角膜屈光手术后人工晶状体度数计算的误差及矫正

Error sources and correction of intraocular lens power calculation after corneal refractive surgery

如何准确计算角膜屈光手术后白内障患者的人工晶状体（intraocularlens，IOL）度数是常见的临床问题。常规的IOL计算误差主要来源于仪器检测误差、屈光指数误差和公式计算误差，解决方法主要是通过矫正屈光术后角膜屈光度，或直接矫正IOL计算值来减小预测误差。各种方法的临床应用准确性仍存在一些争议，临床医生应根据自己掌握的资料、临床经验和患者的期望选择合适的计算方法。

As the increasing popularity of corneal refractive surgery and the aging of the society pop- ulation, it presents a major challenge in accurate calculation of intraocular lens （IOL） power in cataract pa- tients with prior refractive surgery. To cope with this situation, great efforts have been made to reveal the sources of calculation error and available corrective process. Essentially, the instrument error, the keratome- ter index error and the IOL formula error are considered to be the main three sources, whereas other biomet- ric measurements （e. g. axial length） contribute slightly. Numerous established algorithms aim to reduce IOL prediction error mainly through postoperative corneal power correction or direct adjustment of calculated IOL power. However, it presents a confusing of the variety of procedures and formulas for the controversy of optimal choice still going on, so it is important to make comprehensive consideration of reliable historic mate- rial, physician＇s experience, and patient＇ s expectation when faced with this issues clinically.