角卡帕对近视LASIK/PRK后白内障患者的折射预测精度的影响
Haorui Yuan1, Jiaqing Zhang1, Yuxing Zheng1
1From the State Key Laboratory of Ophthalmology (H.Y., J.Z., Y.Z., H.L., X.X., X.H., W.Y., X.Q., Z.L., W.C., L.L., X.T.), Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China; Guangdong Provincial Clinical Research Center for Ocular Diseases (H.Y., J.Z., Y.Z., H.L., X.X., X.H., W.Y., X.Q., Z.L., W.C., L.L., X.T.), Guangzhou, China.
American journal of ophthalmology
|November 30, 2025
概括
角卡帕显著影响近视LASIK/PRK后的折射预测准确性. 对于具有较大角卡帕 (≥0.4毫米) 的患者,以改善结果,以瞳孔为中心的角膜测量是首选的.
科学领域:
- 眼科医生 眼科 眼科
- 折射手术是一种折射手术.
- 生物医学光学 生物医学光学
背景情况:
- 准确的折射预测对于成功的白内障手术结果至关重要,特别是在先前有近视激光视力校正的患者中.
- 视角卡帕 (angle kappa),即瞳孔中心与视觉轴之间的错位,可以影响透测量测量和影响眼内透镜 (IOL) 功率计算.
研究的目的:
- 为了研究角卡帕对近视激光辅助现场角膜修复 (LASIK) 或光折射性角膜切除术 (PRK) 的眼睛中折射预测的准确性的影响.
- 为了比较不同角质量测量 (K) 测量方法的性能及其对该患者队列预测误差的影响.
主要方法:
- 对127名近视LASIK/PRK患者 (176只眼睛) 的回顾性分析,这些患者随后接受了白内障手术.
- 使用IOLMaster 700 (以顶部为中心的2.5毫米环) 和Pentacam AXL (以顶部为中心的[CV]和以瞳孔为中心的[PC],3毫米区域) 获得了角质测量值.
- 用不同的K值使用巴雷特True-K公式,并根据角卡帕 (<0.4毫米和≥0.4毫米) 进行亚组分析.
主要成果:
- 在使用IOLMaster 700和Pentacam (CV) 两种以顶点为中心的K值时,高视度预测错误随着更大的角度kappa增加.
- 在角卡帕≥0.4毫米的眼睛中,以瞳孔为中心的Pentacam (PC) 模式显示了与以顶点为中心的模式 (0.90-0.96 D) 相比的显著较低的平均绝对预测误差 (0.70 D).
- 在Pentacam (PC) 模式下,在较大的角卡帕子组中,眼睛在±0.5 D预测误差 (51.22%) 内的比例也更高.
结论:
- 在近视LASIK/PRK后的折射预测准确性在采用以顶点为中心的角质测量时,随着角卡帕的增加而减少.
- 建议以瞳孔为中心的角质量测量,特别是从Pentacam (PC) 模式进行,以改善近视后LASIK/PRK患者的折射可预测性,角卡帕为0.4mm或更大.
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