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LASIK 术后白内障手术中使用术中像差仪计划使用远距优势多焦点和单焦点人工晶状体的临床结果。

Clinical outcomes with distance-dominant multifocal and monofocal intraocular lenses in post-LASIK cataract surgery planned using an intraoperative aberrometer.

机构信息

Eye Center of North Florida, Panama City, Florida, USA.

Science in Vision, Akron, New York, USA.

出版信息

Clin Exp Ophthalmol. 2018 Aug;46(6):630-636. doi: 10.1111/ceo.13153. Epub 2018 Feb 23.

Abstract

IMPORTANCE

Studies evaluating the clinical benefits of intraoperative aberrometry (IA) in cataract surgery are limited.

BACKGROUND

The study was designed to determine whether IA improved clinical outcomes of post-laser in situ keratomileusis (LASIK) cataract surgery with different intraocular lenses (IOLs) implanted.

DESIGN

A retrospective chart review of clinical outcomes from one surgeon at one surgical centre was conducted. It included post-LASIK cataract surgeries where IA was used for the confirmation of IOL power, with either a distant-dominant multifocal IOL or a monofocal IOL implanted.

PARTICIPANTS

Records for 44 eyes of 31 patients were analysed.

METHODS

Differences in visual acuity (VA) and refractions by lens type were compared, and the effects of IA were evaluated.

MAIN OUTCOME MEASURES

Uncorrected distance VA and the percentage of eyes with a spherical equivalent refraction within 0.5D of the intended correction were the primary outcome measures.

RESULTS

There was no statistically significant difference in the percentage of eyes with uncorrected distance VA of 20/25 or better between IOL groups (P = 0.41). More eyes in the multifocal group had a refraction within 0.50D of intended (P = 0.03). In 39% of cases, the preoperative and IA power calculations suggested the same IOL power. When not equal, the IA results were not significantly more likely to be 'best' (P = 0.08).

CONCLUSIONS AND RELEVANCE

Results suggest that a history of previous LASIK is not a contraindication to use of distant-dominant multifocal IOLs. IA did not appear to improve clinical outcomes in post-LASIK eyes, although a positive trend was evident.

摘要

重要性

评估白内障手术中术中像差(IA)的临床益处的研究有限。

背景

本研究旨在确定 IA 是否改善了植入不同人工晶状体(IOL)的激光原位角膜磨镶术(LASIK)后白内障手术的临床结果。

设计

对一名外科医生在一个手术中心的临床结果进行了回顾性图表审查。它包括使用 IA 确认 IOL 屈光力的 LASIK 后白内障手术,植入了远距优势多焦点 IOL 或单焦点 IOL。

参与者

分析了 31 名患者的 44 只眼的记录。

方法

比较了不同晶状体类型的视力(VA)和屈光度差异,并评估了 IA 的效果。

主要观察指标

未矫正远视力和屈光度在预期矫正值的 0.5D 内的眼的百分比是主要观察指标。

结果

IOL 组之间未矫正远视力为 20/25 或更好的眼的百分比没有统计学差异(P = 0.41)。多焦点组中更多的眼屈光度在预期的 0.50D 以内(P = 0.03)。在 39%的情况下,术前和 IA 屈光力计算建议使用相同的 IOL 屈光力。当不相等时,IA 结果并不明显更有可能是“最佳”(P = 0.08)。

结论和相关性

结果表明,先前有 LASIK 史不是使用远距优势多焦点 IOL 的禁忌症。IA 似乎并没有改善 LASIK 后眼的临床结果,尽管有积极的趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29b0/6100005/969e15f9daa6/CEO-46-630-g001.jpg

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