LASIK术后白内障患者应用不同公式计算的人工晶状体植入后效果分析  

Postoperative effects of phacoemulsification and IOL implantation using different IOL formulas in cataracts after LASIK

作　　者：张景尚[1] 王进达[1] 刘雪[1] 熊瑛[1] 李婧[1] 李晓霞[1] 赵晶[1] 万修华[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心,北京市眼科研究所,眼科学与视觉科学北京市重点实验室,北京市100005

出　　处：《眼科新进展》2016年第5期435-438,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:30471861);北京市科技新星课题项目(编号:H020821380190;Z131102000413025);国务院妇女儿童工作委员会课题项目(编号:2014108)~~

摘　　要：目的评估LASIK术后白内障患者应用SRK-T公式、HOFFER-Q修正公式和Haigis-L修正公式进行白内障超声乳化+人工晶状体(intraocular lens,IOL)植入术后的临床效果。方法收集从2011年1月至2015年2月行白内障超声乳化+IOL植入术且既往有LASIK术史的患者13例(21眼)。根据不同IOL计算公式分为3组,分别为SRK-T公式(6眼)、HOFFERQ修正公式(5眼)和Haigis-L修正公式(10眼)。所有患者在白内障术前术后均进行常规检查,均由同一手术医师进行透明角膜切口超声乳化+IOL植入术。术后随访6个月,使用配对t检验比较手术前后裸眼视力、最佳矫正视力、等效球镜、眼压、角膜内皮细胞密度的变化,对不同公式计算的术后等效球镜和术后等效球镜与目标屈光度之间的差值进行方差分析。结果术后等效球镜和术后等效球镜与目标屈光度之间的差值,在±0.25 D内分别为5眼(23.81%)和1眼(4.76%),在±0.5 D内均为6眼(28.57%),在±1.0 D分别为10眼(47.62%)、11眼(52.38%)。与术前相比,术后6个月时裸眼视力、最佳矫正视力明显提高(均为P<0.001),等效球镜偏差度数显著减小(P<0.001)。应用SRK-T公式、HOFFER-Q修正公式和Haigis-L修正公式后,术后等效球镜误差在±1.0 D内的分别为67%、80%、30%;而术后等效球镜与目标屈光度之间的差值,误差在±1.0 D内的分别为50%、60%、50%。术后等效球镜和术后等效球镜与目标屈光度之间差值采用Haigis-L修正公式和HOFFER-Q修正公式组间差异有统计学意义(P<0.001、P=0.001)、Haigis-L修正公式和SRK-T公式组间差异有统计学意义(P<0.001、P<0.001)。结论 LASIK术后白内障患者在进行白内障超声乳化+IOL植入术后,HOFFER-Q修正公式计算的IOL度数误差相对较小。Objective To evaluate the clinical effects of SRK-T formula,HOFFER-Q m odified form ula and H aigis-L m odified form ula in the operation of phacoem ulsification and intraocular lens（ IOL） im plantation after LASIK. Meth od s From January 2 0 1 1to February 2 0 1 5,1 3 cases（ 2 1 eyes） after LASIK operation treated by phacoem ulsification and IOL im plantation were collected. The 2 1 eyes were divided into 3 groups by the different calculation form ula,SRK-T form ula（ 6 eyes）,H OFFER-Q m odified form ula（ 5 eyes）,and H aigis-L m odified form ula（ 1 0 eyes）. Patients at the pre-operation and post-operation were perform ed routine exam ination,and the operation of phacoem ulsification and IOL im plantation was perform ed by the sam e doctor. The data at 6 m onths after the operation were analyzed. The paired t test was used to analyze the difference of uncorrected visual acuity,corrected visual acuity,intraocular pressure and corneal endothelial cell between the pre-operation and post-operation; The difference of the postoperative spherical equivalent and the error between postoperative equivalent sphere and target＇s refraction was analyzed by the variance for different form ulas. R esu lts After the operation,the spherical equivalent and the error between postoperative equivalent sphere and target＇s refraction respectively were 5 eyes（ 2 3. 8 1 %） and 1 eyes（ 4.7 6 %） within ± 0. 2 5 D,both 6 eyes（ 2 8. 5 7 %） within ± 0. 5 D,and 1 0 eyes（ 4 7.6 2 %） and 1 1 eyes（ 5 2. 3 8 %） with ± 1. 0 D. The results showed that the postoperative uncorrected visual acuity and corrected visual acuity were increased,and postoperative spherical equivalent were im proved significantly（ all P〈 0. 0 0 1）. The error of postoperative spherical equivalent using SRK-T form ula,H OFFER-Q m odified form ula and H aigis-L m odified form ula respectively were 6 7 %,8 0 %,3 0 % within ± 1. 0 D;The error between postoperative spherical equivalent and target＇s refraction using SRK-T form ul

关 键 词：白内障 LASIK 人工晶状体计算公式 

分 类 号：R779.6[医药卫生—眼科]