OrbscanⅡ预测准分子激光原位角膜磨镶术后人工晶状体度数的准确性  

Orbscan Ⅱ-assisted intraocular lens power calculation after LASIK

作　　者：蔡剑秋[1] 张加裕[1] 陈如[1] 杨顺海[1] 查屹[1] 施明光[1] 

机构地区：[1]温州医学院附属第二医院眼科,325027

出　　处：《中华医学杂志》2011年第1期33-36,共4页National Medical Journal of China

基　　金：温州市对外科技合作项目（H20080030）,浙江省自然科学基金（Y1100099）

摘　　要：目的 分析应用Orbscan Ⅱ角膜地形图中央某一区域角膜屈光力,结合Holladay IOL Consultant软件预测准分子激光原位角膜磨镶术（LASIK）后丢失术前资料者人工晶状体（IOL）度数准确性.方法 （1）比较118只LASIK术后眼Orbscan Ⅱ中央4个区域（1.5、2.0、2.5、3.0 mm）角膜屈光力与术后实际角膜屈光力的大小.（2）另选62只LASIK术后眼,取与临床病史法最接近区域角膜屈光力代入Holladay IOL Consultant软件（Holladay Ⅱ、SRK/T、HofferQ 公式）计算IOL度数,然后同临床病史法计算得IOL度数进行比较.结果 （1）LASIK术后Orbscan Ⅱ中央1.5 mm区角膜屈光力小于术后实际角膜屈光力,3.0 mm 区角膜屈光力大于术后实际角膜屈光力,其中2.0及2.5 mm区角膜屈光力与之最为接近,适合用于计算术后IOL度数.（2）采用2.5 mm区角膜屈光力结合Holladay Ⅱ和HofferQ公式计算IOL度数与临床病史法计算IOL度数差值分别为（0.47±0.75）D和（0.52±0.83）D,与临床病史法计算IOL度数差值在±0.5 D之内眼数分别占48.4%和43.5%,差值在±1.0D之内眼数分别占80.6%和74.2%.结论 LASIK术后Orbscan Ⅱ中央2.5 mm区角膜屈光力结合Holladay IOLConsultant软件中的Holladay Ⅱ和HofferQ公式可准确预测丢失术前资料者IOL度数.Objective To evaluate the accuracy of keratometric value derived from one zone of Orbscan Ⅱ mean power map after Laser in situ keratomileusis （LASIK） in combination with Holladay IOL Consultant software to calculate the intraocular lens （IOL） power. Methods A two-part study was conducted at a referral practice. Part 1 was a prospective study of 118 eyes undergoing LASIK. The changes in Orbscan Ⅱ mean power maps at four central zones （ 1.5, 2. 0, 2. 5 and 3.0 mm） were compared with the cornea power calculated from pre-LASIK data to determine the optimum Orbscan Ⅱ correlation zone. In Part 2, the power of optimum measured by Orbscan Ⅱ after LASIK was applied to IOL calculations for 62 eyes undergoing LASIK. And the results were compared with the IOL power calculated by the pre-LASIK data.Results （ 1 ） An analysis at the Orbscan Ⅱ 1.5 mm measurement zone demonstrated an underestimation of net cornea power after LASIK while the 3.0 mm zones demonstrated an overestimation. The 2.0 mm and 2.5mm zones best approximated the net cornea power calculated from pre-LASIK data; （2）The cornea power at 2. 5 mm from Orbscan Ⅱ was selected for IOL calculations in combination with Holladay IOL Consultant software Holladay Ⅱ and HofferQ formula. The refractive error calculated by Holladay Ⅱ and HofferQ formula were （0. 47 ± 0. 75 ） D and （0. 52 ± 0. 83 ） D versus the IOL power calculated by clinical history method. The refractive errors of two formula within ± 0. 50 D were 48.4% and 43.5% and within ± 1.0 D 80. 6% and 74. 2%. Conclusions The cornea power from 2. 5 mm Orbscan Ⅱ zone after LASIK in combination with Holladay Ⅱ or HofferQ formula can accurately predict the IOL power for cataract surgery.

关 键 词：准分子激光原位角膜磨镶术 人工晶状体 ORBSCAN Ⅱ 

分 类 号：R779.63[医药卫生—眼科]