Whang Woong-Joo, Yoo Young-Sik, Joo Choun-Ki
Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital.
Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Medicine (Baltimore). 2018 Dec;97(50):e13306. doi: 10.1097/MD.0000000000013306.
To evaluate surgically induced refractive change (SIRC) by manifest refraction and corneal power changes using an automated keratometer and Scheimpflug rotating camera, and to find the best keratometric measurements reflecting SIRC after hyperopic laser-assisted in situ keratomileusis (LASIK).This retrospective study included 18 eyes of 18 patients undergoing hyperopic LASIK using the Schwind Amaris 750S excimer laser. All measurements were performed preoperatively and 12 months postoperatively. Cycloplegic manifest refractions were performed and keratometric measurements were obtained via an RK-5 automated keratometer and a Pentacam rotating Scheimpflug camera. Sim K, true net power (TNP), and total corneal refractive power (TCRP) at 2.0 to 5.0 mm were analyzed using a Scheimpflug camera.The mean manifest refractive changes in the spherical equivalent (SE) at the corneal plane were 2.32 ± 1.65 D at 12 months postoperatively. The refractive power changes by the automated keratometer and Sim K were significantly less than SIRC (P = .043 and P = .048, respectively). Both TNP and the TCRP in the 5.0 mm zone produced lesser mean differences with SIRC (0.05 D and 0.06 D) and showed closer agreements with SIRC on Bland-Altman plots and higher correlation coefficients with SIRC.Corneal power measured on the anterior corneal surface underestimated SIRC. TCRP at the 5.0 mm zone provided by a Pentacam Scheimpflug camera reflected the SIRC accurately and precisely, and would be applicable for prediction of intraocular power before cataract surgery and follow-up measurement of corneal refractive power.
使用自动角膜曲率计和Scheimpflug旋转相机，通过显验光和角膜屈光力变化来评估手术引起的屈光变化（SIRC），并找出反映远视性准分子激光原位角膜磨镶术（LASIK）后SIRC的最佳角膜曲率测量值。这项回顾性研究纳入了18例接受Schwind Amaris 750S准分子激光远视性LASIK手术的患者的18只眼睛。所有测量均在术前和术后12个月进行。进行了睫状肌麻痹下的显验光，并通过RK-5自动角膜曲率计和Pentacam旋转Scheimpflug相机获得角膜曲率测量值。使用Scheimpflug相机分析了2.0至5.0毫米处的Sim K、真实净屈光力（TNP）和总角膜屈光力（TCRP）。术后12个月，角膜平面球镜等效值（SE）的平均显验光变化为2.32±1.65 D。自动角膜曲率计和Sim K测量的屈光力变化明显小于SIRC（分别为P = 0.043和P = 0.048）。5.0毫米区域的TNP和TCRP与SIRC的平均差异较小（分别为0.05 D和0.06 D），在Bland-Altman图上与SIRC的一致性更高，与SIRC的相关系数也更高。在前角膜表面测量的角膜屈光力低估了SIRC。Pentacam Scheimpflug相机提供的5.0毫米区域的TCRP准确且精确地反映了SIRC，可用于白内障手术前眼内屈光力的预测和角膜屈光力的随访测量。
