Lukewich Mark K, Murtaza Fahmeeda, Somani Sohel, Tam Eric S, Chiu Hannah H
Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
William Osler Health System, Brampton, Ontario, Canada.
Clin Ophthalmol. 2022 Jun 1;16:1739-1751. doi: 10.2147/OPTH.S351011. eCollection 2022.
To compare residual astigmatism prediction errors across Barrett toric calculations using predicted posterior corneal astigmatism (PCA) and PCA measured using the IOL Master 700 with total keratometry (IOLM).
A retrospective cohort study was undertaken on patients with corneal astigmatism and no other ocular comorbidities that underwent uneventful refractive femtosecond laser-assisted cataract surgery with toric IOL implantation between May 2019 and November 2019. Toric calculations were performed using the Barrett toric calculator and the following values: predicted PCA with anterior corneal measurements from Pentacam, IOLM standard keratometry (SK), OPD scan, and median measurements from these devices; predicted PCA with IOLM total keratometry (TK); and measured PCA with IOLM SK or IOLM TK. Residual astigmatism prediction error was calculated for each device and method of calculation at postoperative month 1 and 3 using the astigmatism double angle plot tool.
A total of 24 eyes, 10 with-the-rule (WTR), 10 against-the-rule (ATR) and 4 oblique astigmatism, from 24 patients were included in this study. PCA ranged from 0.00 to 0.67 D with a mean of 0.24 ± 0.15 D in all eyes. PCA was significantly greater in WTR eyes (0.32 D) compared to ATR eyes (0.16 D; p < 0.05). In ATR eyes, calculations made using IOLM SK and measured PCA had significantly lower total corneal astigmatism and toric IOL cylinder power compared to calculations made using Pentacam and IOLM TK (p < 0.05). No significant difference in mean absolute or centroid residual astigmatism prediction error was observed across devices or calculation methods. The percentage of eyes with absolute astigmatism prediction errors ≤0.5 D was not significantly different across groups.
Barrett toric calculations using predicted PCA and PCA measured using IOLM produced comparable residual astigmatism prediction errors. The incorporation of median measurements did not significantly impact calculation accuracy.
比较使用预测性角膜后表面散光（PCA）的巴雷特散光计算法与使用IOL Master 700测量的PCA结合总角膜曲率计测量值（IOLM）在巴雷特散光计算中的残余散光预测误差。
对2019年5月至2019年11月期间接受了平稳的屈光性飞秒激光辅助白内障手术并植入散光人工晶状体的角膜散光且无其他眼部合并症的患者进行了一项回顾性队列研究。使用巴雷特散光计算器并采用以下值进行散光计算：根据Pentacam的前角膜测量值、IOLM标准角膜曲率测量值（SK）、OPD扫描以及这些设备的中位数测量值得出的预测性PCA；根据IOLM总角膜曲率测量值（TK）得出的预测性PCA；以及使用IOLM SK或IOLM TK测量的PCA。使用散光双角度图工具在术后第1个月和第3个月计算每种设备和计算方法的残余散光预测误差。
本研究共纳入24例患者的24只眼，其中顺规散光10只眼，逆规散光10只眼，斜轴散光4只眼。所有眼中PCA范围为0.00至0.67 D，平均为0.24±0.15 D。顺规散光眼的PCA（0.32 D）显著高于逆规散光眼（0.16 D；p<0.05）。在逆规散光眼中，与使用Pentacam和IOLM TK进行的计算相比，使用IOLM SK和测量的PCA进行的计算得出的总角膜散光和散光人工晶状体柱镜度数显著更低（p<0.05）。在不同设备或计算方法之间，平均绝对或质心残余散光预测误差未观察到显著差异。绝对散光预测误差≤0.5 D的眼的百分比在各组之间无显著差异。
使用预测性PCA的巴雷特散光计算法与使用IOLM测量的PCA产生了相当的残余散光预测误差。纳入中位数测量值对计算准确性没有显著影响。
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