):785-9. doi: 10.1016/j.jcrs.2014.07.035.
PURPOSE
To evaluate the possible influence of anterior corneal surface asphericity on the refractive outcomes in eyes having intraocular lens (IOL) implantation after cataract surgery.
SETTING
Fondazione G.B. Bietti IRCCS, Rome, Italy.
DESIGN
Retrospective comparative case series.
METHODS
Intraocular lens power was calculated using the Haigis, Hoffer Q, Holladay 1, and SRK/T formulas. Asphericity (Q-value) was measured at 8.0 mm with a Placido-disk corneal topographer (Keratron), a rotating Scheimpflug camera (Pentacam), and a rotating Scheimpflug camera combined with Placido-disk corneal topography (Sirius). The relationship between the error in refraction prediction (ie, difference between expected refraction and refraction measured 1 month after surgery) and the Q-value was assessed by linear regression.
RESULTS
The same IOL model (Acrysof SA60AT) was implanted in 115 eyes of 115 consecutive patients. Regression analysis showed a statistically significant relationship between the error in refraction prediction and the Q-value with all formulas and all devices. In all cases, a more negative Q-value (prolate cornea) was associated with a myopic outcome, whereas a more positive Q-value (oblate cornea) was associated with a hyperopic outcome. The highest coefficient of determination was detected between the Hoffer Q formula and the Placido-disk corneal topographer (R(2) = 0.2630), for which the error in refraction prediction (y) was related to the Q-value (x) according to the formula y = -0.2641 + 1.4589 × x.
CONCLUSION
Corneal asphericity influences the refractive outcomes of IOL implantation and should be taken into consideration when using third-generation IOL power formulas.
FINANCIAL DISCLOSURE
Dr. Hoffer receives book royalties from Slack, Inc., Thorofare, New Jersey, and formula royalties from all manufacturers using the Hoffer Q formula. No other author has a financial or proprietary interest in any material or method mentioned.
目的
评估白内障手术后人工晶状体（IOL）植入眼中角膜前表面非球面性对屈光结果的可能影响。
设置
意大利罗马的G.B. Bietti IRCCS基金会。
设计
回顾性比较病例系列。
方法
使用Haigis、Hoffer Q、Holladay 1和SRK/T公式计算人工晶状体度数。使用Placido盘角膜地形图仪（Keratron）、旋转式Scheimpflug相机（Pentacam）以及结合Placido盘角膜地形图的旋转式Scheimpflug相机（Sirius）在8.0 mm处测量非球面性（Q值）。通过线性回归评估屈光预测误差（即预期屈光与术后1个月测量的屈光之间的差异）与Q值之间的关系。
结果
连续115例患者的115只眼植入了相同型号的IOL（Acrysof SA60AT）。回归分析显示，所有公式和所有设备的屈光预测误差与Q值之间均存在统计学上的显著关系。在所有情况下，Q值越负（角膜呈长椭圆形）与近视结果相关，而Q值更正（角膜呈扁圆形）与远视结果相关。在Hoffer Q公式与Placido盘角膜地形图仪之间检测到最高的决定系数（R(2)=0.2630），其屈光预测误差（y）与Q值（x）的关系符合公式y = -0.2641 + 1.4589×x。
结论
角膜非球面性影响IOL植入的屈光结果，在使用第三代IOL度数公式时应予以考虑。
财务披露
霍弗博士从新泽西州索罗法尔的Slack公司获得图书版税，并从所有使用Hoffer Q公式的制造商获得公式版税。其他作者对文中提及的任何材料或方法均无财务或专利权益。
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