Anders Philipp, Anders Lisa-Marie, Barbara Adel, Szentmary Nora, Langenbucher Achim, Gatzioufas Zisis
Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland.
Department of Ophthalmology, University of Basel, Basel, Switzerland.
Ther Adv Ophthalmol. 2022 Aug 30;14:25158414221118524. doi: 10.1177/25158414221118524. eCollection 2022 Jan-Dec.
Intraocular lens (IOL) power calculation after corneal refractive surgery (CRS) becomes an expanding challenge for ophthalmologists as more and more cataract surgeries after CRS are required. These patients typically also have high expectations as to visual performance. Conventional IOL power calculation schemes frequently provide inaccurate results in these cases. This review aims to summarize and recommend currently available IOL power calculation methods for eyes with the most common CRS methods: radial keratotomy (RK), photorefractive keratectomy (PRK), laser keratomileusis (LASIK), and small incision lenticule extraction (SMILE). To this end, biometry measuring methods and IOL formulas will be explained and combinations of both are proposed. In synopsis, it is evident that the latest generation of vergence formulas exhibit favorable IOL power prediction accuracy in post-CRS eyes, even though the predictive precision of methods in eyes without CRS is not attained. Ray tracing computation, intraoperative aberrometry, and machine learning-based formulas hold potential to further improve refractive outcomes in post-CRS eyes.
随着越来越多的白内障手术在角膜屈光手术后进行，角膜屈光手术（CRS）后的人工晶状体（IOL）屈光度计算对眼科医生来说成为一项日益艰巨的挑战。这些患者通常对视觉效果也有很高期望。在这些情况下，传统的IOL屈光度计算方案常常得出不准确的结果。本综述旨在总结并推荐目前适用于采用最常见CRS方法的眼睛的IOL屈光度计算方法，这些方法包括：放射状角膜切开术（RK）、准分子激光角膜切削术（PRK）、准分子原位角膜磨镶术（LASIK）和小切口基质透镜切除术（SMILE）。为此，将解释生物测量方法和IOL公式，并提出两者的组合。总的来说，很明显，尽管在无CRS的眼睛中这些方法的预测精度尚未达到，但最新一代的屈光公式在CRS后的眼睛中显示出良好的IOL屈光度预测准确性。光线追踪计算、术中像差测量和基于机器学习的公式有潜力进一步改善CRS后眼睛的屈光结果。
