International Medicine and Health Guidance News ›› 2025, Vol. 31 ›› Issue (9): 1461-1465.DOI: 10.3760/cma.j.cn441417-20241114-09011

• New Medical Advances • Previous Articles     Next Articles

Advances in intraocular lens refractive power calculation for cataract surgery following radial keratotomy 

Zhi Danlin1, Huo Chaokui1,2, Lu Jianmei1, Xia Ruiqing1, Cheng Hao1,3, Cao Danmin1,3   

  1. 1 The First Clinical College, Guangzhou Medical University, Guangzhou 510000, China; 2 Department of Ophthalmology, The Fourth People's Hospital of Shenzhen, Shenzhen 518000, China; 3 Department of Ophthalmology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510000, China

  • Received:2024-11-14 Online:2025-05-01 Published:2025-05-20
  • Contact: Cao Danmin, Email: cdm1732@126.com
  • Supported by:

    Medical Science and Technology Research Foundation of Guangdong Province (A2024147); Research Capacity Improvement Program of Guangzhou Medical University (2024SRP057); Special Project Jointly Sponsored by Municipalities, Universities (Institutes), and Enterprises under the Basic Research Program (SL2024A03J01543)

放射状角膜切开术后白内障手术人工晶状体度数计算进展

植丹琳1  霍朝魁1,2  卢建梅1  夏瑞卿1  程浩1,3  曹丹敏1,3   

  1. 1广州医科大学第一临床学院,广州 510000;2深圳市第四人民医院眼科,深圳 518000;3广州医科大学附属第一医院眼科,广州 510000

  • 通讯作者: 曹丹敏,Email:cdm1732@126.com
  • 基金资助:

    广东省医学科学技术研究基金(A2024147);广州医科大学科研能力提升计划(2024SRP057);基础研究计划市校(院)企联合资助专题项目(SL2024A03J01543)

Abstract:

Radial keratotomy (RK) is a procedure in which a number of 4-24 non-penetrating radial release incisions (80%-90% depth) are made in the paracentral periphery outside the optical zone of the cornea, indirectly altering the curvature of the central cornea, resulting in a relative flattening of the central anterior surface of the cornea and a reduction in refractive power under intraocular pressure, and by varying the number and depth of the incisions, it is possible to correct myopia from 0-12 D. RK became a widely adopted surgical solution for myopia and astigmatism from the 1970s to the 1990s. However, refractive outcomes after RK are highly variable and are associated with many short- and long-term complications. Over time, the majority of patients undergoing RK have aged to the point of needing cataract surgery, and this group of patients is relatively young compared to conventional age-related cataract patients with relatively high expectations of post-cataract refractive accuracy. However, the change in corneal curvature after RK and the often irregular corneal surface make it difficult to measure preoperative cataract ocular biology and calculate intraocular lens (IOL) degrees. The proportion of refractive error ±0.5D after conventional cataract surgery is higher than that after RK. In this section, the reasons for the difficulty in calculating IOL after RK and the methods for calculating IOL after RK are discussed.

Key words:

Radial keratotomy, Cataract,  , Intraocular lens,  , Refractive power calculation

摘要:

放射状角膜切开术(radial keratotomy,RK)是一种在角膜光学区外的旁周边部做若干条(4~24条)非穿透性放射状松解切口(深度80%~90%),间接改变中央角膜曲率,在眼内压作用下使角膜中央前表面相对变平,屈光力降低,通过改变切口数量和深度,可以矫正0~12 D的近视。20世纪70年代到90年代,RK成为广泛采用的近视和散光手术解决方案。然而,RK术后屈光结果变化很大,并伴有许多短期和长期并发症。随着时间的推移,接受RK的患者中,大部分人已经老龄化,需要行白内障手术,这部分患者较常规老年白内障患者年纪轻,对于白内障术后的屈光准确性期望较高。然而,由于RK术后角膜曲率的改变以及角膜表面常不规则,给白内障术前眼部生物学测量和人工晶状体(intraocular lens,IOL)度数的计算带来困难,常规白内障术后屈光度±0.5D的比例高于RK术后。本文就RK术后IOL度数计算困难原因及计算方法展开阐述。

关键词:

放射状角膜切开术, 白内障, 人工晶状体, 屈光力计算