LASIK术后白内障手术植入的人工晶状体屈光度的预测  

Research on the forecast of intraocular lens power in cataract surgery after laser in situ keratomileusis(LASIK)

作　　者：余旸[1] 吕勇[1] 

机构地区：[1]郑州大学第一附属医院眼科,河南郑州450052

出　　处：《眼外伤职业眼病杂志》2010年第7期496-500,共5页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的探讨LASIK术后,不同公式及不同的测算方法预测所需人工晶状体(IOL)屈光度的准确性。方法对27例近视(52眼)于LASIK手术前、后分别应用SRKⅡ公式、SRK/T公式、Holladay公式和Haigis公式计算将术眼矫正至正视眼所需的IOL屈光度,并应用F值计算与术眼原晶状体屈光力等值的IOL屈光度。并且术后应用OrbscanⅡ角膜地形图、IOLMaster测量获得的K值和临床病史法计算出的K值分别代入上述4种公式计算IOL屈光度。应用SPSS统计软件对数据进行统计学分析。结果低度近视者4种公式计算结果手术前、后比较,差异均无统计学意义(P>0.05);中、高度近视者4种公式计算结果LASIK术后均小于术前,差异有统计学意义(P<0.01),其中Haigis公式差值最小。中、低度近视者,LASIK术后OrbscanⅡ角膜地形图测量所得的K值与临床病史法获得的K值分别代入不同公式计算出的IOL屈光度比较,差异均无统计学意义(P>0.05);高度近视者,这两种方法获得的K值分别代入SRKII、SRK/T、Haigis公式计算出的IOL屈光度比较,差异均有统计学意义(P<0.05),临床病史法相对较准确。结论对于中高度近视,LASIK手术后应用现有的IOL屈光度计算公式,其结果均偏小,但Haigis公式优于其他公式。对于高度近视最好选择临床病史法获得角膜K值。Objective To study the accuracy of different formulas and different methords of the corneal power estimation forecasting intraoeular lens（IOL） power after LASIK. Methods Fifty-two eyes（27 cases） underwent LASIK surgery. Before and after the surgery, the IOL powers were calculated to correct the myopia to emmetropia by experiential SRKII formula, theoretical SRK/T formula, Haigis formula and Holladay formula respectively. Then we calculated the IOL power equal to original lens power by F value .In addition, calculating the IOL powers after LASIK using keratometric value（ K value） measured by Orbscan Ⅱ corneal topography, IOL Master facility and the clinical history method respectively, then analyzed the results before and after LASIK by SPSS staffstical software.. Results 1. In low myopia the IOL powers were not Obviously different by above-mentioned different formulas between pre-operative and post-operative（P 〉0. 05） ; In middle and high myopia there were completely obvious differences（ P 〈 0.01 ） , the post-operative results were less than the pre-operative ones, and the difference value by Haigis formula is the least of all. 2. In low and middle myopic patients, the IOL powers were not obviously different（P 〉 0.05 ） after LASIK by different formulas using K value obtaining from Orbscan Ⅱ corneal topography and the clinical histo-ry method separately;In high myopic patients there were obvious differences（ P 〈 0.05 ） by Haigis formula, SRK/T formula and SRK Ⅱ formula with these two methods measuring K value, and the clinical history method was relatively accurate. Conclusion The IOL powers calculated by current different formulas are smaller in middle and high myopia after LASIK than those beforethe operation, but Haigis formula is more accurate than other formulas. In high myopia K value estimated by the clinical history method is the bestchoice.

关 键 词：晶状体 人工 屈光度 屈光性角膜手术 

分 类 号：R779.6[医药卫生—眼科] R776.1[医药卫生—临床医学]