Reitblat Olga, Levy Adi, Kleinmann Guy, Abulafia Adi, Assia Ehud I
From the Ein-Tal Eye Center (Reitblat, Levy, Kleinmann, Abulafia, Assia), Tel-Aviv, the Kaplan Medical Center (Kleinmann), Rehovot, affiliated with The Hebrew University, Jerusalem, the Assaf Harofeh Medical Center (Abulafia), Zerifin affiliated with Tel-Aviv University, Ramat Aviv, and the Meir Medical Center (Assia), Kfar-Saba, affiliated with Tel-Aviv University, Ramat Aviv, Israel.
From the Ein-Tal Eye Center (Reitblat, Levy, Kleinmann, Abulafia, Assia), Tel-Aviv, the Kaplan Medical Center (Kleinmann), Rehovot, affiliated with The Hebrew University, Jerusalem, the Assaf Harofeh Medical Center (Abulafia), Zerifin affiliated with Tel-Aviv University, Ramat Aviv, and the Meir Medical Center (Assia), Kfar-Saba, affiliated with Tel-Aviv University, Ramat Aviv, Israel.
J Cataract Refract Surg. 2016 Feb;42(2):217-25. doi: 10.1016/j.jcrs.2015.11.036.
To compare the accuracy of different methods that consider posterior corneal curvature in toric intraocular lens (IOL) calculations.
Ein-Tal Eye Center, Tel-Aviv, Israel.
Retrospective comparative case series.
Consecutive cases of toric IOL implantation and preoperative measurements by optical biometry with optical low-coherence reflectometry (OLCR) (Lenstar LS 900) and a Scheimpflug camera (Pentacam) were retrospectively reviewed. Five methods of toric IOL calculation were compared as follows: (1) anterior corneal astigmatism using OLCR, (2) application of the Baylor nomogram, (3) posterior tomography combined with anterior corneal measurements using vector summation, (4) the Scheimpflug camera's true net power, and (5) total corneal refractive power. Toric IOL astigmatic power and axis, aiming for the lowest residual astigmatism, were selected according to these methods. Simulated residual refraction was calculated for each method based on manifest refraction and measured IOL alignment more than 3 weeks after surgery.
The study included 115 eyes of 92 patients. The median simulated residual astigmatism was lower when based on vector summation of anterior and posterior astigmatisms than with calculations based on anterior corneal measurements only, application of the Baylor nomogram, true net power, and total corneal refractive power readings (0.49 diopters [D] versus 0.70 D, 0.60 D, 0.64 D, and 0.76 D, respectively) (P < .001).
Residual astigmatism after toric IOL implantation can be reduced by appropriate consideration of the posterior corneal astigmatism. Using methods that take into account the effect of the posterior cornea in toric IOL calculations is suggested.
Drs. Assia and Kleinmann are consultants to Hanita Lenses, Israel. Dr. Abulafia received a speaker's fee from Haag-Streit AG. No other author has a financial or proprietary interest in any material or method mentioned.
比较在有晶状体眼人工晶状体（IOL）计算中考虑后角膜曲率的不同方法的准确性。
以色列特拉维夫的Ein-Tal眼科中心。
回顾性比较病例系列。
回顾性分析连续的有晶状体眼人工晶状体植入病例以及术前通过光学低相干反射测量法（OLCR）（Lenstar LS 900）和Scheimpflug相机（Pentacam）进行的测量。比较了五种有晶状体眼人工晶状体计算方法如下：（1）使用OLCR测量的前角膜散光，（2）应用贝勒列线图，（3）后断层扫描结合使用矢量求和的前角膜测量，（4）Scheimpflug相机的真实净度数，以及（5）总角膜屈光力。根据这些方法选择有晶状体眼人工晶状体的散光度数和轴位，目标是使残余散光最小。基于明显验光结果并在术后3周以上测量人工晶状体的对准情况，为每种方法计算模拟残余屈光不正。
该研究纳入了92例患者的115只眼。基于前后散光矢量求和计算的模拟残余散光中位数低于仅基于前角膜测量、应用贝勒列线图、真实净度数和总角膜屈光力读数计算的结果（分别为0.49屈光度[D]对0.70 D、0.60 D、0.64 D和0.76 D）（P <.001）。
通过适当考虑后角膜散光可降低有晶状体眼人工晶状体植入术后的残余散光。建议在有晶状体眼人工晶状体计算中使用考虑后角膜影响的方法。
阿西亚博士和克莱因曼博士是以色列哈尼塔镜片公司的顾问。阿布拉菲亚博士从哈格-施特赖特公司获得了演讲费。其他作者在文中提及的任何材料或方法中均无财务或专利权益。
