Kappa角在屈光手术中研究进展
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摘要
Kappa角在眼科屈光手术中具有重要意义,Kappa角的补偿已成为共识,尤其在远视角膜屈光手术矫正中需慎重处理。Kappa角的人群分布特点受到种族、年龄、性别、眼别、眼屈光状态、眼球生物测量及不同精确度测量仪器的影响,Kappa角也可随着体位或瞳孔大小等因素的变化而变化。目前,合并大Kappa角飞秒激光及白内障超声乳化吸除联合多焦点人工晶状体置入术术后视觉质量分析及处理对策研究较少,需要更多大样本研究加入其中,进一步为临床医生提供依据。
It is great significant for angle Kappa in refractive surgery,and it has been a consensus to adjust angle Kappa,especially in the correction of hyperopia corneal refractive surgery.The population distribution of angle Kappa is influenced by race,age,gender,eye,refractive status,ocular biometry and different precision measuring instruments,and it may also vary with the change of position or pupil size and other factors. At present,fewer researches on visual quality and treatment have been conducted in femtoseeond laser and cataract phacoemulsification combined with multifocal intraocular lens implantation in eyes with large angle Kappa,so more large sample researches are needed to perform in order to provide evidences for clinicians.
It is great significant for angle Kappa in refractive surgery,and it has been a consensus to adjust angle Kappa,especially in the correction of hyperopia corneal refractive surgery.The population distribution of angle Kappa is influenced by race,age,gender,eye,refractive status,ocular biometry and different precision measuring instruments,and it may also vary with the change of position or pupil size and other factors. At present,fewer researches on visual quality and treatment have been conducted in femtoseeond laser and cataract phacoemulsification combined with multifocal intraocular lens implantation in eyes with large angle Kappa,so more large sample researches are needed to perform in order to provide evidences for clinicians.
引文
[1]HU YK,LI WJ,GAO XW,GUO YL,DONG J.Effects of kappa angle on femtosecond laser small incision lenticule extraction for myopia[J].Rec Adv Ophthalmol,2014,34(2):168-171.胡裕坤,李文静,高晓唯,郭云林,董晶.Kappa角对飞秒激光角膜基质透镜切除术治疗近视的影响[J].眼科新进展,2014,34(2):168-171.
[2]LIU Y,YUAN J.Vision quality after personalized implantation of aspheric intraocular lens[J].Recent Advances in Ophthalmology,2016,36(1):35-37.刘昳,袁进.个性化植入非球面人工晶状体术后视觉质量的临床观察[J].眼科新进展,2016,36(1):35-37.
[3]PRAKASH G,PRAKASH DR,AGARWAL A,KUMAR D,AGAR-WAL A,JACOB S.Predictive factor and kappa angle analysis for visual satisfactions in patients with multifocal IOLimplantation[J].Eye(Lond),2011,25(9):1187-1193.
[4]PARK CY,OH SY,CHUCK RS.Measurement of angle kappa and centration in refractive surgery[J].Curr Opin Ophthalmol,2012,23(4):269-275.
[5]GHARAEE H,SHAFIEE M,HOSEINI R,ABRISHAMI M,ABRISH-AMI Y,ABRISHAMI M.Angle kappa measurements:normal values in healthy iranian population obtained with the orbscanⅡ[J].Iran Red Crescent Med J,2015,17(1):e17873.
[6]ZHANG Y,CHU RY.Analysis of kappa angle measurement of myopic eyes in excimer laser refractive surgery[J].Shandong Med J,2011,51(35):36.张泳,褚仁远.准分子激光屈光手术中近视眼Kappa角测量结果分析[J].山东医药,2011,51(35):36.
[7]CHENG D,XU JJ,BAO JH,PAN JD,LV F.Weight analysis of influencing factors of human angle Kappa[J].Chin J Exp Ophthalmol,2014,32(5):425-429.程丹,徐菁菁,保金华,潘建东,吕帆.人眼Kappa角的影响因素权重分析[J].中华实验眼科杂志,2014,32(5):425-429.
[8]SRIVANNABOON S,CHOTIKAVANICH S.Corneal characteristics in myopic patients[J].J Med Assoc Thai,2005,88(9):1222-1227.
[9]BASMAK H,SAHIN A,YILDIRIM N,PAPAKOSTAS TD,KAN-ELLOPOULOS AJ.Measurement of angle kappa with synoptophore and OrbscanⅡin a normal population[J].J Refract Surg,2007,23(5):456-460.
[10]ZAREI-GHANAVATI S,GHARAEE H,ESLAMPOUR A,ABRIS-HAMI M,GHASEMI-MOGHADAM S.Angle kappa changes after photorefractive keratectomy for myopia[J].Int Ophthalmol,2014,34(1):15-18.
[11]DOMNGUEZ-VICENT A,MONSLVEZ-ROMN D,PREZ-VIVES C,FERRER-BLASCO T,MONTS-MICR.Measurement of angle Kappa with OrbscanⅡand Galilei G4:effect of accommodation[J].Grafes Arch Clin Exp Ophthalmol,2014,252(2):249-255.
[12]Yeo JH,Moon NJ,Lee JK.Measurement of angle Kappa using ultrasound biomicroscopy and corneal topography[J].Korean JOphthalmol,2017,31(3):257-262.
[13]HASHEMI H,KHABAZKHOOB M,YAZDANI KA,JAFARZADE-HPUR E,FOTOUHI A.Distribution of angle kappa measurements with orbscanⅡin a population-based survey[J].J Refrac Surg,2010,26(12):966-971.
[14]SCHAEFFEL F.Kappa and hirschberg ratio measured with an automated video gaze tracker[J].Optom Vis Sci,2002,79(5):329-334.
[15]CHOI SR,KIM US.The correlation between angle kappa and ocular biometry in Koreans[J].Korean J Ophthalmol,2013,27(6):421-424.
[16]FENG WQ,ZHENG HH,CAI JQ.Effects of angle Kappa on eccentricity in corneal refractive surgery[J].J Pract Med,2010,26(8):1348-1350.冯旺强,郑海华,蔡剑秋.Kappa角对近视屈光手术偏心量的影响[J].实用医学杂志,2010,26(8):1348-1350.
[17]LU XZ,BI HS,PAN XM,WANG GM,YUAN MJ.The analysis of the cause of big kappa angle[J].Chin J Prac Ophthalmol,2010,28(2):130-132.卢秀珍,毕宏生,潘雪梅,王桂敏,袁明俊.大kappa角成因的分析[J].中国实用眼科杂志,2010,28(2):130-132.
[18]FABIAN ID,SPIERER A,BERGER Y,BEN-ZION I.Abnormal vertical angle kappa caused by ectopic fovea[J].J AAPOS,2012,16(6):575-576.
[19]SHI R,DONG ZH,ZHAO H,CHEN XT,DONG LR,FENG J,et al.Analysis of angle Kappa variation in corneal refractive surgery under light and dark conditions[J].Int Eye Sci,2016,16(8):1462-1464.师蓉,董泽红,赵炜,陈雪婷,董丽蓉,冯洁,等.角膜屈光手术患者明暗瞳孔下Kappa角的变化及分析[J].国际眼科杂志,2016,16(8):1462-1464.
[20]LI YY,QIU Y,QIU HY,DI YL,ZHAI GG,QU Z.The observation of shift in pupil center locations during LASIK[J].Int Eye Sci,2007,7(2):432-434.李耀宇,邱岩,邱怀雨,邸玉兰,翟国光,屈哲.LASIK术中瞳孔中心移位的观察研究[J].国际眼科杂志,2007,7(2):432-434.
[21]XIA LK,ZHOU J,ZHOU JZ,GAO DW.Effect of initiative corrected eyeball rotation in LASIK by iris localization on remnant degrees of astigmatism and higher-order aberrations in patients with myopic astigmatism[J].Rec Adv Ophthalmol,2010,30(6):543-546.夏丽坤,周晶,周佳子,高殿文.虹膜定位技术主动校正LASIK术中眼球旋转对近视散光患者术后残余散光度数及高阶像差的影响[J].眼科新进展,2010,30(6):543-546.
[22]QI H,JIANG JJ,JIANG YM,WANG L.Kappa angles in different positions in patients with myopia during LASIK[J].Int J Ophthalmol,2016,9(4):585-589.
[23]YUE HY,ZHANG L,GAO QY,CHEN YQ,ZHANG BH.Clinical study of angle kappa characteristic after strabotomy[J].Chin J Ocular Trauma Occup Eye Dis,2013,35(8):583-585.岳红云,张丽,高清垚,陈亚琼,张百红.斜视手术对kappa角影响及临床意义[J].中华眼外伤职业眼病杂志,2013,35(8):583-585.
[24]MOSHIRFAR M,HOGGAN RN,MUTHAPPAN V.Angle kappa and its importance in refractive surgery[J].Oman J Ophthalmol,2013,6(3):151-158.
[25]NEPOMUCENO RL,BOXER BS,KIM JM,SCRUGGS R,SATOM.Laser in situ keratomileusis for hyperopia with the LADARVision 4000 with centration on the coaxially sighted corneal light reflex[J].J Cataract Refract Surg,2004,30(6):1281-1286.
[26]Kanellopoulos AJ.Topography-guided hyperopic and hyperopic astigmatism femtosecond laser-assisted LASIK:long-term experience with the 400 Hz eye-Q excimer platform[J].Clin Ophthalmol,2012,6:895-901.
[27]SOLER V,BENITO A,SOLER P,TRIOZON C,ARNJL,MADARIAGA V,et al.A randomized comparison of pupil-centered versus vertex-centered ablation in LASIKcorrection of hyperopia[J].Am J Ophthalmol,2011,152(4):591-599.
[28]REINSTEIN DZ,GOBBE M,ARCHER TJ.Coaxially sighted corneal light reflex versus entrance pupil center centration of moderate tohigh hyperopic corneal ablations in eyes with small and large angle kappa[J].J Refract Surg,2013,29(8):518-525.(200)(上接第196页)
[29]ZHOU CY,CHEN J,XIE AR,HE Q,HU Y.The effect of LASIKwith Kappa angle adjust on aberration in human cornea[J].J Chin Ophthalmol Otorhinolaryngol,2013,3(2):78-80.周春阳,陈婕,谢艾芮,何清,胡缘.LASIK术中Kappa角调整对角膜像差影响的研究[J].中医眼耳鼻喉杂志,2013,3(2):78-80.
[30]QI H,JIANG JJ,Jiang YM,DU GP,HUANG YF.Effect of adjusted kappa angle of individual laser assisted in-situ keratomi leusis on high level aberration[J].Med Pharm J Chin PLA,2013,25(10):73-75.齐惠,蒋晶晶,姜严明,杜改萍,黄一飞.修正Kappa角的个性化准分子激光原位角膜镶磨术对高阶像差的影响[J].解放军医药杂志,2013,25(10):73-75.
[31]CHANG JS,LAW AK,NG JC,CHAN VK.Comparison of refractive and visual outcomes with centration points 80%and 100%from pupilcenter toward the coaxially sighted corneal light reflex[J].J Cataract Refract Surg,2016,42(3):412-419.
[32]LIANG G,ZHA X,ZHANG FJ.A clinical study comparing the changes in higher-order aberrations following SBK and femtosecond laser LASIK with a customized Q-factor and Kappa adjustment[J].Chin J Optom Ophthalmol Vis Sci,2014,16(1):25-29.梁刚,查旭,张丰菊.Q值引导及Kappa角调整后SBK和飞秒LASIK术后高阶像差的对比[J].中华眼视光学与视觉科学杂志,2014,16(1):25-29.
[33]KHAKSHOOR H,MCCAUGHEY MV,VEJDANI AH,DANESH-VAR R,MOSHIRFAR M.Use of angle kappa in myopic photorefractive keratectomy[J].Clin Ophthalmol,2015,29(9):193-195.
[34]KARHANOVM,PLUHCˇEK F,MLCˇK P,VLCˇIL O,SˇN M,MARESˇOVK.The importance of angle kappa evaluation for implantation of diffractive multifocal intra-ocular lenses using pseudophakic eye model[J].Acta Ophthalmol,2015,93(2):e123-e128.
[35]TCHAH H,NAM K,YOO A.Predictive factors for photic phenomena after refractive,rotationally asymmetric,multifocalintraocular lens implantation[J].Int J Ophthalmol,2017,10(2):241-245.
[36]CHEN C,YE J,HUANG CJ,AI LY.The visual quality after implantation of multifocal intraocular lenses in different angle kappa eyes[J].Chin J Optom Ophthalmol Vis Sci,2016,18(5):298-301.陈琛,叶剑,黄婵娟,艾李倩玉.不同Kappa角眼多焦点人工晶状体植入术后的视觉质量[J].中华眼视光学与视觉科学杂志,2016,18(5):298-301.
[37]MELKI SA,HARISSI-DAGHER M.Coaxially sighted intraocular lens light reflex for centration of the multifocal single piece intraocular lens[J].Can J Ophthalmol,2011,46(4):319-321.
[2]LIU Y,YUAN J.Vision quality after personalized implantation of aspheric intraocular lens[J].Recent Advances in Ophthalmology,2016,36(1):35-37.刘昳,袁进.个性化植入非球面人工晶状体术后视觉质量的临床观察[J].眼科新进展,2016,36(1):35-37.
[3]PRAKASH G,PRAKASH DR,AGARWAL A,KUMAR D,AGAR-WAL A,JACOB S.Predictive factor and kappa angle analysis for visual satisfactions in patients with multifocal IOLimplantation[J].Eye(Lond),2011,25(9):1187-1193.
[4]PARK CY,OH SY,CHUCK RS.Measurement of angle kappa and centration in refractive surgery[J].Curr Opin Ophthalmol,2012,23(4):269-275.
[5]GHARAEE H,SHAFIEE M,HOSEINI R,ABRISHAMI M,ABRISH-AMI Y,ABRISHAMI M.Angle kappa measurements:normal values in healthy iranian population obtained with the orbscanⅡ[J].Iran Red Crescent Med J,2015,17(1):e17873.
[6]ZHANG Y,CHU RY.Analysis of kappa angle measurement of myopic eyes in excimer laser refractive surgery[J].Shandong Med J,2011,51(35):36.张泳,褚仁远.准分子激光屈光手术中近视眼Kappa角测量结果分析[J].山东医药,2011,51(35):36.
[7]CHENG D,XU JJ,BAO JH,PAN JD,LV F.Weight analysis of influencing factors of human angle Kappa[J].Chin J Exp Ophthalmol,2014,32(5):425-429.程丹,徐菁菁,保金华,潘建东,吕帆.人眼Kappa角的影响因素权重分析[J].中华实验眼科杂志,2014,32(5):425-429.
[8]SRIVANNABOON S,CHOTIKAVANICH S.Corneal characteristics in myopic patients[J].J Med Assoc Thai,2005,88(9):1222-1227.
[9]BASMAK H,SAHIN A,YILDIRIM N,PAPAKOSTAS TD,KAN-ELLOPOULOS AJ.Measurement of angle kappa with synoptophore and OrbscanⅡin a normal population[J].J Refract Surg,2007,23(5):456-460.
[10]ZAREI-GHANAVATI S,GHARAEE H,ESLAMPOUR A,ABRIS-HAMI M,GHASEMI-MOGHADAM S.Angle kappa changes after photorefractive keratectomy for myopia[J].Int Ophthalmol,2014,34(1):15-18.
[11]DOMNGUEZ-VICENT A,MONSLVEZ-ROMN D,PREZ-VIVES C,FERRER-BLASCO T,MONTS-MICR.Measurement of angle Kappa with OrbscanⅡand Galilei G4:effect of accommodation[J].Grafes Arch Clin Exp Ophthalmol,2014,252(2):249-255.
[12]Yeo JH,Moon NJ,Lee JK.Measurement of angle Kappa using ultrasound biomicroscopy and corneal topography[J].Korean JOphthalmol,2017,31(3):257-262.
[13]HASHEMI H,KHABAZKHOOB M,YAZDANI KA,JAFARZADE-HPUR E,FOTOUHI A.Distribution of angle kappa measurements with orbscanⅡin a population-based survey[J].J Refrac Surg,2010,26(12):966-971.
[14]SCHAEFFEL F.Kappa and hirschberg ratio measured with an automated video gaze tracker[J].Optom Vis Sci,2002,79(5):329-334.
[15]CHOI SR,KIM US.The correlation between angle kappa and ocular biometry in Koreans[J].Korean J Ophthalmol,2013,27(6):421-424.
[16]FENG WQ,ZHENG HH,CAI JQ.Effects of angle Kappa on eccentricity in corneal refractive surgery[J].J Pract Med,2010,26(8):1348-1350.冯旺强,郑海华,蔡剑秋.Kappa角对近视屈光手术偏心量的影响[J].实用医学杂志,2010,26(8):1348-1350.
[17]LU XZ,BI HS,PAN XM,WANG GM,YUAN MJ.The analysis of the cause of big kappa angle[J].Chin J Prac Ophthalmol,2010,28(2):130-132.卢秀珍,毕宏生,潘雪梅,王桂敏,袁明俊.大kappa角成因的分析[J].中国实用眼科杂志,2010,28(2):130-132.
[18]FABIAN ID,SPIERER A,BERGER Y,BEN-ZION I.Abnormal vertical angle kappa caused by ectopic fovea[J].J AAPOS,2012,16(6):575-576.
[19]SHI R,DONG ZH,ZHAO H,CHEN XT,DONG LR,FENG J,et al.Analysis of angle Kappa variation in corneal refractive surgery under light and dark conditions[J].Int Eye Sci,2016,16(8):1462-1464.师蓉,董泽红,赵炜,陈雪婷,董丽蓉,冯洁,等.角膜屈光手术患者明暗瞳孔下Kappa角的变化及分析[J].国际眼科杂志,2016,16(8):1462-1464.
[20]LI YY,QIU Y,QIU HY,DI YL,ZHAI GG,QU Z.The observation of shift in pupil center locations during LASIK[J].Int Eye Sci,2007,7(2):432-434.李耀宇,邱岩,邱怀雨,邸玉兰,翟国光,屈哲.LASIK术中瞳孔中心移位的观察研究[J].国际眼科杂志,2007,7(2):432-434.
[21]XIA LK,ZHOU J,ZHOU JZ,GAO DW.Effect of initiative corrected eyeball rotation in LASIK by iris localization on remnant degrees of astigmatism and higher-order aberrations in patients with myopic astigmatism[J].Rec Adv Ophthalmol,2010,30(6):543-546.夏丽坤,周晶,周佳子,高殿文.虹膜定位技术主动校正LASIK术中眼球旋转对近视散光患者术后残余散光度数及高阶像差的影响[J].眼科新进展,2010,30(6):543-546.
[22]QI H,JIANG JJ,JIANG YM,WANG L.Kappa angles in different positions in patients with myopia during LASIK[J].Int J Ophthalmol,2016,9(4):585-589.
[23]YUE HY,ZHANG L,GAO QY,CHEN YQ,ZHANG BH.Clinical study of angle kappa characteristic after strabotomy[J].Chin J Ocular Trauma Occup Eye Dis,2013,35(8):583-585.岳红云,张丽,高清垚,陈亚琼,张百红.斜视手术对kappa角影响及临床意义[J].中华眼外伤职业眼病杂志,2013,35(8):583-585.
[24]MOSHIRFAR M,HOGGAN RN,MUTHAPPAN V.Angle kappa and its importance in refractive surgery[J].Oman J Ophthalmol,2013,6(3):151-158.
[25]NEPOMUCENO RL,BOXER BS,KIM JM,SCRUGGS R,SATOM.Laser in situ keratomileusis for hyperopia with the LADARVision 4000 with centration on the coaxially sighted corneal light reflex[J].J Cataract Refract Surg,2004,30(6):1281-1286.
[26]Kanellopoulos AJ.Topography-guided hyperopic and hyperopic astigmatism femtosecond laser-assisted LASIK:long-term experience with the 400 Hz eye-Q excimer platform[J].Clin Ophthalmol,2012,6:895-901.
[27]SOLER V,BENITO A,SOLER P,TRIOZON C,ARNJL,MADARIAGA V,et al.A randomized comparison of pupil-centered versus vertex-centered ablation in LASIKcorrection of hyperopia[J].Am J Ophthalmol,2011,152(4):591-599.
[28]REINSTEIN DZ,GOBBE M,ARCHER TJ.Coaxially sighted corneal light reflex versus entrance pupil center centration of moderate tohigh hyperopic corneal ablations in eyes with small and large angle kappa[J].J Refract Surg,2013,29(8):518-525.(200)(上接第196页)
[29]ZHOU CY,CHEN J,XIE AR,HE Q,HU Y.The effect of LASIKwith Kappa angle adjust on aberration in human cornea[J].J Chin Ophthalmol Otorhinolaryngol,2013,3(2):78-80.周春阳,陈婕,谢艾芮,何清,胡缘.LASIK术中Kappa角调整对角膜像差影响的研究[J].中医眼耳鼻喉杂志,2013,3(2):78-80.
[30]QI H,JIANG JJ,Jiang YM,DU GP,HUANG YF.Effect of adjusted kappa angle of individual laser assisted in-situ keratomi leusis on high level aberration[J].Med Pharm J Chin PLA,2013,25(10):73-75.齐惠,蒋晶晶,姜严明,杜改萍,黄一飞.修正Kappa角的个性化准分子激光原位角膜镶磨术对高阶像差的影响[J].解放军医药杂志,2013,25(10):73-75.
[31]CHANG JS,LAW AK,NG JC,CHAN VK.Comparison of refractive and visual outcomes with centration points 80%and 100%from pupilcenter toward the coaxially sighted corneal light reflex[J].J Cataract Refract Surg,2016,42(3):412-419.
[32]LIANG G,ZHA X,ZHANG FJ.A clinical study comparing the changes in higher-order aberrations following SBK and femtosecond laser LASIK with a customized Q-factor and Kappa adjustment[J].Chin J Optom Ophthalmol Vis Sci,2014,16(1):25-29.梁刚,查旭,张丰菊.Q值引导及Kappa角调整后SBK和飞秒LASIK术后高阶像差的对比[J].中华眼视光学与视觉科学杂志,2014,16(1):25-29.
[33]KHAKSHOOR H,MCCAUGHEY MV,VEJDANI AH,DANESH-VAR R,MOSHIRFAR M.Use of angle kappa in myopic photorefractive keratectomy[J].Clin Ophthalmol,2015,29(9):193-195.
[34]KARHANOVM,PLUHCˇEK F,MLCˇK P,VLCˇIL O,SˇN M,MARESˇOVK.The importance of angle kappa evaluation for implantation of diffractive multifocal intra-ocular lenses using pseudophakic eye model[J].Acta Ophthalmol,2015,93(2):e123-e128.
[35]TCHAH H,NAM K,YOO A.Predictive factors for photic phenomena after refractive,rotationally asymmetric,multifocalintraocular lens implantation[J].Int J Ophthalmol,2017,10(2):241-245.
[36]CHEN C,YE J,HUANG CJ,AI LY.The visual quality after implantation of multifocal intraocular lenses in different angle kappa eyes[J].Chin J Optom Ophthalmol Vis Sci,2016,18(5):298-301.陈琛,叶剑,黄婵娟,艾李倩玉.不同Kappa角眼多焦点人工晶状体植入术后的视觉质量[J].中华眼视光学与视觉科学杂志,2016,18(5):298-301.
[37]MELKI SA,HARISSI-DAGHER M.Coaxially sighted intraocular lens light reflex for centration of the multifocal single piece intraocular lens[J].Can J Ophthalmol,2011,46(4):319-321.