Improving refractive predictability with high-powered intraocular lenses: Refractive implications of various optic designs.

IF 2.6 3区 医学 Q2 OPHTHALMOLOGY
David L Cooke, Michael S Seward, Timothy L Cooke
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引用次数: 0

Abstract

Purpose: To identify and reduce refractive prediction errors associated with several common intraocular lens (IOL) models.

Setting: Multiple private and university practices across the United States.

Design: Retrospective analysis of a large de-identified database.

Methods: For all IOL models with at least 800 eyes, prediction errors were plotted as a function of IOL power using Olsen, Barrett, and Cooke K6 (K6) formulas. Plots were categorized as myopic, hyperopic, or neutral profiles, according to their prediction error trends at higher dioptric powers. Prediction modifications (PMODs) were developed with K6 formula, via optical calculations for one IOL (SA60AT), and by empirical data for all others. The PMODs were then tested for their applicability to other modern IOL formulas.

Results: Data from 71,183 cataract surgeries were analyzed. At higher powers, Tecnis platform IOLs and one Acrysof model IOL produced unintended myopia. Conversely, enVista platform IOLs produced unintended hyperopia at higher powers. In all cases, results were improved when incorporating PMODs. In 12 of 13 cases, predictability as measured by root-mean-square error was improved (P < 0.03). This included measurements by seven modern formulas in the case of the Tecnis data. Overall, 1306 eyes (1.8%) required more than 0.25 D of adjustment to their predicted refractions. At highest available powers, the needed prediction corrections were -0.61, +0.76, and -0.69 for the Tecnis, enVista, and SN60AT IOLs, respectively.

Conclusions: Above 23.5 D, some IOLs cause either myopic or hyperopic prediction errors. Specific adjustments are recommended to improve refractive predictability for several common IOL models.

用高倍率人工晶状体改善屈光预测:各种光学设计的屈光影响。
目的:识别和减少与几种常见人工晶状体(IOL)模型相关的屈光预测误差。背景:在美国多个私人和大学实习。设计:对大型去标识数据库进行回顾性分析。方法:使用Olsen、Barrett和Cooke K6 (K6)公式,对所有至少800眼的IOL模型的预测误差绘制为IOL度数的函数。根据高屈光度下的预测误差趋势,将图分类为近视、远视或中性。预测修正(PMODs)通过K6公式,通过光学计算一个IOL (SA60AT),并通过经验数据对所有其他的。然后测试PMODs是否适用于其他现代IOL配方。结果:对71183例白内障手术资料进行分析。在高倍倍率下,Tecnis平台人工晶状体和一个acryysof模型人工晶状体产生了意外近视。相反,enVista平台人工晶状体在高倍倍率下会产生意想不到的远视。在所有情况下,当加入PMODs时,结果都得到了改善。在13例中的12例中,通过均方根误差测量的可预测性得到了改善(P < 0.03)。在Tecnis数据的例子中,这包括七个现代公式的测量。总的来说,1306只眼睛(1.8%)需要超过0.25 D的调整来预测他们的折射。在最高可用功率下,Tecnis、enVista和SN60AT人工晶状体所需的预测校正分别为-0.61、+0.76和-0.69。结论:在23.5 D以上,部分iol会导致近视或远视的预测误差。建议对几种常见的人工晶状体模型进行具体的调整,以提高屈光可预测性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.60
自引率
14.30%
发文量
259
审稿时长
8.5 weeks
期刊介绍: The Journal of Cataract & Refractive Surgery (JCRS), a preeminent peer-reviewed monthly ophthalmology publication, is the official journal of the American Society of Cataract and Refractive Surgery (ASCRS) and the European Society of Cataract and Refractive Surgeons (ESCRS). JCRS publishes high quality articles on all aspects of anterior segment surgery. In addition to original clinical studies, the journal features a consultation section, practical techniques, important cases, and reviews as well as basic science articles.
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