- 作者：Tsontcho Ianchulev ; Kenneth J. Hoffer ; Sonia H. Yoo ; David F. Chang ; Michael Breen ; Thomas Padrick ; Dan B. Tran
- 刊名：Ophthalmology
- 出版年：January, 2014
- 年：2014
- 卷：121
- 期：1
- 页码：56-60
- 全文大小：193 K
ss="h4">Purpose
To evaluate a new method of intraoperative refractive biometry (IRB) for intraocular lens (IOL) power calculation in eyes undergoing cataract surgery after prior myopic LASIK or photorefractive keratectomy.ss="h4">Design
Retrospective consecutive cases series.
ss="h4">Participants
We included 215 patients undergoing cataract surgery with a history of myopic LASIK or photorefractive keratectomy.
ss="h4">Methods
Patients underwent IRB for IOL power estimation. The Optiwave Refractive Analysis (ORA) System wavefront aberrometer was used to obtain aphakic refractive measurements intraoperatively and then calculate the IOL power with a modified vergence formula obtained before refractive surgery. Comparative effectiveness analysis was done for IRB predictive accuracy of IOL power determination against 3 conventional clinical practice methods: surgeon best preoperative choice (determined by the surgeon using all available clinical data), the Haigis L, and the Shammas IOL formulas.
ss="h4">Main Outcome Measures
Median absolute error of prediction and percentage of eyes within 卤0.50 diopters (D) and 卤1.00 D of refractive prediction error.
ss="h4">Results
In 246 eyes (215 first eyes and 31 second eyes) IRB using ORA achieved the greatest predictive accuracy (P鈥?lt;鈥?.0001), with a median absolute error of 0.35 D and mean absolute error of 0.42 D. Sixty-seven percent of eyes were within 卤0.5 D and 94% were within 卤1.0 D of the IRB's predicted outcome. This was significantly more accurate than the other preoperative methods: Median absolute error was 0.6, 0.53, and 0.51 D for surgeon best choice, Haigis L method, and Shammas method, respectively.
ss="h4">Conclusions
The IOL power estimation in challenging eyes with prior LASIK/photorefractive keratectomy was most accurately predicted by IRB/ORA.