摘要目的 探讨角膜屈光手术前后眼球相关参数的改变情况,分析这些改变对术后人工晶状体度数计算产生的影响,选择出较好的角膜屈光手术后计算人工晶状体度数的方法.方法 临床病例系列研究.对2014年6～12月在东莞市人民医院眼科应用IOL-Master分别测量角膜屈光手术前后患眼的各项参数(角膜曲率、眼轴长度、前房深度),分析其术前术后发生的改变.应用临床病史法、SRK/T公式、Haigis和Haigis-L公式计算术前和术后人工晶状体屈光度数,对计算结果进行统计学分析比较,评价术后计算方法的准确性并分析其中的影响因素.结果 角膜屈光手术后角膜曲率、眼轴长度、前房深度值较术前均有降低,且矫正屈光度数越高偏差越大.常规公式计算的术后人工晶状体度数出现低估,Haigis-L公式采用直接测量数据计算术后人工晶状体度数有较高的预测性,临床病史法可以减少传统公式计算产生的误差,但计算结果可靠性差,且矫正屈光度数越高产生误差也越大.结论 采用测量数据直接计算角膜屈光手术后人工晶状体屈光度数方法值得选择,如Haigis-L公式,临床病史可作为一个参考.

abstractsObjective To investigate the changes of the eye-related parameters before and after the corneal refractive surgery,analyze the impact of these changes on postoperative IOL diopter calculation,thereby selecting the good method for calculating of IOL diopter after corneal refractive surgery.Methods The eye-related parameters by IOL-Master before and after the corneal refractive surgery (corneal curvature,axial length,anterior chamber depth) were measured,the difference of the preoperation and postoperation was analyzed,the preoperative and the postoperative IOL diopter by the clinical history method was calculated using SRK/T,Haigis and Haigis-L formula.The statistical methods were used to analyze and compare the results of those calculations,the advantage and disadvantage of the calculation method after surgery was evaluated,the factors of the corneal refractive surgery were analyzed.Results Postoperative corneal curvature,axial length and anterior chamber depth were lower than the preoperative with the increased in the corrective diopter,deviation increases.The postoperative lens diopter of the general formulas was lower than actual lens diopter,Haigis-L had a higher prediction.The clinical history method could reduce the error of the general formulas,but its reliability was poor.Conclusions Haigis-L is worthy of choice,it is calculated by measuring postoperative data.Clinical history method can be used as a reference.