中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2010年
6期
518-524
,共7页
陈旭%季樱红%蒋永祥%罗怡%姜春晖%卢奕
陳旭%季櫻紅%蔣永祥%囉怡%薑春暉%盧奕
진욱%계앵홍%장영상%라이%강춘휘%로혁
屈光外科手术%白内障%晶体%人工%算法
屈光外科手術%白內障%晶體%人工%算法
굴광외과수술%백내장%정체%인공%산법
Refractive surgical procedures%Cataract%Lenses,intraocular%Algorithms
目的 对准分子激光角膜屈光手术后的白内障患者,分析其超声乳化白内障吸除联合人工晶状体(IOL)植入术后的屈光状态以及各种IOL度数计算方法的准确性.方法 回顾性系列病例研究.17例(24只眼)患者根据是否提供准分子激光术前(包括准分子激光角膜切削术和准分子激光角膜原位磨镶术)角膜屈光度数资料分为两组(有历史资料组和无历史资料组).所有患者在白内障术前接受自动角膜曲率计、角膜地形图、Pentacam、IOL Master综合检查,分别采用临床病史法、Feiz-Mannis公式法、Feiz-Mannis法等多种公式进行IOL度数计算.白内障术后3个月时进行客观验光.采用非配对t检验,Pearson相关分析及线性回归分析,配对t检验以及Bland-Ahman一致性检验对数据进行分析.结果 有历史资料组患者准分子激光术前的平均屈光度数与平均等效球镜分别为(43.28±1.21)D与(-15.33±4.36)D;无历史资料组的平均等效球镜为(-10.11±3.12)D.白内障术前两组平均角膜屈光度数为(36.96 ± 2.07)D与(36.85±1.40)D.白内障术后两组平均屈光误差分别为(-0.66±1.27)D与(-0.47 ± 0.82)D.Hamed Wang Koch法、Masket法、Koch/Maloney法、Shammar法与Pentacam ERK法计算值低于平均真实值,易造成术后欠矫;Feiz-Mannis公式法、Latkany法、Savini法与Armberri Double K的计算值高于真实值.临床病史法,角膜忽略法和Haigis-L法的计算值与真实值之间差异无统计学意义(P=0.364,0.318,0.069;t=0.956,-1.057,-1.911).Feiz-Mannis法和Haigis-L法计算结果与真实值之间具有一定相关性(r=0.921,0.915;P=0.000,0.000).但无一种方法计算结果与真实值具有一致性.结论 为避免术后发生屈光欠矫,需要通过综合方法计算IOL度数,应联合临床病史法、Feiz-Mannis法、角膜忽略法、Haigis-L法进行IOL度数计算.
目的 對準分子激光角膜屈光手術後的白內障患者,分析其超聲乳化白內障吸除聯閤人工晶狀體(IOL)植入術後的屈光狀態以及各種IOL度數計算方法的準確性.方法 迴顧性繫列病例研究.17例(24隻眼)患者根據是否提供準分子激光術前(包括準分子激光角膜切削術和準分子激光角膜原位磨鑲術)角膜屈光度數資料分為兩組(有歷史資料組和無歷史資料組).所有患者在白內障術前接受自動角膜麯率計、角膜地形圖、Pentacam、IOL Master綜閤檢查,分彆採用臨床病史法、Feiz-Mannis公式法、Feiz-Mannis法等多種公式進行IOL度數計算.白內障術後3箇月時進行客觀驗光.採用非配對t檢驗,Pearson相關分析及線性迴歸分析,配對t檢驗以及Bland-Ahman一緻性檢驗對數據進行分析.結果 有歷史資料組患者準分子激光術前的平均屈光度數與平均等效毬鏡分彆為(43.28±1.21)D與(-15.33±4.36)D;無歷史資料組的平均等效毬鏡為(-10.11±3.12)D.白內障術前兩組平均角膜屈光度數為(36.96 ± 2.07)D與(36.85±1.40)D.白內障術後兩組平均屈光誤差分彆為(-0.66±1.27)D與(-0.47 ± 0.82)D.Hamed Wang Koch法、Masket法、Koch/Maloney法、Shammar法與Pentacam ERK法計算值低于平均真實值,易造成術後欠矯;Feiz-Mannis公式法、Latkany法、Savini法與Armberri Double K的計算值高于真實值.臨床病史法,角膜忽略法和Haigis-L法的計算值與真實值之間差異無統計學意義(P=0.364,0.318,0.069;t=0.956,-1.057,-1.911).Feiz-Mannis法和Haigis-L法計算結果與真實值之間具有一定相關性(r=0.921,0.915;P=0.000,0.000).但無一種方法計算結果與真實值具有一緻性.結論 為避免術後髮生屈光欠矯,需要通過綜閤方法計算IOL度數,應聯閤臨床病史法、Feiz-Mannis法、角膜忽略法、Haigis-L法進行IOL度數計算.
목적 대준분자격광각막굴광수술후적백내장환자,분석기초성유화백내장흡제연합인공정상체(IOL)식입술후적굴광상태이급각충IOL도수계산방법적준학성.방법 회고성계렬병례연구.17례(24지안)환자근거시부제공준분자격광술전(포괄준분자격광각막절삭술화준분자격광각막원위마양술)각막굴광도수자료분위량조(유역사자료조화무역사자료조).소유환자재백내장술전접수자동각막곡솔계、각막지형도、Pentacam、IOL Master종합검사,분별채용림상병사법、Feiz-Mannis공식법、Feiz-Mannis법등다충공식진행IOL도수계산.백내장술후3개월시진행객관험광.채용비배대t검험,Pearson상관분석급선성회귀분석,배대t검험이급Bland-Ahman일치성검험대수거진행분석.결과 유역사자료조환자준분자격광술전적평균굴광도수여평균등효구경분별위(43.28±1.21)D여(-15.33±4.36)D;무역사자료조적평균등효구경위(-10.11±3.12)D.백내장술전량조평균각막굴광도수위(36.96 ± 2.07)D여(36.85±1.40)D.백내장술후량조평균굴광오차분별위(-0.66±1.27)D여(-0.47 ± 0.82)D.Hamed Wang Koch법、Masket법、Koch/Maloney법、Shammar법여Pentacam ERK법계산치저우평균진실치,역조성술후흠교;Feiz-Mannis공식법、Latkany법、Savini법여Armberri Double K적계산치고우진실치.림상병사법,각막홀략법화Haigis-L법적계산치여진실치지간차이무통계학의의(P=0.364,0.318,0.069;t=0.956,-1.057,-1.911).Feiz-Mannis법화Haigis-L법계산결과여진실치지간구유일정상관성(r=0.921,0.915;P=0.000,0.000).단무일충방법계산결과여진실치구유일치성.결론 위피면술후발생굴광흠교,수요통과종합방법계산IOL도수,응연합림상병사법、Feiz-Mannis법、각막홀략법、Haigis-L법진행IOL도수계산.
Objective To evaluate the results of cataract surgery in myopia patients after laser in situ keratomileusis(LASIK)and to compare the predictability of various methods of intraccular lens(IOL)power calculation.Method Seventeen cases (24 eyes)who had LASIK for myopia were divided into two group by with or without history of corneal power data.Corneal power was obtained by autokeratometry,corneal topography.Pentacam and IOLMaster.The IOL power was calculated with the clinical history method,Feiz-Mannis formula,Feiz-Mannis method and other methods.Postoperative final refraction and the deviation of the final spherical equivalent (SEQ) from the refractive target were measured 3 month after the surgery.Two sample t-test.linear correlation and regression analysis,paired t-test and Bland-Altman method of agreement were used to analyze these data.Results In the group with history data,the mean corneal power was(43.28±1.21)D and the mean SEQ was(-15.33±4.36)D before the LASIK surgery.In the group without history data,the mean SEQ was(-10.11±3.12)D.Before cataract surgery,the mean corneal power was(36.96±2.07)D and(36.85±1.40)D in these two groups.The mean arithmetic refractive prediction error after cataract surgery was(-0.66±1.27)D and(-0.47 ± 0.82)D in these two groups, respectively. Data calculated by using Hamed-Wang-Koch method, Masket Formula, Koch/Maloney method, Shammar method and Pentacam ERK method were lower than the emmetropic IOL power. Data calculated by using Feiz-Mannis Formula, Latkany Method, Savini method, Armberri Double K method were overestimated. The mean arithmetic errors of clinic history method, Corneal Passby Method and Haigis-L Formula were not significantly different from the predict refraction (P=0. 364, 0. 318 and 0. 069;t=0. 956,-1. 057 and -1. 911, respectively). There was strong correlation between the value calculated by using Feiz-Mannis Method or Haigis-L Formula and the true power (r = 0. 921,0. 915; P = 0. 000 and 0. 000,respectively). But none of the values calculated by these method could fully agree with the true value.Conclusions IOL power should be calculated accurately to avoid undercorrection. We recommend the combination of clinical history method, Feiz-Mannis Method, Corneal Passby Method and Haigis-L Formula for the calculation of IOL power.
