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首页> 外文期刊>Investigative ophthalmology & visual science >Astigmatism Correction in Laser Cataract Surgery. Comparison of IOL Master and Corneal Topography measurements, how Accurately do these Devices Account for the Role of Posterior Corneal Astigmatism?
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Astigmatism Correction in Laser Cataract Surgery. Comparison of IOL Master and Corneal Topography measurements, how Accurately do these Devices Account for the Role of Posterior Corneal Astigmatism?

机译：激光白内障手术中的像散校正。比较IOL主角膜和角膜地形图的测量结果，这些设备如何准确地解释后角膜散光的作用？

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Purpose : To compare PreOperative IOL Master(IOLm) and Corneal Topography(CT) Ks and PostOperative(PO) results. We also seek to understand some of the factors resulting in outcomes not predicted preoperatively, at the time of toric IOL selection. Methods : Retrospective review of 50 Toric IOL eyes, comparing IOLm vs CT values. All patients underwent cataract extraction with LenSx laser assisted surgery and received a 20 degree laser astigmatism correction, performed at the steepest meridian.PO goal was defined as: +/- 0.50D and 10 degrees of axis. Failure was defined as: cylinder 0.50D, and/or off axis 10 degrees. Failure were also categorized as Under-Correction (UC) or Over-Correction(OC). Factors assessed included: type of Astigmatism(Ast) corrected, High Ast 2.5D, intraoperative aberrometry (ORA) measured with LenSx and Posterior Ast(PA) measured with Pentacam. Results : When comparing IOLm vs CT: cylinder differed by 0.50D in 36% of cases, and axis differed by 10 degrees in 32% of cases. 58% of cases reached PO goal of cylinder 0.50D and axis 10 degrees. 16% of the cases where found to be UC, with 88% having preoperative ATR Ast. 26% of the cases where OC, with 86% having preoperative WTR Ast. High Ast accounted for 25% of UC, and 29% of OC. ORA underestimated 25% of the UC cases, and ORA suggested and insufficient decrease in 14% of OC. PA accounted for 88% of UC, and 86% of OC, resulting in the most influential factor for improving IOL selection. Conclusions : IOLm uses partial coherence interferometry, where as CT uses placido-based technology, both measurement devices do not factor in PA. Pentacam uses scheimpflug technology and has been found to accurately assess anterior and posterior corneal Ast. This study shows that the influence of PA, most commonly resulted in less than optimal toric IOL selection. Our results also demontrate UC of ATR Ast, along with OC of WTR Ast. Our data supports the concept of factoring PA into toric IOL selection. These findings have been described in the literature and have become well accepted. Koch et al., proposed a nomogram, and suggested that 0.5 D should be subtracted in WTR Ast and 0.3 D should be added for ATR Ast. More studies are needed to solidify these ideas, and compare the accuracy of measuring PA with different devices. This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
机译：目的：比较术前IOL Master（IOLm）和角膜地形图（CT）Ks和术后OOL Master（PO）的结果。在选择复曲面人工晶状体时，我们还试图了解一些导致术前无法预测的结果的因素。方法：回顾性分析50只复曲面IOL眼，比较IOLm与CT值。所有患者均使用LenSx激光辅助手术进行白内障摘除术，并在最陡的子午线进行20度激光散光矫正，PO目标定义为：+/- 0.50D和<10度轴。失效定义为：圆柱体> 0.50D，和/或偏轴> 10度。失败也归类为矫正不足（UC）或矫正过度（OC）。评估的因素包括：矫正散光（Ast）的类型，高Ast> 2.5D，使用LenSx测量的术中像差（ORA）和使用Pentacam测量的后视Ast（PA）。结果：比较IOLm与CT：在36％的情况下，圆柱体相差> 0.50D，在32％的情况下轴相差> 10度。 58％的病例达到了缸<0.50D和轴<10度的PO目标。发现UC的病例占16％，术前ATR Ast占88％。 OC病例中有26％，术前WTR Ast有86％。高分占UC的25％和OC的29％。 ORA低估了25％的UC病例，而ORA提示14％的OC减少不足。 PA占UC的88％，OC占86％，是改善IOL选择的最有影响力的因素。结论：IOLm使用部分相干干涉术，而CT使用基于普拉西多技术的技术，这两种测量设备均不考虑PA。 Pentacam使用scheimpflug技术，已被发现可以准确评估角膜前和后角的Ast。这项研究表明，PA的影响最常导致最佳复曲面IOL选择不理想。我们的结果还使ATR Ast的UC以及WTR Ast的OC偏离了标准。我们的数据支持将PA纳入复曲面IOL选择的概念。这些发现已在文献中描述，并已被广泛接受。 Koch等人提出了列线图，并建议在WTR Ast中减去0.5 D，为ATR Ast添加0.3D。需要更多的研究来巩固这些想法，并比较使用不同设备测量PA的准确性。这是提交给2016年5月1-5日在华盛顿州西雅图市举行的2016 ARVO年会的摘要。

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