[Comparison of corneal power assessment methods after small incision lenticule extraction]

Zhonghua Yan Ke Za Zhi. 2023 Jun 11;59(6):460-466. doi: 10.3760/cma.j.cn112142-20220707-00330.
[Article in Chinese]

Abstract

Objective: To compare the accuracy of different corneal curvature parameters in assessing the corneal refractive status and tracking corneal power changes after small incision lenticule extraction (SMILE). Methods: This prospective cross-sectional study tracked and recorded total corneal curvature parameters measured by different instruments before and three months after SMILE for myopia. These parameters, including total keratometry (TK) from the IOLMaster 700, total corneal refractive power (TCRP) from the Pentacam AXL, real keratometry (RK) from the CASIA 2, and corrected parameters calculated using the Haigis, Shammas, and Maloney methods, were compared with data obtained using the clinical history method (CHM). Surgically induced changes in TK, TCRP, and RK were analyzed and compared with those in spherical equivalent on the corneal plane (ΔSEco). Results: The study included 40 eyes (40 participants). After SMILE, the difference was smallest between TK [(0.08±0.38) D] and CHM values (P>0.05). However, TCRP, RK, KHaigis, KShammas, and KMaloney were significantly different from CHM data (P<0.05). The width of the 95% limits of agreement of TK (1.49 D) was narrowest, followed by that of RK (1.57 D). Pearson analysis showed that each parameter had a good correlation with CHM data. The differences between the changes in TK, TCRP and RK caused by surgery and ΔSEco were (0.03±0.39) D, (0.17±0.43) D, and (-0.19±0.46) D, respectively. The width of the 95% limits of agreement of ΔTK (1.54 D) was narrowest, and the correlation coefficient of ΔTK (0.951) was highest. Conclusion: The parameter TK of the IOLMaster 700 can provide accurate and objective corneal power evaluation after SMILE.

目的: 探讨不同角膜曲率测算方法评估飞秒激光小切口角膜基质透镜取出术(SMILE)后角膜屈光状态的准确性。 方法: 横断面研究。连续收集2020年12月在首都医科大学附属北京同仁医院屈光中心门诊接受SMILE的近视眼患者,纳入右眼进行研究。术前和术后3个月用临床病史法(CHM)获取总角膜曲率,并分别获取IOL Master 700生物测量仪的TK、Pentacam AXL全景生物测量仪的TCRP和CASIA 2眼前节成像仪的RK,同时基于模拟角膜曲率测量值分别采用Haigis法、Shammas法、Maloney法计算校正的角膜曲率,分析这些角膜曲率参数或计算结果与CHM角膜曲率的差异、一致性和相关性。将手术引起的TK、TCRP、RK的改变量与角膜平面等效球镜度数改变量(ΔSEco)进行比较。 结果: 最终纳入40例患者,其中男性12例,女性28例,年龄(27.38±6.00)岁。SMILE术后TK与CHM角膜曲率的差异最小,为(0.08±0.38)D,无统计学意义(P>0.05),而TCRP、RK及Haigis法、Shammas法、Maloney法计算的角膜曲率与CHM角膜曲率的差异均有统计学意义(均P<0.05)。TK与CHM角膜曲率95%一致性界限宽度最窄,为1.49 D,其次为RK的1.57 D。各参数与CHM角膜曲率的相关性均较好(均P<0.05)。手术引起的TK、TCRP和RK的改变量与ΔSEco的差异分别为(0.03±0.39)、(0.17±0.43)、(-0.19±0.46)D,TK改变量与ΔSEco的95%一致性界限宽度最窄,为1.54 D,相关系数最高,为0.951。 结论: TK测算SMILE术后角膜屈光状态更为准确。.

Publication types

  • English Abstract

MeSH terms

  • Cornea / surgery
  • Corneal Surgery, Laser*
  • Corneal Topography
  • Cross-Sectional Studies
  • Humans
  • Myopia* / surgery
  • Prospective Studies
  • Refraction, Ocular