Department of Convergence Medical Science, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Flaum Eye Institute, The Institute of Optics, Center for Visual Science, University of Rochester, Rochester, New York, USA.
Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
Am J Ophthalmol. 2019 Feb;198:17-24. doi: 10.1016/j.ajo.2018.09.005. Epub 2018 Sep 17.
To assess whether preoperative crystalline lens equatorial plane (LEP) reliably predicts the postoperative position of the intraocular lens (IOL).
Comparative, interventional case series.
Phacoemulsification and IOL implantation (Group I, ZCB00; Group II, EC-1PAL; and Group III, CT Asphina) were performed for 104 eyes. Lens geometry parameters, including LEP, were obtained from a femtosecond laser cataract surgery system prior to surgery. LEP was defined as the distance from the front surface of the cornea to the equatorial plane of the crystalline lens. Postoperative anterior chamber depth (ACD) was measured using a Scheimpflug camera. Median absolute error was calculated using an optical ray-tracing method that incorporated LEP into an individualized eye model, and the results were compared with those from the Haigis formula.
Preoperative ACD (3.27 ± 0.39 mm [R = 0.428], 3.30 ± 0.47 mm [R = 0.591], and 3.49 ± 0.39 mm [R = 0.373] in Groups I, II, and III, respectively) and LEP (4.81 ± 0.29 mm [R = 0.570], 4.84 ± 0.27 mm [R = 0.634], and 4.97 ± 0.23 mm [R = 0.565] in Groups I, II, and III, respectively) were found to have significant positive correlations with postoperative ACD (5.24 ± 0.40 mm, 5.02 ± 0.31 mm, and 5.19 ± 0.26 mm in Groups I, II, and III, respectively). Stepwise regression analysis showed that postoperative ACD was significantly correlated with LEP in all groups. Median absolute errors predicted by the ray-tracing method using LEP were smaller than those from the Haigis formula in all groups.
LEP is a promising measure from preoperative crystalline lens geometry and could serve as a new parameter to improve refractive outcomes in cataract surgery.
评估术前晶状体赤道平面（LEP）是否能可靠地预测人工晶状体（IOL）的术后位置。
比较、干预性病例系列研究。
对 104 只眼行白内障超声乳化术和 IOL 植入术（ZCB00 组、EC-1PAL 组和 CT Asphina 组）。手术前，采用飞秒激光白内障手术系统获取晶状体几何参数，包括 LEP。LEP 定义为角膜前表面至晶状体赤道平面的距离。使用 Scheimpflug 相机测量术后前房深度（ACD）。采用光射线追踪法计算中位绝对误差，该方法将 LEP 纳入个体化眼模型，并将结果与 Haigis 公式进行比较。
术前 ACD（分别为 3.27 ± 0.39mm [R=0.428]、3.30 ± 0.47mm [R=0.591]和 3.49 ± 0.39mm [R=0.373]）和 LEP（分别为 4.81 ± 0.29mm [R=0.570]、4.84 ± 0.27mm [R=0.634]和 4.97 ± 0.23mm [R=0.565]）与术后 ACD 均呈显著正相关（分别为 5.24 ± 0.40mm、5.02 ± 0.31mm 和 5.19 ± 0.26mm）。逐步回归分析显示，所有组的术后 ACD 均与 LEP 显著相关。所有组中，基于 LEP 的光射线追踪法预测的中位绝对误差均小于 Haigis 公式。
LEP 是术前晶状体几何形状的一项有前途的指标，可作为改善白内障手术屈光结果的新参数。
