Crawford G J, Stulting R D, Waring G O, Van Meter W S, Wilson L A
Ophthalmology. 1986 Jun;93(6):817-24. doi: 10.1016/s0161-6420(86)33673-x.
Presented are the results of 66 consecutive, elective, combined procedures of penetrating keratoplasty, extracapsular cataract extraction, and intraocular lens insertion (triple procedure) performed by three surgeons between January 1981 and January 1984. After a mean postoperative followup of 15.8 months, over 90% of the eyes had clear grafts, and of the 56 eyes with good preoperative visual potential, 77% achieved a best corrected visual acuity of 20/40 or better. The postoperative mean refractive deviation from emmetropia was 2.17 diopters, with a range of +6.62 D to -5.50 D, 62% falling between -2.00 and +2.00 diopters. Using multiple regression analysis of preoperative and postoperative variables, an attempt was made to derive a predictive formula for the power of the intraocular lens to be implanted during the triple procedure. In contrast to cataract surgery, where axial length and corneal power remain fairly constant preoperatively and postoperatively, penetrating keratoplasty produces marked changes in corneal curvature and power. Therefore, a single formula could not be derived to predict accurately the intraocular lens power for the patients. However, using the results for an individual surgeon, a formula was derived that could improve the predictability of intraocular lens power.
本文呈现了1981年1月至1984年1月期间，三位外科医生连续进行的66例穿透性角膜移植术、囊外白内障摘除术和人工晶状体植入术（三联手术）的择期联合手术结果。术后平均随访15.8个月，超过90%的术眼植片清晰，在56例术前视力潜力良好的眼中，77%的患者最佳矫正视力达到20/40或更好。术后平均屈光不正偏离正视眼为2.17屈光度，范围为+6.62 D至-5.50 D，62%的患者在-2.00至+2.00屈光度之间。通过对术前和术后变量进行多元回归分析，试图推导出三联手术中植入人工晶状体屈光度的预测公式。与白内障手术不同，白内障手术中眼轴长度和角膜屈光度在术前和术后保持相当稳定，而穿透性角膜移植术会导致角膜曲率和屈光度发生显著变化。因此，无法推导出一个单一公式来准确预测患者的人工晶状体屈光度。然而，利用个别外科医生的结果，推导出了一个可以提高人工晶状体屈光度预测性的公式。
