Development of postLASIK IOL Power Adjustmet NomogramLASIK术后人工晶状体度数调整列线图发展.pptVIP

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Development of postLASIK IOL Power Adjustmet NomogramLASIK术后人工晶状体度数调整列线图发展.ppt

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Development of postLASIK IOL Power Adjustmet NomogramLASIK术后人工晶状体度数调整列线图发展

Post-LASIK Intraocular Lens Power Adjustment Nomogram Joseph Diehl jdiehl@ucla.edu Kevin Miller, MD Jules Stein Eye Institute, David Geffen School of Medicine at UCLA --No Disclosures-- What’s the problem? Cataract surgery normally gives a good refractive result, BUT… LASIK surgery on the rise Changes to corneal power from LASIK are not adequately detected by corneal topography With inaccurate corneal power measurements, IOL calculations are inaccurate as well …and cataract patients have an unsatisfactory refractive result How do we solve it? Investigate the relationship between the LASIK-induced correction in manifest spherical refraction equivalent (MSRE) and post-cataract MSRE (the post-operative error) Retrospective, chart-based study of consecutive patients having cataract surgery after LASIK Requires pre- and post-LASIK surgical records Methods Plot LASIK correction in MSRE (in Diopters) vs predicted (based on K values from corneal topography) post-cataract MSRE (D) On same graph, plot the actual post-cataract MSRE The difference between the predicted and actual post-cataract MSRE is the post-operative error the surgeon should target to achieve emmetropia for the given LASIK correction in MSRE Graph the LASIK correction against this difference to determine if a relationship exists Statistically Speaking: Deviation from trendline (D): Mean +/- Std Dev (Range) -0.1 +/- 0.6 (-1.1 to 0.8) ABSOLUTE deviation from trendline (D): Mean +/- Std Dev (Range) 0.5 +/- 0.3 (0.0 to 1.1) STANDARD (statistically predicted) ERROR: Mean of 0.65 D (0.64 to 0.71) Post-LASIK IOL Power Adjustment Nomogram LASIK correction (D) target MSRE (D) -12 -4.9 -11 -4.3 -10 -3.8 -9 -3.2 -8 -2.7 -7 -2.3 -6 -1.9 -5 -1.5 -4 -1.1 -3 -0.8 -2 -0.5 -1 -0.3 1 0.1 2 0.3 3 0.4 4 0.5 Discussion Mathematical relationship clearly