近视眼LASIK术后人工晶状体屈光度测算中矫正角膜曲率的回归公式建立及其效能检验  

Efficacy of A New Regression Formula for Correcting Corneal Power in Intraocular Lens Power Calculation after Myopic LASIK Surgery

作　　者：于华军[1,2] 吴欣怡[1] 蔄雪静[2] 

机构地区：[1]山东大学齐鲁医院眼科,山东济南250012 [2]烟台毓璜顶医院眼科,山东烟台264000

出　　处：《中山大学学报（医学科学版）》2012年第2期265-269,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：山东省科技厅自然科学基金(2007GG20002031)

摘　　要：【目的】探讨近视眼LASIK术后测算人工晶状体屈光度时不需要其术前资料的方法。【方法】本研究分为两部分,研究的第一部分是通过对97例(193眼)接受近视眼LASIK手术的病人,记录其术前及术后3个月的等效球镜以及由IOLMaster测量的平均角膜曲率(Km),并应用临床病史法计算出术后3个月时的实际角膜曲率(Kchm),建立Kchm对术后平均角膜曲率(Km-post)的回归公式。研究的第二部分是选取另外67例(132眼)拟接受近视眼LASIK手术的病人,在LASIK术前及术后3个月后将等效球镜设定为目标屈光度,应用在研究第一部分中建立的回归公式来矫正LASIK术后角膜曲率,应用IOLmaster自带的不同人工晶状体屈光度计算公式计算并进行分析比较。【结果】在研究的第一部分中,建立Kchm对Km-post的的回归模型为:Kchm=1.033×Km-post-2.192,模型决定系数R2=0.916。在研究的第二部分中,分析比较由回归公式矫正的术后角膜曲率输入不同人工晶状体屈光度计算公式的计算结果,对于选定的3种人工晶状体类型,与术前等值人工晶状体屈光度差值在±1.0D内者,应用Holladay I和SRK-T公式的准确性优于Haigis、Hoffer-Q公式。【结论】建立了不需要术前数据的矫正近视眼LASIK术后角膜曲率的回归公式,将对该类病人因白内障需要行人工晶状体植入而又缺失LASIK术前数据时有实用价值。【Objective】 To investigate a method of calculating intraocular lens power that may be independent of prerefractive surgery data in eyes that have previously undergone myopic laser in situ keratomileusis（LASIK）.【Methods】 In 193 eyes of 97 myopic patients,before and 3 months after LASIK,the spherical equivalent（SE） and mean corneal power（Km） measured by IOLMaster were recorded in the first part of this study.On the basis of above data,the regression model was established between the actual postoperative corneal power calculated by clinical history method（Kchm） and postoperative mean corneal power（Km-post） directly measured by the IOLMaster.In the second part of this study,before and 3 months after LASIK,intraocular lens power calculation with the SE as the target refraction by the IOLMaster was done in another set of 67 myopic patients（132 eyes）.The postoperative corneal power corrected by the regression formula obtained from the first part of this study was used for intraocular lens power calculation after LASIK surgery.【Results】 The regression model（Kchm = 1.033×Km-post-2.192） was established and the model R2 was 0.916 in the first part of this study.In the second part of this study,intraocular lens power calculation with Holladay I or SRK-T formula by using corrected postoperative corneal power was more accurate than that with Haigis or Hoffer-Q formula within ± 1.0D refraction difference versus preoperative equivalent intraocular lens power by comparing above four formula for three selected intraocular lens types.【Conclusion】 This study presents a new useful regression formula for correcting postoperative corneal power independent of preoperative data in intraocular lens power calculation for myopic post-LASIK patients that requiring cataract surgery but without pre-LASIK data.

关 键 词：回归公式 矫正术后角膜曲率 人工晶状体屈光度测算 近视眼 LASIK 

分 类 号：R779.63[医药卫生—眼科]