[1]李鸿钰,李军,宋慧.基于Pentacam的角膜后前表面曲率半径比值分布及其对角膜屈光力的影响[J].眼科新进展,2020,40(11):1065-1069.[doi:10.13389/j.cnki.rao.2020.0238]
　LI Hongyu,LI Jun,SONG Hui.The distribution of the back-front corneal radius ratio and its effect on the corneal refractive power based on Pentacam[J].Recent Advances in Ophthalmology,2020,40(11):1065-1069.[doi:10.13389/j.cnki.rao.2020.0238]
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基于Pentacam的角膜后前表面曲率半径比值分布及其对角膜屈光力的影响/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年11期
页码:
1065-1069
栏目:
应用研究
出版日期:
2020-11-05

文章信息/Info

Title:
The distribution of the back-front corneal radius ratio and its effect on the corneal refractive power based on Pentacam
作者:
李鸿钰; 李军; 宋慧
300020　天津市，天津医科大学眼科临床学院，天津市眼科医院，天津市眼科学与视觉科学重点实验室，天津市眼科研究所
Author(s):
LI Hongyu; LI Jun; SONG Hui
Department of Ophthalmology and Clinic,Clinical College of Ophthalmology,Tianjin Medical University,Tianjin Eye Hospital,Tianjin Key Lab of Ophthalmology and Vision Science,Tianjin Eye Institute,Tianjin 300020,China
关键词:
年龄相关性白内障; 角膜后前表面曲率半径比值; 角膜曲率; 折射指数
Keywords:
age-related cataract;  back-front corneal radius ratio;  keraotometry;  refractive index
分类号:
R772
DOI:
10.13389/j.cnki.rao.2020.0238
文献标志码:
A
摘要:
目的　分析年龄相关性白内障人群角膜后前表面曲率半径比值分布特点及其影响因素，探讨其与模拟角膜曲率和全角膜屈光力差值间的关系。方法　回顾性研究。选取2018年9月至2020年1月在天津市眼科医院白内障中心诊断为年龄相关性白内障患者317例317眼。术前应用Pentacam眼前节分析仪测量角膜后前表面曲率半径比值及眼前节相关参数，检查质量合格者纳入研究。运用线性相关及回归分析探讨角膜后前表面曲率半径比值与年龄、眼前节参数及角膜曲率差值ΔK（模拟角膜曲率-全角膜屈光力）的关系，并根据真实角膜后前表面曲率半径比值及厚透镜公式计算矫正角膜折射指数。结果　正常年龄相关性白内障人群角膜后前表面曲率半径比值为77.0%~86.0%［（81.59 ±1.69）%］，不同眼别及性别间差异均无统计学意义（P=0.376、0.232）。角膜后前表面曲率半径比值与角膜后表面半径（rp=0.528,P<0.001）、角膜不规则散光（γs=0.151,P =0.007）、眼轴长度（rs=0.149,P =0.010）均呈正相关，与角膜球差（γp=-0.271,P<0.001）、角膜中央厚度（γp=-0.218,P<0.001）、角膜后表面散光（γs=-0.164,P =0.003）均呈负相关，而与年龄、角膜前表面半径、前房深度、角膜前表面散光均无相关性（均为P>0.05)。角膜后前表面曲率半径比值越大，ΔK反而越小，说明模拟角膜曲率与全角膜屈光力的差异越小。矫正角膜折射指数值为1.325 0~1.330 5（1.327 8±0.000 1）。结论　正常年龄相关性白内障人群中角膜后前表面曲率半径比值存在偏离正常值情况，且与ΔK呈负相关。采用传统角膜折射指数计算角膜屈光力是不准确的，基于B/F Ratio得到的矫正角膜折射指数1.327 8更能反映真实角膜曲率。
Abstract:
Objective　To analyze the distribution of the back-front corneal radius ratio (B/F Ratio) of age-related cataract patients and explore its relationship with the difference between simulated keraotometry reading and total corneal refractive power.Methods　Retrospective research. A total of 317 patients (317 eyes) with age-related cataract patients who performed a dual-rotating Scheimpflug camera (Pentacam AXL) in Tianjin Eye Hospital from September 2018 to January 2020 were collected. The Pentacam anterior segment analyzer was used to measure the B/F Ratio and related parameters of the anterior segment before the operation. Those who passed the inspection were included in the study. Linear correlation and regression analysis was used to explore the relationships between B/F Ratio and age, parameters of the anterior segment, and ΔK (simulated keraotometry reading-total corneal refractive power). Adjusted refractive index of the cornea was calculated using the geometric mean B/F Ratio value and thick lens formula.Results　The mean value of B/F Ratio was (81.59 ± 1.69)% (77.0% to 86.0%) in the age-related cataract patients with normal cornea. There was no statistically significant difference of the B/F Ratio between different eyes and genders (P=0.376, 0.232). B/F Ratio was positively correlated with posterior corneal radius (rp=0.528, P<0.001), irregular astigmatism (rs=0.151, P=0.007)，axial length (rs=0.149, P=0.010), and negatively with spherical aberration (rp=-0.271, P<0.001), corneal center thickness (rp=-0.218, P<0.001), posterior astigmatism (rs=-0.164, P=0.003). There were no correlations between B/F Ratio and age, anterior chamber depth, anterior corneal radius and anterior astigmatism (all P>0.05). The larger of the B/F Ratio was, the smaller of the ΔK was, which indicated that the difference between the simulated corneal curvature and the total corneal refractive power decreased. The adjusted refractive index of the cornea was 1.325 0-1.330 5 (1.327 8±0.000 1). Conclusion　The B/F Ratio of partial age-related cataract patients with normal cornea deviates from the normal value, and even has negatively correlated with the ΔK. The traditional corneal refractive index is inaccurate to calculate the true corneal power. The corrected corneal refractive index of 1.327 8 based on B/F Ratio can better reflect the true corneal curvature.

参考文献/References:

［1］　OLSEN T.Calculation of intraocular lens power:a review［J］.Acta Ophthalmol Scand,2007,85:472-485.
［2］　NORRBY S.Sources of error in intraocular lens power calculation［J］.J Cataract Refract Surg,2008,34(3):368-376.
［3］　SAVINI G,HOFFER K J,LOMORIELLO D S,DUCOLI P.Simulated keratometry versus total corneal power by ray tracing:A comparison in prediction accuracy of intraocular lens power［J］.Cornea,2017,36(11):1368-1372.
［4］　SAYED K M,ALSAMMAN A H.Interchange ability between Pentacam and IOLMaster in phakic intraocular lens calculation［J］.Eur J Ophthalmol,2015,25(3):202-207.
［5］　TAMAOKI A,KOJIMA T,HASEGAWA A,NAKAMURA H,TANAKA K,ICHIKAWA K.Intraocular lens power calculation in cases with posterior keratoconus［J］.J Cataract Refract Surg,2015,41(10):2190-2195.
［6］　DUBBELMAN M,SICAM V A,VAN DER HEIJDE G L.The shape of the anterior and posterior surface of the aging human cornea［J］.Vision Res,2006,46(6-7):993-1001.
［7］　MONTALBAN R,PINERO D P,JAVALOY J,ALIO J L.Scheimpflug photography-based clinical characterization of the correlation of the corneal shape between the anterior and posterior corneal surfaces in the normal human eye［J］.J Cataract Refract Surg,2012,38(11):1925-1933.
［8］　TANG M,CHEN A,LI Y,HUANG D.Corneal power measurement with Fourier-domain optical coherence tomography［J］.J Cataract Refract Surg,2010,36(12):2115-2122.
［9］　GARNER L F,OWENS H,YAP M K,FRITH M J,KINNEAR R F.Radius of curvature of the posterior surface of the cornea［J］.Optom Vis Sci,1997,74(7):496-498.
［10］　BAO F J,YU A Y,KASSEM W,WANG Q M,ELSHEIKH A.Biometry of the cornea in myopic Chinese patients［J］.J Refract Surg,2011,27(5):345-355.
［11］　OLSEN T,ARNARSSON A,SASAKI H,SASAKI K,JONASSON F.On the ocular refractive components:the Reykjavik Eye Study［J］.Acta Ophthalmol Scand,2007,85(4):361-366.
［12］　DUBBELMAN M,WEEBER H A,VAN DER HEIJDE R G,VOLKER-DIEBEN H J.Radius and asphericity of the posterior corneal surface determined by corrected Scheimpflug photography［J］.Acta Ophthalmol Scand,2002,80(4):379-383.
［13］　HASEGAWA A,KOJIMA T,YAMAMOTO M,KATO Y,TAMAOKI A,ICHIKAWA K.Impact of the anterior-posterior corneal radius ratio on intraocular lens power calculation errors［J］.Clin Ophthalmol,2018,12:1549-1558.
［14］　HASHEMI H,ASGARI S,EMAMIAN M H,MEHRAVARAN S,FOTOUHI A.Age-related changes in corneal curvature and shape:the shahroud eye cohort study［J］.Cornea,2015,34(11):1456-1458.
［15］　SEITZ B,LANGENBUCHER A,NGUYEN N X,KUS M M,KUCHLE M.Underestimation of intraocular lens power for cataract surgery after myopic photorefractive keratectomy［J］.Ophthalmology,1999,106(4):693-702.
［16］　SAVINI G,BARBONI P,CARBONELLI M,HOFFER K J.Accuracy of corneal power measurements by a new Scheimpflug camera combined with Placido-disk corneal topography for intraocular lens power calculation in unoperated eyes［J］.J Cataract Refract Surg,2012,38(5):787-792.
［17］　SHIRAYAMA M,WANG L,KOCH D D,WEIKERT M P.Comparison of accuracy of intraocular lens calculations using automated keratometry,a Placido-based corneal topographer,and a combined Placido-based and dual Scheimpflug corneal topographer［J］.Cornea,2010,29(10):1136-1138.
［18］　MELLES R B,HOLLADAY J T,CHANG W J.Accuracy of intraocular lens calculation formulas［J］.Ophthalmology,2018,125(2):169-178.
［19］　OLSEN T.On the calculation of power from curvature of the cornea［J］.Br J Ophthalmol,1986,70(2):152-154.
［20］　FAM H B,LIM K L.Validity of the keratometric index:large population-based study［J］.J Cataract Refract Surg,2007,33(4):686-691.
［21］　HELALY H A,EL-HIFNAWY M A,SHAHEEN M S,ABOU EL-KHEIR A F.Accuracy of corneal power measurements for intraocular lens power calculation after myopic laser in situ keratomileusis［J］.Middle East Afr J Ophthalmol,2016,23(1):122-128.
［22］　KARUNARATNE N.Comparison of the pentacam equivalent keratometry reading and IOL Master keratometry measurement in intraocular lens power calculations［J］.Clin Exp Ophthalmol,2013,41(9):825-834.

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备注/Memo

备注/Memo:
天津市卫生局科技基金项目（编号：2014KY37）
更新日期/Last Update: 2020-11-05