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水凝胶镶嵌植入术后角膜曲率值和角膜高阶像差的变化

Changes in Keratometric Values and Corneal High Order Aberrations After Hydrogel Inlay Implantation.

作者信息

Whang Woong-Joo, Yoo Young-Sik, Joo Choun-Ki, Yoon Geunyoung

机构信息

Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Am J Ophthalmol. 2017 Jan;173:98-105. doi: 10.1016/j.ajo.2016.09.027. Epub 2016 Sep 30.

DOI:10.1016/j.ajo.2016.09.027
PMID:27697473
Abstract

PURPOSE

We sought to analyze surgically induced refractive change (SIRC) and change in high-order aberration after Raindrop corneal inlay insertion (ReVision Optics, Lake Forest, CA), and assess the extent to which Raindrop corneal inlay insertion could correct presbyopia.

DESIGN

Interventional case series.

METHODS

Seventeen patients were included if they had a corneal thickness ≥500 μm and a stable manifest spherical equivalent refraction between 0.50 and +1.00 diopters (D). The Raindrop corneal inlay was implanted on the stromal bed of a femtosecond laser-assisted generated flap of nondominant eyes. Manifest refraction, corneal powers, and corneal high-order aberrations were measured preoperatively and at 3 and 12 months postoperatively.

RESULTS

The SIRC by manifest refraction was 0.99 ± 0.26 D. The changes derived from simulated keratometry (K), true net power, and equivalent K reading (EKR) at 1.0-4.0 mm were greater than the SIRC (all P < .01) while the change in EKR at 6.0 mm was less than the SIRC (P < .01). The changes in EKR 5.0 mm, automated K, and EKR 4.5 mm did not differ significantly from the SIRC (P = .81, .29, and .09, respectively), and the difference was the least for EKR 5.0 mm. In analysis of high-order aberrations, only spherical aberration showed statistically significant difference between preoperative and postoperative on both anterior cornea and total cornea (all P < .01).

CONCLUSION

Raindrop corneal inlay corrects presbyopia via increasing negative spherical aberration. The equivalent K reading at 5.0 mm accurately reflected the SIRC, and would be applicable for intraocular power prediction before cataract surgery.

摘要

目的

我们试图分析Raindrop角膜嵌体植入术(ReVision Optics公司,加利福尼亚州莱克福里斯特)后手术诱导的屈光变化(SIRC)和高阶像差变化,并评估Raindrop角膜嵌体植入术矫正老花眼的程度。

设计

介入性病例系列。

方法

纳入17例角膜厚度≥500μm且明显等效球镜度在0.50至+1.00屈光度(D)之间稳定的患者。Raindrop角膜嵌体植入非优势眼飞秒激光辅助制作的角膜瓣的基质床上。术前及术后3个月和12个月测量明显屈光、角膜屈光力和角膜高阶像差。

结果

明显屈光的SIRC为0.99±0.26 D。在1.0 - 4.0mm处,模拟角膜曲率计(K)、真实净屈光力和等效K读数(EKR)得出的变化大于SIRC(所有P <.01),而在6.0mm处EKR的变化小于SIRC(P <.01)。5.0mm处的EKR、自动角膜曲率计和4.5mm处的EKR变化与SIRC无显著差异(分别为P =.81、.29和.09),5.0mm处的EKR差异最小。在高阶像差分析中,仅球差在术前和术后前角膜和全角膜上均显示出统计学显著差异(所有P <.01)。

结论

Raindrop角膜嵌体通过增加负球差来矫正老花眼。5.0mm处的等效K读数准确反映了SIRC,适用于白内障手术前的眼内屈光力预测。

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