School of Allied Health Sciences, Kitasato University, Kitasato, Japan.
Department of Ophthalmology, Kitasato University, Kitasato, Japan.
Sci Rep. 2018 Aug 20;8(1):12436. doi: 10.1038/s41598-018-31008-1.
This study was aimed to assess the simulated keratometry (Sim K) and the total corneal refractive power (TCRP) in eyes with keratoconus with respect to the Amsler-Krumeich classification. We enrolled 100 eyes of 100 keratoconic patients and 25 age-matched normal eyes. The Sim K and TCRP were measured with a rotating Scheimpflug system (Pentacam HR, Oculus). The differences between Sim K and TCRP in the keratoconus group were significantly larger than those in the control group (p < 0.001). The differences between Sim K and TCRP became larger in the progressive stages of the disease (p = 0.191 for stage 1, p = 0.008 for stage 2, p < 0.001 for stage 3, p < 0.001 for stage 4). We found a significant correlation of Sim K with the differences between Sim K and TCRP in keratoconic patients (r = 0.497, p < 0.001). The differences between Sim K and TCRP for keratoconus were significantly larger than those for normal eyes, and the differences between Sim K and TCRP tended to become larger in the progressive stages of the disease. It is suggested that the Sim K readings overestimate the TCRP, especially in advanced keratoconus, and that this discrepancy is a possible source of a hyperopic refractive error after cataract surgery.
本研究旨在评估圆锥角膜患者的模拟角膜曲率（Sim K）和总角膜屈光力（TCRP）与 Amsler-Krumeich 分类的关系。我们纳入了 100 例圆锥角膜患者的 100 只眼和 25 名年龄匹配的正常眼。使用旋转式 Scheimpflug 系统（Oculus 公司的 Pentacam HR）测量 Sim K 和 TCRP。圆锥角膜组的 Sim K 和 TCRP 之间的差异明显大于对照组（p<0.001）。随着疾病的进展，Sim K 和 TCRP 之间的差异也越来越大（第 1 期 p=0.191，第 2 期 p=0.008，第 3 期 p<0.001，第 4 期 p<0.001）。我们发现圆锥角膜患者的 Sim K 与 Sim K 和 TCRP 之间的差异呈显著相关（r=0.497，p<0.001）。圆锥角膜患者的 Sim K 和 TCRP 之间的差异明显大于正常眼，且随着疾病的进展，这种差异有增大的趋势。提示 Sim K 读数高估了 TCRP，尤其是在晚期圆锥角膜中，这种差异可能是白内障手术后远视屈光误差的一个来源。
