Journal of Optometry最新文献_第5页

Reply from the authors to: The correlation between relative peripheral refraction and myopia progression: A commentary on the utility of retinoscopy for peripheral refraction assessment 相对外周屈光与近视进展之间的相关性：视网膜镜对外周屈光评估的应用评论

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-05-07 DOI: 10.1016/j.optom.2025.100549

Maciej Perdziak , Krystian Prymula , Anna Przekoracka-Krawczyk

引用次数: 0

Retinal and choroidal microvasculature and structural analysis in OCTA for refractive amblyopia diagnosis using machine learning 利用机器学习诊断屈光性弱视的OCTA视网膜和脉络膜微血管及结构分析

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-05-06 DOI: 10.1016/j.optom.2025.100555

Xinlong Liu , Caihong Xue , Mengdi Li , Yatu Guo , Wei Zhang

Objective

To evaluate the features of retinal and choroidal microcirculation and structure in patients with amblyopia compared to healthy adolescents of the same age (>10 years old). To classify and diagnose amblyopia using machine learning techniques on optical coherence tomographic angiography (OCTA) images.

Methods

Nineteen adolescents aged 11–17 with hyperopic refractive amblyopia and 22 age-matched healthy controls underwent 12 × 12 mm macular OCTA scans. The eyes were classified into three groups: amblyopic, contralateral non-amblyopic, and control. Retinal thickness (RT), choroidal thickness (ChT), and perfusion densities in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were measured across nine regions. A combination of statistical analysis and machine learning, including cross-validation and Random Forest classification, was used to enhance the diagnostic accuracy and classify amblyopic and normal eyes.

Results

Retinal thickness was significantly higher in the amblyopic eyes compared to the control group in multiple regions, including the central (p < 0.001), nasal (p < 0.01), and temporal zones(p < 0.01). Choroidal thickness was also greater in the amblyopic eyes, particularly in the central and nasal regions (p < 0.05). However, no significant differences were observed in the perfusion densities of SCP and DCP. The machine learning classification model incorporating cross-validation achieved an accuracy of 92%, with Random Forest demonstrating improved classification and feature importance analysis.

Conclusion

The results indicate that eyes with refractive amblyopia have notably thicker retinal and choroidal layers, particularly in the central and nasal regions. Combining OCTA data with machine learning creates a strong diagnostic framework for detecting changes in the retina and choroid associated with refractive amblyopia. Utilizing sophisticated classification methods, like Random Forest and cross-validation, improves diagnostic precision and presents new possibilities for automated clinical evaluation.

目的比较弱视患者视网膜和脉络膜微循环及结构的特点，并与同龄（10岁）健康青少年进行比较。利用机器学习技术对光学相干断层血管造影（OCTA）图像进行分类和诊断弱视。方法对19例11 ~ 17岁的远视屈光性弱视青少年和22例年龄匹配的健康对照进行12 × 12 mm黄斑OCTA扫描。眼睛分为三组：弱视、对侧非弱视和对照组。测量9个区域的视网膜厚度（RT）、脉络膜厚度（ChT）以及浅毛细血管丛（SCP）和深毛细血管丛（DCP）的灌注密度。采用交叉验证、随机森林分类等统计分析与机器学习相结合的方法，提高诊断准确率，对弱视和正常眼进行分类。结果弱视组视网膜厚度明显高于对照组，包括中央(p <；0.001)，鼻腔(p <；0.01)，时间带(p <；0.01)。弱视眼的脉络膜厚度也更大，特别是在中央和鼻区(p <；0.05)。但SCP与DCP灌注密度无明显差异。结合交叉验证的机器学习分类模型达到了92%的准确率，其中Random Forest展示了改进的分类和特征重要性分析。结论屈光性弱视的视网膜和脉络膜层明显变厚，特别是在中部和鼻区。将OCTA数据与机器学习相结合，创建了一个强大的诊断框架，用于检测与屈光性弱视相关的视网膜和脉络膜的变化。利用复杂的分类方法，如随机森林和交叉验证，提高了诊断精度，并为自动临床评估提供了新的可能性。

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引用次数: 0

Letter to the editor: Prevalence of astigmatism among 99,515 children in different areas of Xi'an City, China 致编辑：中国西安市不同地区99515名儿童散光患病率

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-04-01 DOI: 10.1016/j.optom.2025.100548

Aleksandra Opala, Łukasz Kołodziejski, Iwona Grabska-Liberek

引用次数: 0

Postoperative visual outcomes with lenticule extraction in high myopia: a pilot study 摘出晶状体治疗高度近视的术后视力结果：一项初步研究

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-04-01 DOI: 10.1016/j.optom.2025.100553

Kishore Raj Pradhan , Samuel Arba Mosquera

Purpose

To evaluate the postoperative visual outcomes from day 1 to 1-year postoperative follow-ups after lenticule extraction in high myopia above −10D

Methods

A retrospective review identified 49 eyes treated with the SCHWIND ATOS using lenticule extraction for high myopia above −10D, with at least 6 months of follow-up. Standard visual and refractive outcomes, as well as astigmatism outcomes, were analyzed.

Results

At the last follow-up, 73 % of the eyes achieved uncorrected distance visual acuity (UDVA) of 20/25 or better. Additionally, 88 % of the eyes had postoperative UDVA within 1 line of preoperative corrected distance visual acuity (CDVA), with only 6 % of eyes losing 2 lines of CDVA. The postoperative spherical equivalent (−0.07±0.55D) was within 0.75D in 92 % of the cases, demonstrating excellent stability from 1-week to 1-year postoperative follow-ups (with only 10 % eyes changing by 0.5D of defocus). Postoperative refractive astigmatism (0.10±0.20D) was highly accurate, with 96 % of the cases within 0.5D and 93 % within 5 degrees of the attempted axis. The astigmatic correction index (1.02±0.28) showed 76 % of the cases within 10 % deviation.

Conclusions

In this pilot cohort, lenticule extraction using SCHWIND ATOS for high myopia above −10D is safe and effective. The procedure shows stability from 1-week to 1-year postoperative follow-ups and suggests accurate and precise corrections for both defocus and astigmatism.

目的评价- 10D以上高度近视晶状体摘除术后第1天至1年随访的视力情况。方法回顾性分析49例使用SCHWIND ATOS晶状体摘除治疗- 10D以上高度近视的患者，随访至少6个月。对标准视力和屈光结果以及散光结果进行分析。结果最后一次随访时，73%的眼未矫正距离视力（UDVA）达到20/25以上。此外，88%的眼睛术后UDVA在术前矫正距离视力（CDVA） 1线以内，只有6%的眼睛失去了2线的CDVA。在92%的病例中，术后球面等效（- 0.07±0.55D）在0.75D以内，在术后1周至1年的随访中表现出极好的稳定性（只有10%的眼睛发生0.5D的离焦变化）。术后屈光散光（0.10±0.20D）高度准确，96%的病例在0.5D范围内，93%的病例在尝试轴的5度范围内。像散校正指数（1.02±0.28）显示76%的病例误差在10%以内。结论在本试验队列中，SCHWIND ATOS用于−10D以上高度近视的晶状体摘除是安全有效的。术后随访1周至1年，该方法表现出稳定性，并建议对散焦和散光进行准确和精确的矫正。

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引用次数: 0

Reply to comment on: “Mean cycloplegic refractive error in emmetropic adults: The Tehran eye study” 回复对“正视性成人平均单眼麻痹性屈光不正：德黑兰眼科研究”的评论

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-04-01 DOI: 10.1016/j.optom.2025.100550

Jos J. Rozema , Rafael Iribarren

引用次数: 0

Insights into burnout among optometrists in the United States: findings from a nationwide survey 对美国验光师职业倦怠的洞察：一项全国性调查的结果

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-04-01 DOI: 10.1016/j.optom.2025.100552

Kaleb Abbott , Emily Auer , Neda Gioia , Karen DeLoss , Leonard Seibold , Jennifer Patnaik

Purpose

To determine the prevalence of burnout among optometrists in the United States and identify associated demographic and clinical factors.

Methods

A survey was distributed to optometrists via email listservs from the American Academy of Optometry and optometric societies. Participants completed a modified Mini Z Survey with 10 questions rated on Likert scale, followed by demographic questions. Burnout was classified as mild, moderate, or severe, with subgroup comparisons made using multinomial logistic regression.

Results

1436 optometrists responded. 53.6 % of respondents reported symptoms of burnout: 61.4 % mild, 30.4 % moderate, and 8.2 % severe. Females reported higher burnout rates than males (60.9 % vs. 40.6 %, p < 0.0001). Optometrists with a spouse/partner in healthcare reported lower burnout (47.7 %) compared to those without (55.3 %, p = 0.0035). Respondents with children reported less burnout (49.6 % vs. 61.0 %, p < 0.0001). Burnout was less prevalent among those practicing <5 years (51.1 %) and 30+ years (33.7 %) compared to mid-career (5–29 years). Average number of clinic days was associated with burnout severity. Electronic health record (EHR) use was associated with higher rates of burnout (p = 0.0040). Respondents in private practice and academic settings reported the lowest burnout rates.

Conclusions

Burnout is a significant concern among U.S. optometrists, with female optometrists disproportionately affected. Protective factors include male gender, having children, both shorter and longer commutes, and specific work settings. Risk factors include female gender, increased clinic days, higher patient volume, and EHR use. Future research should focus on longitudinal studies of burnout, intervention-based studies to evaluate mitigation strategies, and qualitative research to explore gender differences and work-related stressors in optometry.

目的确定美国验光师职业倦怠的发生率，并找出相关的人口和临床因素。方法通过美国验光学会和验光协会的电子邮件列表向验光师发放调查问卷。参与者填写了一份经修改的迷你 Z 调查表，其中包括 10 个以李克特量表评分的问题，然后是人口统计学问题。职业倦怠分为轻度、中度和重度，采用多项式逻辑回归法进行亚组比较。53.6%的受访者报告了职业倦怠症状：61.4%为轻度，30.4%为中度，8.2%为重度。女性报告的职业倦怠率高于男性（60.9% 对 40.6%，p < 0.0001）。有配偶/伴侣从事医疗保健工作的验光师报告的职业倦怠率（47.7%）低于没有配偶/伴侣的验光师（55.3%，p = 0.0035）。有子女的受访者倦怠感较低（49.6% 对 61.0%，p = 0.0001）。与职业生涯中期（5-29 年）相比，职业倦怠在从业 5 年（51.1%）和 30 年以上（33.7%）的受访者中发生率较低。平均门诊天数与职业倦怠的严重程度有关。电子健康记录（EHR）的使用与较高的职业倦怠率相关（p = 0.0040）。结论职业倦怠是美国验光师的一个重要问题，女性验光师受到的影响更大。保护因素包括男性性别、有子女、通勤时间较短和较长、特定的工作环境。风险因素包括女性性别、门诊天数增加、患者量增加以及电子病历的使用。未来的研究应重点关注职业倦怠的纵向研究、评估缓解策略的干预性研究，以及探索验光师性别差异和工作压力的定性研究。

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引用次数: 0

A novel large diameter rigid gas-permeable corneal contact lens design for keratoconus 一种新型圆锥角膜大直径刚性透气性角膜接触镜的设计

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-04-01 DOI: 10.1016/j.optom.2025.100547

Manel Larrosa, Núria Lupón, Joan Gispets, Genis Cardona

Purpose

To assess the fitting process and clinical feasibility of a novel large diameter rigid gas-permeable (RGP) corneal contact lens (CL) presenting regular or reverse geometry for managing keratoconus (KC). The lens was designed to rest on the peripheral cornea and vault over the cone, aiming to enhance visual quality, comfort, and corneal physiology.

Methods

32 KC patients across all severity stages, including central, paracentral and peripheral cones enrolled. Lens parameters were customized from corneal measurements obtained via Oculus Pentacam HR tomography, mainly based on sagittal height and accounting for adequate tear film clearance. Visual acuity (VA), contrast sensitivity (CS), ocular complications, and user satisfaction were evaluated at baseline, and at one week and three months of lens wear.

Results

Twenty-four patients (41 eyes) were fitted and completed the 3-month follow-up (median age of 28.5 years, 9 females). A median of 2 trial lenses per eye (interquartile range of 4.5) were needed during the fitting process. Significant improvements in median VA (baseline: 0.32 logMAR; three months: 0.01 logMAR; p = 0.002) and CS (p < 0.001 at all frequencies) were observed compared to baseline values. Ocular complications remained below clinical significance, with superior limbic keratoconjunctivitis showing significant reduction over time (p < 0.001). Patient satisfaction was high, with a median daily lens wear of 9.5 h. Most users (79.2%) reported consistent comfort with their CLs.

Conclusion

The novel large diameter RGP corneal CL demonstrated comparable efficacy to existing RGP CL designs, offering high levels of comfort and improved vision with minimal ocular complications.

目的探讨一种新型大直径刚性透气性角膜接触镜（RGP）在治疗圆锥角膜（KC）中的配戴过程及临床可行性。晶状体被设计为放置在周围角膜上，并在锥体上拱顶，旨在提高视觉质量、舒适度和角膜生理学。方法32例不同严重阶段的KC患者，包括中枢、旁中枢和外周锥体。镜片参数是根据Oculus Pentacam HR断层扫描获得的角膜测量数据定制的，主要基于矢状高度，并考虑到足够的泪膜间隙。视力（VA）、对比敏感度（CS）、眼部并发症和使用者满意度分别在基线、佩戴晶状体一周和三个月时进行评估。结果24例患者（41只眼）完成3个月的随访，中位年龄28.5岁，女性9例。在拟合过程中，每只眼睛需要2个试用镜片（四分位数间距为4.5）。中位VA显著改善(基线：0.32 logMAR；三个月：0.01 logMAR；p = 0.002)和CS (p <；与基线值相比，所有频率均为0.001)。眼部并发症仍然低于临床意义，随着时间的推移，上边缘角膜结膜炎明显减少(p <；0.001)。患者的满意度很高，平均每天的镜片佩戴时间为9.5小时。大多数用户（79.2%）报告他们的CLs一致舒适。结论新型大直径RGP角膜CL与现有的RGP CL设计具有相当的疗效，提供了高水平的舒适性和视力改善，眼部并发症最少。

{"title":"A novel large diameter rigid gas-permeable corneal contact lens design for keratoconus","authors":"Manel Larrosa, Núria Lupón, Joan Gispets, Genis Cardona","doi":"10.1016/j.optom.2025.100547","DOIUrl":"10.1016/j.optom.2025.100547","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the fitting process and clinical feasibility of a novel large diameter rigid gas-permeable (RGP) corneal contact lens (CL) presenting regular or reverse geometry for managing keratoconus (KC). The lens was designed to rest on the peripheral cornea and vault over the cone, aiming to enhance visual quality, comfort, and corneal physiology.</div></div><div><h3>Methods</h3><div>32 KC patients across all severity stages, including central, paracentral and peripheral cones enrolled. Lens parameters were customized from corneal measurements obtained via Oculus Pentacam HR tomography, mainly based on sagittal height and accounting for adequate tear film clearance. Visual acuity (VA), contrast sensitivity (CS), ocular complications, and user satisfaction were evaluated at baseline, and at one week and three months of lens wear.</div></div><div><h3>Results</h3><div>Twenty-four patients (41 eyes) were fitted and completed the 3-month follow-up (median age of 28.5 years, 9 females). A median of 2 trial lenses per eye (interquartile range of 4.5) were needed during the fitting process. Significant improvements in median VA (baseline: 0.32 logMAR; three months: 0.01 logMAR; <em>p</em> = 0.002) and CS (<em>p</em> < 0.001 at all frequencies) were observed compared to baseline values. Ocular complications remained below clinical significance, with superior limbic keratoconjunctivitis showing significant reduction over time (<em>p</em> < 0.001). Patient satisfaction was high, with a median daily lens wear of 9.5 h. Most users (79.2%) reported consistent comfort with their CLs.</div></div><div><h3>Conclusion</h3><div>The novel large diameter RGP corneal CL demonstrated comparable efficacy to existing RGP CL designs, offering high levels of comfort and improved vision with minimal ocular complications.</div></div>","PeriodicalId":46407,"journal":{"name":"Journal of Optometry","volume":"18 2","pages":"Article 100547"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of binocular summation ratio before and after vision training in patients with intermittent exotropia: A pilot prospective cohort study 间歇性外斜视患者视力训练前后的双眼综合比率评估：一项前瞻性队列研究

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-04-01 DOI: 10.1016/j.optom.2025.100542

Masoud Rostami , Mohammad Yaser Kiarudi , Mehdi Sharifi , Samira Hassanzadeh , Kasra Jafari

Purpose

To investigate the binocular summation ratio (BSR) in intermittent exotropia (IXT) before and after vision training under varying light conditions, and to evaluate its association with the control of deviation.

Methods

Twenty IXT patients were included in the study. Patients were divided into three groups based on their control of deviation: poor, fair, and good control. Contrast sensitivity was assessed using the CSV1000-HGT chart at four spatial frequencies, evaluated both monocularly and binocularly from a distance of 2.5 meters. This evaluation occurred under both photopic and mesopic lighting conditions, with and without glare. Additionally, the BSR for each patient was calculated before and after the vision training process.

Results

The mesopic BSR under glare-free conditions demonstrated a significant increase following vision training. In the presence of glare, the mesopic BSR significantly increased across all spatial frequencies: 3, 6, 12, and 18 cycles/degree. Additionally, after vision training, the photopic BSR in glare-free conditions also showed an increase at all frequencies. However, under glare conditions, the photopic BSR only increased at the frequencies of 3, 12, and 18 cycles/degree, but this increase was not statistically significant. A significant increase in the BSR was observed only at the frequency of 6 cycles/degree. Furthermore, following vision training, the degree of control over deviation improved significantly.

Conclusion

The BSR and deviation control scores in patients diagnosed with IXT demonstrated significant improvement following vision training, underscoring the efficacy of this treatment method in the management of IXT.

目的探讨不同光照条件下间歇性外斜视（IXT）患者视力训练前后的双眼总合比（BSR），并评价其与偏差控制的关系。方法选取20例IXT患者作为研究对象。根据偏差控制情况将患者分为控制差、控制一般、控制良好三组。使用CSV1000-HGT图表在四个空间频率下评估对比灵敏度，在2.5米的距离上进行单眼和双目评估。这种评价发生在光和介观照明条件下，有眩光和没有眩光。此外，在视力训练过程前后计算每位患者的BSR。结果无眩光条件下的中观BSR在视力训练后有明显提高。在强光下，介观BSR在3、6、12和18周期/度的空间频率上均显著增加。此外，经过视觉训练后，无眩光条件下的光性BSR在所有频率下也显示出增加。然而，在强光条件下，光性BSR仅在3、12和18 cycles/度频率下增加，但这种增加没有统计学意义。仅在6个周期/度的频率下观察到BSR的显著增加。此外，经过视觉训练后，对偏差的控制程度显著提高。结论经视力训练后，诊断为IXT患者的BSR和偏差控制评分均有显著改善，说明该治疗方法对IXT的治疗效果显著。

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引用次数: 0

Deep learning-based segmentation of OCT images for choroidal thickness 基于深度学习的脉络膜厚度OCT图像分割

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-04-01 DOI: 10.1016/j.optom.2025.100556

Raman Prasad Sah, Nimesh B. Patel, Hope M. Queener, Pavan K. Narra, Lisa A. Ostrin

Purpose

To develop and validate a custom deep learning-based automated segmentation for choroidal thickness of optical coherence tomography (OCT) scans.

Methods

An in-house automated algorithm was trained on a Deeplabv3+ network, based on ResNet50, using a training set of 10,798 manually segmented OCT scans (accuracy 99.25% and loss 0.0229). A test set of 130 unique scans was segmented using manual and in-house automated methods. For manual segmentation, the choroid-sclera border was delineated by the user. For in-house automated segmentation, all borders were automatically detected by the program and manually inspected. Bland-Altman analysis, intraclass correlation coefficient (ICC), and Deming regression compared the central 1-mm diameter and 3-mm and 6-mm annuli for the two methods. The in-house method was also compared with an open-source algorithm for the test set of 130 scans.

Results

Mean choroidal thicknesses obtained with manual and in-house automated methods were not significantly different for the three regions (P > 0.05 for all). The fixed bias between methods ranged from -2.41 to 3.49 µm. Proportional bias ranged from -0.04 to -0.12 (P < 0.05 for all). The two methods demonstrated excellent agreement across regions (ICC: 0.96 to 0.98, P < 0.001 for all). The open-source automated method consistently resulted in thinner choroidal thickness compared to manual and in-house automated methods.

Conclusions

Custom in-house deep learning automated choroid segmentation demonstrated excellent agreement and strong positive linear relationship with manual segmentation. The automated approach holds distinct advantages for estimating choroidal thickness, being more objective and efficient than the manual approach.

目的开发并验证一种基于深度学习的光学相干断层扫描（OCT）脉络膜厚度自动分割方法。方法内部自动算法在Deeplabv3+网络上进行训练，基于ResNet50，使用10,798个手动分割OCT扫描的训练集（准确率99.25%，损失0.0229）。使用手动和内部自动化方法对130个独立扫描的测试集进行了分割。对于人工分割，脉络膜-巩膜边界由用户划定。对于内部自动分割，所有边界都由程序自动检测并手动检查。Bland-Altman分析、类内相关系数（ICC）和Deming回归比较了两种方法的中心直径1 mm、3 mm和6 mm环空。对于130个扫描的测试集，还将内部方法与开源算法进行了比较。结果手工方法和内部自动方法获得的平均脉络膜厚度在三个区域无显著差异(P >；0.05)。方法间的固定偏差范围为-2.41 ~ 3.49µm。比例偏差范围为-0.04至-0.12 (P <；0.05)。两种方法在区域间表现出极好的一致性(ICC: 0.96 ~ 0.98, P <；0.001)。与手工和内部自动化方法相比，开源自动化方法始终导致脉络膜厚度更薄。结论自定义内部深度学习自动脉络膜分割与人工分割具有良好的一致性和强的正线性关系。自动方法在估计脉络膜厚度方面具有明显的优势，比人工方法更客观、更有效。

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引用次数: 0

Optimizing IOL calculation in triple-DMEK: Data from a real-life cohort 优化三dmek的人工晶状体计算：来自现实生活队列的数据

IF 2.2 Q2 OPHTHALMOLOGY

Journal of Optometry

Pub Date : 2025-04-01 DOI: 10.1016/j.optom.2025.100551

Natalia Lorenzana-Blanco, Gonzalo Velarde-Rodríguez, Sofía Corte-Alonso, Blanca García-Sandoval, Ignacio Jiménez-Alfaro, Nicolás Alejandre-Alba

Purpose

To enhance the accuracy of intraocular lens (IOL) power calculation in patients with Fuchs’ endothelial corneal dystrophy (FECD) undergoing simultaneous cataract surgery and Descemet membrane endothelial keratoplasty (triple-DMEK) by predicting corneal power changes.

Methods

Observational ambispective monocentric cohort study. A linear corneal change model (LCCM) was developed to predict corneal change from the preoperative corneal ratio (anterior/posterior radius). LCCM was validated by comparing prediction errors with the traditional IOL optimization method.

Results

97 eyes of 69 patients were analyzed. Preoperative keratometry was biometrically unmeasurable in 9 eyes, so manually entered autorefractometer data were used for IOL calculations and were analyzed separately. Mean absolute error (MAE) in the manual group (1.35 D (-1.04, 3.75)) was higher than the measured group (0.75 D (-0.62, 2.12)). The median change in simulated keratometry (SimK) was -0.21 ± 0.68 D and in total keratometry (TK) was -0.62 ± 1.09 D (p < 0.001). SRKT outperformed the rest with constant optimization (0.60 D (-0.53, 1.74)). LCCM showed similar MAE to the constant optimization method (p > 0.05). However, MAE for the optimization method was higher (2.08 D (1.77, 2.39)) than LCCM method (1.87 D (1.62, 2.12)).

Conclusions

SimK and TK change significantly after Triple-DMEK. The LCCM could reduce extreme refractive surprises by assisting surgeons in the individualized selection of the best IOL for each eye based on the expected corneal change. Study limitations include variability in FECD severity and the inherent limitations of biometric formulas applied to non-standard eyes. Further studies are recommended.

目的通过预测Fuchs角膜内皮性营养不良（FECD）患者同时行白内障手术和Descemet膜内皮角膜移植术（3dmek）时角膜度数变化，提高人工晶状体（IOL）度数计算的准确性。方法采用观察性双视角单中心队列研究。建立线性角膜变化模型（LCCM），从术前角膜比值（前/后桡骨）预测角膜变化。通过与传统人工晶状体优化方法的预测误差比较，验证了LCCM的有效性。结果对69例患者的97只眼进行了分析。术前有9只眼的角膜测量无法进行生物测量，因此使用人工输入的自动屈光计数据进行人工晶状体计算并单独分析。手工组的平均绝对误差（MAE）为1.35 D(-1.04, 3.75)，高于测量组（0.75 D(-0.62, 2.12)）。模拟角膜测量（SimK）的中位变化为-0.21±0.68 D，总角膜测量（TK）的中位变化为-0.62±1.09 D (p <；0.001)。SRKT在持续优化条件下的表现优于其他条件（0.60 D(-0.53, 1.74)）。LCCM的MAE与常数优化方法相似(p >；0.05)。然而，优化方法的MAE （2.08 D(1.77, 2.39)）高于LCCM方法（1.87 D(1.62, 2.12)）。结论Triple-DMEK术后simk和TK有明显变化。LCCM可以帮助外科医生根据预期的角膜变化为每只眼睛选择最佳的人工晶状体，从而减少极端的屈光意外。研究的局限性包括FECD严重程度的可变性和应用于非标准眼睛的生物识别公式的固有局限性。建议进一步研究。

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引用次数: 0