Pan Chao, Tan Weina, Hua Yanjun, Lei Xiaohua
Hankou Aier Eye Hospital, 34 Machang Road, Jianghan District, Wuhan, Hubei Province, China.
Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.
Int Ophthalmol. 2019 Dec;39(12):2815-2824. doi: 10.1007/s10792-019-01128-2. Epub 2019 May 27.
To assess corneal power measurements obtained by the OPD SCAN III Topographer in eyes with prior myopic small incision lenticule extraction (SMILE) surgery.
Sixty untreated myopic eyes of sixty subjects and forty previous myopic SMILE surgery eyes of forty subjects were consecutively enrolled in the present study. Manifest refraction, OPD SCAN III and Pentacam HR were performed. Keratometric measurements assessed by OPD SCAN III-simulated keratometry, average pupil power and effective central corneal power (ECCP) were compared with mean keratometry (Km) obtained by Pentacam HR in the untreated group and the clinical history method (CHM) in the treated group.
In the untreated group, no statistically significant differences were revealed between all corneal power measurements obtained with OPD SCAN III and Km. In the treated group, all the corneal power measurements were statistically different from the CHM except for the Haigis method and the Shammas method, while ECCP had a statistically but not clinically significant overestimation of 0.42 D with 95% limit of agreement (LOA) of - 0.81 D to 1.64 D. The three modified ECCP had better prediction performance with narrower 95% of LOA lying in (- 1.20, 1.20 D) (- 1.22, 1.23 D) and (- 0.90, 1.00 D), respectively.
The ECCP provided with OPD SCAN III could be used as an alternative option for the CHM after specific modifications in eyes with previous myopic SMILE surgery when the preoperative data are unavailable considering the narrowest agreement between the modified ECCP and the CHM. Otherwise, caution must be raised considering the wide LOA.
评估使用OPD SCAN III角膜地形图仪对接受过近视性小切口透镜切除术（SMILE）的眼睛进行角膜屈光力测量的结果。
本研究连续纳入了60名受试者的60只未治疗的近视眼睛和40名受试者的40只既往接受过近视SMILE手术的眼睛。进行了综合验光、OPD SCAN III和Pentacam HR检查。将通过OPD SCAN III模拟角膜曲率测量、平均瞳孔屈光力和有效中央角膜屈光力（ECCP）评估的角膜曲率测量结果与未治疗组中Pentacam HR获得的平均角膜曲率（Km）以及治疗组中的临床病史法（CHM）进行比较。
在未治疗组中，OPD SCAN III获得的所有角膜屈光力测量结果与Km之间均未显示出统计学上的显著差异。在治疗组中，除Haigis法和Shammas法外，所有角膜屈光力测量结果与CHM均存在统计学差异，而ECCP在统计学上有0.42 D的高估，但临床上无显著意义，95%一致性界限（LOA）为-0.81 D至1.64 D。三种改良的ECCP具有更好的预测性能，95% LOA范围更窄，分别为（-1.20, 1.20 D）、（-1.22, 1.23 D）和（-0.90, 1.00 D）。
考虑到改良后的ECCP与CHM之间的一致性最窄，当术前数据不可用时，OPD SCAN III提供的ECCP经过特定修改后可作为既往接受过近视SMILE手术的眼睛中CHM的替代选择。否则，鉴于较宽的LOA，必须谨慎使用。
