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題名 | 近視及散光病人施行準分子雷射輔助層狀角膜重塑術後之不同角膜弧度值變化=The Variance of Different Keratometric Readings after Laser Assisted in Situ Keratomileusis for Myopia and Astigmatism |
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作者 | 胡朝乾; 施玫如; 盧雪玉; Hu, Chao-chien; Shih, Mei-ru; Lu, Hsuei-yuh; |
期刊 | 中華民國眼科醫學會雜誌 |
出版日期 | 19991200 |
卷期 | 38:4 1999.12[民88.12] |
頁次 | 頁635-642 |
分類號 | 416.703 |
語文 | chi |
關鍵詞 | 近視; 散光; 準分子雷射輔助層狀角膜重塑術; Keratometric readings; Laser assisted in situ keratomileusis; LASIK; IOL power calculation; |
中文摘要 | 目的:由於不同的角膜弧度值(keratometric readings)會造成相當不同程度的人 工水晶體度數計算上之差異。於本篇文章中,我們將討論對於中、高度數近視病患,於準分 子雷射輔助層狀角膜重塑術後之許多不同K值變化。 方法:本實驗共採集二十九隻眼睛。於術前以傳統角膜弧度器(Manual keratometer)測 量傳統K值,並利用角膜地圖儀(Corneal topography)記錄擬傳統平均K值(Average simulated keratometry; Avg.Sim.K)。而所有準分子雷射輔助層狀角膜重塑術為利用 Schwind公司的微小角膜切開器(Microkeratome)與Schwind公司之準分子雷射機 (Keratome-F excimer laser)。我們於每一次術後回診時、以角膜地圖儀記錄術後擬傳統平 均K值及有效屈光能力(Effective refractive power; Eff.RP)。並於術後最後一次回診時, 記錄在眼鏡面上(at the spectacle plane)與角膜面上(at the corneal plane)所得之屈 光手術前後變化差異得到的擬傳統平均K值(Refraction-derived videokeratography)。最 後將所有記錄到之不同角膜弧度值納入統計分析。 結果:統計分析發現術前之傳統平均K值與擬傳統平均K值兩組間沒有統計上的差異 (p<0.05)。我們亦發現術後之擬傳統平均K值及有效屈光能力兩組間亦沒有統計上的差異 (p<0.05)。然而,資料顯示術後最後一次回診時,擬傳統平均K值與在眼鏡面上或角膜面上 屈光手術前後變化差異得到的擬傳統平均K值間有顯著的差異。同時,我們亦發現當在眼鏡 面上與角膜面上所達到的屈光度數越多時,兩組數值間之差距亦隨之增大。由於傳統平均K 值與擬傳統平均K值均只測量角膜的前弧度(Anterior radius of cornea),故於準分子雷 射屈光手術後,若僅以這些方法量得角膜的屈光能力(Corneal power),將會產生數值過大 現象(Overestimation)。 結論:對於中、高度數近視病患,其術前之傳統平均K值與擬傳統平均K值兩數值間沒 有差異性。於準分子雷射輔助層狀角膜重塑術後,其擬傳統平均K值及有效屈光能力兩數值 間亦沒有差別。但術後擬傳統平均K值與在眼鏡面上與角膜面上屈光手術前後變化差異得到 的擬傳統平均K值間卻有顯著不同。且兩數值間之差距與在眼鏡面上或角膜面上達到的屈光 度數改變多寡形成中等至強烈的相關性。 |
英文摘要 | Purpose: Owing to the variance of different keratometric readings can result in rather different IOL power calculations, we tried to discuss the differences between many different K. readings after LASIK surgery for moderate to high degree of myopia. Methods: Twenty-nine eyes have been enrolled in this study. We recorded conventional keratometric readings by manual keratometry and average simulated keratometry (Avg. Sim. K) by corneal topography preoperatively. All the LASIK surgeries were performed with Schwind microkeratome and Schwind keratome-F excimer laser. We measured Avg.Sim.K and Eff. RP (Effective refractive power) at every follow-up visits postoperatively. Refraction-derived videokeratography at the spectacle and corneal plane were also calculated at the final visits. We analyzed these different K readings with statistics at last. Results: We found there was no significant difference between manual K and Avg. Sim. K preoperatively (p <0.05). The same result was also found between Avg. Sim. K and Eff. RP postoperatively (p<0.05). However, rather differences between Avg. Sim. K and refraction-derived videokeratography at the spectacle and corneal plane were noted in our study. We also found a trend that as the achieved refractive changes at the spectacle and corneal plane increase, the differences between Avg. Sim. K and refraction-derived videokeratography at the spectacle plane and corneal plane will also increase. Both of the manual keratometry and average simulated keratometry (Avg.Sim.K) were used to measure anterior radius of cornea only, overestimation of corneal power by them could be expected after refractive surgery (LASIK or PRK) owing to negligence of posterior radius of cornea. Conclusion: There was no differences between manaul K and Avg. Sim. K. preoperatively. Neither was there between Avg. Sim. K. and Eff.RP postoperatively in our study. However, we noted quite differences between Avg. Sim. K and refraction-derived videokeratography at the spectacle or corneal plane and found a moderate to strong correlation between these differences and achieved refractive changes at the spectacle or corneal plane. |
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