Toric人工晶状体植入术前角膜曲率测量及计算公式的优选  

Optimization measurements and formulas of keratometry before Toric intraocular lens implantation

作　　者：陈紫亮 饶惠英[1,2] Chen Ziliang;Rao Huiying(Department of Opthalmology,Clinical Medical College of Fujian Medical University,Fuzhou 350001,China;Department of Opthalmology,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院眼科,福州350001 [2]福建省立医院眼科,福州350001

出　　处：《国际眼科纵览》2022年第5期437-442,共6页International Review of Ophthalmology

基　　金：福建省自然科学基金(2019J01507)。

摘　　要：Toric人工晶状体(intraocular lens,IOL)植入术因其高度安全性及可预测性已成为白内障术中矫正散光的首选方式。角膜散光包括角膜前表面散光(ACA)和角膜后表面散光(PCA)。既往多根据ACA估测角膜散光,会导致一些顺规散光眼的过矫及逆规散光眼的欠矫。PCA对总角膜散光(TCA)的影响不可忽视。IOL Master、Lenstar 900在角膜曲率测量方面有高度预测性与可重复性。可直接测量全角膜曲率的设备理论上更准确。模拟角膜曲率(SimK)散光与TCA一致性良好的情况下,可直接使用Barrett Toric公式搭配IOL Master或Lenstar的SimK;两者一致性差的情况下的选择仍有争议。若PCA≥0.8 D,推荐使用实测的PCA。目前,眼科医生应根据不同设备的测量结果,结合患者自身情况,做到个性化选择及搭配,尽最大可能减少患者术后的残余散光。Toric intraocular lens(IOL)implantation has become the preferred method for astigmatism correction due to its high safety and predictability.Corneal astigmatism includes anterior corneal astigmatism(ACA)and posterior corneal astigmatism(PCA).In the past,corneal astigmatism was evaluated solely base on ACA measurement,which will induce an overcorrection in the with-the-rule corneal astigmatism eyes and an undercorrection in the against-the-rule astigmatism eyes.Therefore the important contribution of the PCA to total corneal astigmatism(TCA)should not be neglected.IOL Master and Lenstar 900 show high predictive and repeatability for keralometry measurement.Some devices which can measure the total keratometry directly is theoretically more accurate than the simulated keratometry.It is suggested that the SimK measured by IOL Master or Lenstar,matched with Barrett Toric formula directly if SimK is consistent well with TCA.The choice in case of poor consistency between SimK and TCA remains controversial.When PCA≥0.8 D,the measured PCA is recommended.At present,ophthalmologists should make individual selection according to the measurement of diverse devices and patients'conditions to minimize the residual astigmatism.

关 键 词：散光矫正型人工晶状体 角膜散光 Toric计算器 

分 类 号：R779.6[医药卫生—眼科]