van den Berg Roberta M, DeVaro Sarah, Rocha Karolinne Maia, Fetrin de Barros Marcela, Klyce Stephen D
Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USA.
Department of Ophthalmology, Federal University of São Paulo (UNIFESP), São Paulo 04023-062, Brazil.
Vision (Basel). 2025 May 29;9(2):46. doi: 10.3390/vision9020046.
The purpose of this study is to evaluate the potential impact of small aperture optics on corneal aberrations in post-RK patients. Preoperative data was evaluated from 32 eyes of 23 post-RK patients. Scheimpflug tomography was used to obtain measurements of corneal HOAs at 6-mm, 4-mm, and 2-mm corneal plane aperture diameters. The data was extrapolated using a non-linear fit to estimate HOAs that would be obtained with the 1.6 mm effective pinhole IOL aperture at the corneal plane for individual patients. The average RMS HOAs estimated for the 1.6 mm aperture was 0.063 ± 0.015 μm compared to 0.185 ± 0.029 μm for the natural pupil size. A postoperative RK case with an IC-8 Apthera™ unilateral implantation demonstrated a 70% reduction in HOAs by objective measurement and prediction, plus a 2-line improvement in CDVA. Prediction modeling revealed that HOAs may be reduced in post-RK patients following pinhole IOL implantation, compared to the natural photopic pupil size. Furthermore, the approach can be used to guide which post-RK patients would benefit from a small aperture IOL during cataract surgery.
本研究的目的是评估小孔径光学器件对RK术后患者角膜像差的潜在影响。对23例RK术后患者的32只眼的术前数据进行了评估。使用Scheimpflug断层扫描技术在角膜平面孔径直径为6mm、4mm和2mm时获取角膜高阶像差（HOAs）的测量值。利用非线性拟合对数据进行外推，以估计个体患者在角膜平面使用1.6mm有效针孔人工晶状体孔径时可获得的HOAs。估计1.6mm孔径的平均均方根高阶像差为0.063±0.015μm，而自然瞳孔大小为0.185±0.029μm。一例术后RK患者进行IC-8 Apthera™单侧植入，客观测量和预测显示高阶像差降低了70%，最佳矫正视力（CDVA）提高了2行。预测模型显示，与自然明视瞳孔大小相比，RK术后患者植入针孔人工晶状体后高阶像差可能会降低。此外，该方法可用于指导哪些RK术后患者在白内障手术中会从小孔径人工晶状体中获益。
