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既往近视性准分子原位角膜磨镶术眼植入扩展视程人工晶状体的屈光预测性及视觉效果

Refractive predictability and visual outcomes of an extended range of vision intraocular lens in eyes with previous myopic laser in situ keratomileusis.

作者信息

Palomino-Bautista Carlos, Carmona-González David, Sánchez-Jean Rubén, Castillo-Gómez Alfredo, Romero-Domínguez Marta, Elías de Tejada Macarena, Piñero David P

机构信息

Department of Ophthalmology, University Hospital Quirónsalud Madrid, Madrid, Spain.

European University of Madrid, Madrid, Spain.

出版信息

Eur J Ophthalmol. 2019 Nov;29(6):593-599. doi: 10.1177/1120672118804950. Epub 2018 Oct 4.

Abstract

PURPOSE

To evaluate the refractive predictability obtained with an extended range of vision intraocular lens in eyes with previous myopic laser in situ keratomileusis, confirming which intraocular lens power formula provides the most accurate calculation.

METHODS

The study enrolled 71 eyes with previous successful myopic laser in situ keratomileusis surgery of 43 patients undergoing cataract surgery with implantation of the extended range of vision intraocular lens TECNIS Symfony (Johnson and Johnson Vision). Intraocular lens power was calculated using all American Society of Cataract and Refractive Surgeons formulas, and their average value was selected for implantation. Refractive outcomes were evaluated at 3 months postoperatively.

RESULTS

Postoperative spherical equivalent within ±0.50 and ±1.00 D was found in 61.6% and 86.3% of eyes, respectively. In eyes with pre-laser in situ keratomileusis data available, no significant correlation was found between pre-laser in situ keratomileusis spherical equivalent and post-cataract surgery spherical equivalent (r = 0.237, p = 0.114). A postoperative spherical equivalent within ±0.50 D was found in 65.2% and 55.6% of eyes in the subgroups with and without pre-laser in situ keratomileusis data available, respectively (p = 0.480). Statistically significantly higher differences between the intraocular lens power implanted and the calculation provided by the Potvin-Hill (p = 0.028) and Barrett True K No History formulas (p = 0.022) were found in those eyes with postoperative spherical equivalent > 0.50 D.

CONCLUSION

The extended range of vision intraocular lens evaluated can provide a predictable refractive correction in eyes with previous laser in situ keratomileusis surgery. The Potvin-Hill and Barrett True K No History are the most adequate formulas to perform intraocular lens power calculations in these cases.

摘要

目的

评估在接受过准分子激光原位角膜磨镶术(LASIK)的眼中,使用扩展视程人工晶状体所获得的屈光预测性,确定哪种人工晶状体屈光力计算公式能提供最准确的计算结果。

方法

本研究纳入了43例接受白内障手术并植入扩展视程人工晶状体TECNIS Symfony(强生视力健公司)的患者,这些患者之前均成功接受过准分子激光原位角膜磨镶术。使用美国白内障与屈光手术医师学会的所有公式计算人工晶状体屈光力,并选择其平均值用于植入。术后3个月评估屈光结果。

结果

分别有61.6%和86.3%的术眼术后等效球镜度在±0.50D和±1.00D范围内。在有准分子激光原位角膜磨镶术前数据的术眼中,准分子激光原位角膜磨镶术前等效球镜度与白内障术后等效球镜度之间未发现显著相关性(r = 0.237,p = 0.114)。在有和没有准分子激光原位角膜磨镶术前数据的亚组中,分别有65.2%和55.6%的术眼术后等效球镜度在±0.50D范围内(p = 0.480)。在术后等效球镜度>0.50D的术眼中,发现植入的人工晶状体屈光力与Potvin-Hill公式(p = 0.028)和Barrett True K No History公式(p = 0.022)计算结果之间的差异具有统计学意义。

结论

所评估的扩展视程人工晶状体可为接受过准分子激光原位角膜磨镶术的术眼提供可预测的屈光矫正。在这些病例中,Potvin-Hill公式和Barrett True K No History公式是进行人工晶状体屈光力计算的最合适公式。

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