目的:探究白内障患者人工晶状体(IOL)植入后Kappa角变化趋势及与IOL稳定性的关系。方法:选择2023-02/2024-01于我院接受IOL植入的白内障患者120例120眼为研究对象,其中左眼56眼,右眼64眼。比较手术前后眼科检查结果、Kappa角的分布,以...目的:探究白内障患者人工晶状体(IOL)植入后Kappa角变化趋势及与IOL稳定性的关系。方法:选择2023-02/2024-01于我院接受IOL植入的白内障患者120例120眼为研究对象,其中左眼56眼,右眼64眼。比较手术前后眼科检查结果、Kappa角的分布,以及术后不同时点Kappa角变化和IOL稳定性。Pearson相关及多重线性回归分析IOL旋转稳定性与各眼科检查指标的相关性。多元线性回归分析Kappa角与IOL稳定性的相关性并绘制变化趋势图。结果:术后Kappa角逐渐减小且减小程度逐渐降低(均P<0.05),IOL旋转度数也逐渐减小(P<0.05)。术后2 mo IOL旋转度数与术后1 d AL、LT、K1、K2、PD、Kappa角呈正相关(均P<0.05),与术后1 d ACD呈负相关(均P<0.05)。术后1 d AL、ACD、PD、Kappa角对IOL旋转度数产生显著影响(均P<0.05)。随着Kappa角增大,IOL旋转度数逐渐增大,即IOL稳定性逐渐降低(P<0.05)。结论:白内障患者IOL植入后Kappa角显著减小,前期减小幅度较大,而后趋于稳定,IOL稳定性随Kappa角的增大而降低。展开更多
Background and Objective:Refractive surgery has evolved significantly,with artificial intelligence(AI)offering new possibilities for enhancing patient selection,surgical planning,and postoperative outcome prediction.W...Background and Objective:Refractive surgery has evolved significantly,with artificial intelligence(AI)offering new possibilities for enhancing patient selection,surgical planning,and postoperative outcome prediction.While AI has demonstrated promising applications,its integration into clinical practice remains inconsistent due to challenges in data standardization,model interpretability,and regulatory concerns.This review examines the current applications,limitations,and future directions of AI in refractive surgery,with a focus on its role in laser vision correction(LVC)and phakic intraocular lens(IOL)implantation.Methods:A literature review was conducted using peer-reviewed studies published between January 2010 and October 2024,sourced from databases including Google Scholar,PubMed,Embase,and Web of Science.Studies were selected based on predefined inclusion criteria,covering AI applications in refractive surgery.A total of 33 key studies(16 on LVC and 17 on phakic IOLs)were analyzed,focusing on machine learning and deep learning techniques used for patient selection,surgical optimization,and complication prediction.Only English-language studies were included.Key Content and Findings:AI models utilizing structured tabular data,imaging,and multimodal inputs have demonstrated superior performance in predicting surgical outcomes and refining patient selection compared to traditional methods.Machine learning approaches such as random forests,extreme gradient boosting,and ensemble techniques,alongside deep learning architectures like convolutional neural networks and generative models,have improved risk assessment and surgical planning.In LVC,AI enhances ectasia risk assessment,keratoconus detection,and myopic regression prediction.In phakic IOL implantation,AI improves postoperative vault prediction,lens sizing,and refractive error estimation.Multimodal AI systems integrating imaging,textual data,and clinical parameters hold promise for more comprehensive patient evaluations.However,challenges such as data heterogeneity,limited external validation,and regulatory barriers hinder widespread clinical adoption.Conclusions:AI is transforming refractive surgery by enhancing precision,personalization,and patient safety.Its integration into clinical workflows has the potential to improve surgical outcomes and patient satisfaction.Future efforts should focus on advancing multimodal AI,improving model generalizability,and addressing ethical and regulatory challenges to fully harness AI’s potential in refractive surgery.展开更多
AIM: To evaluate the possible predisposing risk factors for late in-the-bag spontaneous IOL dislocations and to study the early surgical and visual outcomes of repositioning and exchange surgeries.METHODS: Medical and...AIM: To evaluate the possible predisposing risk factors for late in-the-bag spontaneous IOL dislocations and to study the early surgical and visual outcomes of repositioning and exchange surgeries.METHODS: Medical and surgical records of 39 eyes of 39 patients who underwent IOL repositioning or exchange surgery for dislocation between 2010 and 2018 were reviewed. Possible predisposing risk factors and some characteristics of late in-the-bag spontaneous IOL dislocations;outcomes of IOL repositioning and exchange surgeries, including visual acuity, refractive status before and after surgery and postoperative complications were evaluated.RESULTS: The predisposing factors for late in-the-bag spontaneous IOL dislocations were pseudoexfoliation [PEX;12/39(30.8%)], previous vitreoretinal surgery [7/39(17.9%)], axial myopia [3/39(7.7%)], both PEX and axial myopia [1/39(2.6%)], both previous vitreoretinal surgery and axial myopia [2/39(5.1%)] and uveitis (1/39(2.6%))The mean interval between cataract and dislocation surgery was 7.23 y, greater in PEX positive group(8.63 y). The mean best corrected visual acuity(BCVA) improved significantly after dislocation surgery(P<0.001) and also improved significantly after exchange surgery(P=0.001). The mean value of spherical equivalant decreased significantly after dislocation surgery(P=0.011), whereas corneal astigmatism increased but this difference was not significant after dislocation surgery and exchange surgery(P=0.191, P=0.074, respectively).CONCLUSION: The most prevelant risk factors for late inthe-bag spontaneous IOL dislocations are PEX, previous vitreoretinal surgery and axial myopia. In the management of IOL dislocations, exchange surgery with small corneal incision seemed effective with improved BCVA and safety with low postoperative complications.展开更多
目的比较A超与光学相干生物测量仪（IOLMASTER）测量低信噪比（signal to noise ratio，SNR）高度近视眼人工晶状体（intraocular lens，IOL）度数的精确性。方法对2015年3月至2016年2月间在我院行白内障超声乳化联合IOL植入手术并且眼...目的比较A超与光学相干生物测量仪（IOLMASTER）测量低信噪比（signal to noise ratio，SNR）高度近视眼人工晶状体（intraocular lens，IOL）度数的精确性。方法对2015年3月至2016年2月间在我院行白内障超声乳化联合IOL植入手术并且眼轴长度大于26mm的高度近视患者57例（69眼）进行回顾性研究。SNR≤2组11眼、SNR〉2～5组23眼、SNR〉5～10组20眼，无法用IOLMASTER检出的病例设为A超测量组15眼。分别用IOLMASTER或接触式A超测算度数，计算公式采用HOLLADAY-1公式，并按各自方法植入同一类型IOL，术后3个月分别计算各组的平均绝对屈光误差值。结果SNR〉5～10组、SNR〉2～5组、SNR≤2组、A超测量组的绝对屈光误差值分别为（0．44±0．18）D、（0．46±0．26）D、（0．69±0．22）D、（O．81±0．29）D，其中SNR〉2～5组及SNR〉5～10组分别与其他2组比较，差异均有统计学意义（均为P〈0．05），而SNR〉2～5组与SNR〉5—10组以及SNR≤2组与A超测量组之间差异均无统计学意义（均为P〉0．05）。结论对于低SNR的高度近视眼患者，采用IOLMASTER测算IOL度数比传统A超方式具有更高的精确性。展开更多
文摘目的:探究白内障患者人工晶状体(IOL)植入后Kappa角变化趋势及与IOL稳定性的关系。方法:选择2023-02/2024-01于我院接受IOL植入的白内障患者120例120眼为研究对象,其中左眼56眼,右眼64眼。比较手术前后眼科检查结果、Kappa角的分布,以及术后不同时点Kappa角变化和IOL稳定性。Pearson相关及多重线性回归分析IOL旋转稳定性与各眼科检查指标的相关性。多元线性回归分析Kappa角与IOL稳定性的相关性并绘制变化趋势图。结果:术后Kappa角逐渐减小且减小程度逐渐降低(均P<0.05),IOL旋转度数也逐渐减小(P<0.05)。术后2 mo IOL旋转度数与术后1 d AL、LT、K1、K2、PD、Kappa角呈正相关(均P<0.05),与术后1 d ACD呈负相关(均P<0.05)。术后1 d AL、ACD、PD、Kappa角对IOL旋转度数产生显著影响(均P<0.05)。随着Kappa角增大,IOL旋转度数逐渐增大,即IOL稳定性逐渐降低(P<0.05)。结论:白内障患者IOL植入后Kappa角显著减小,前期减小幅度较大,而后趋于稳定,IOL稳定性随Kappa角的增大而降低。
文摘Background and Objective:Refractive surgery has evolved significantly,with artificial intelligence(AI)offering new possibilities for enhancing patient selection,surgical planning,and postoperative outcome prediction.While AI has demonstrated promising applications,its integration into clinical practice remains inconsistent due to challenges in data standardization,model interpretability,and regulatory concerns.This review examines the current applications,limitations,and future directions of AI in refractive surgery,with a focus on its role in laser vision correction(LVC)and phakic intraocular lens(IOL)implantation.Methods:A literature review was conducted using peer-reviewed studies published between January 2010 and October 2024,sourced from databases including Google Scholar,PubMed,Embase,and Web of Science.Studies were selected based on predefined inclusion criteria,covering AI applications in refractive surgery.A total of 33 key studies(16 on LVC and 17 on phakic IOLs)were analyzed,focusing on machine learning and deep learning techniques used for patient selection,surgical optimization,and complication prediction.Only English-language studies were included.Key Content and Findings:AI models utilizing structured tabular data,imaging,and multimodal inputs have demonstrated superior performance in predicting surgical outcomes and refining patient selection compared to traditional methods.Machine learning approaches such as random forests,extreme gradient boosting,and ensemble techniques,alongside deep learning architectures like convolutional neural networks and generative models,have improved risk assessment and surgical planning.In LVC,AI enhances ectasia risk assessment,keratoconus detection,and myopic regression prediction.In phakic IOL implantation,AI improves postoperative vault prediction,lens sizing,and refractive error estimation.Multimodal AI systems integrating imaging,textual data,and clinical parameters hold promise for more comprehensive patient evaluations.However,challenges such as data heterogeneity,limited external validation,and regulatory barriers hinder widespread clinical adoption.Conclusions:AI is transforming refractive surgery by enhancing precision,personalization,and patient safety.Its integration into clinical workflows has the potential to improve surgical outcomes and patient satisfaction.Future efforts should focus on advancing multimodal AI,improving model generalizability,and addressing ethical and regulatory challenges to fully harness AI’s potential in refractive surgery.
文摘AIM: To evaluate the possible predisposing risk factors for late in-the-bag spontaneous IOL dislocations and to study the early surgical and visual outcomes of repositioning and exchange surgeries.METHODS: Medical and surgical records of 39 eyes of 39 patients who underwent IOL repositioning or exchange surgery for dislocation between 2010 and 2018 were reviewed. Possible predisposing risk factors and some characteristics of late in-the-bag spontaneous IOL dislocations;outcomes of IOL repositioning and exchange surgeries, including visual acuity, refractive status before and after surgery and postoperative complications were evaluated.RESULTS: The predisposing factors for late in-the-bag spontaneous IOL dislocations were pseudoexfoliation [PEX;12/39(30.8%)], previous vitreoretinal surgery [7/39(17.9%)], axial myopia [3/39(7.7%)], both PEX and axial myopia [1/39(2.6%)], both previous vitreoretinal surgery and axial myopia [2/39(5.1%)] and uveitis (1/39(2.6%))The mean interval between cataract and dislocation surgery was 7.23 y, greater in PEX positive group(8.63 y). The mean best corrected visual acuity(BCVA) improved significantly after dislocation surgery(P<0.001) and also improved significantly after exchange surgery(P=0.001). The mean value of spherical equivalant decreased significantly after dislocation surgery(P=0.011), whereas corneal astigmatism increased but this difference was not significant after dislocation surgery and exchange surgery(P=0.191, P=0.074, respectively).CONCLUSION: The most prevelant risk factors for late inthe-bag spontaneous IOL dislocations are PEX, previous vitreoretinal surgery and axial myopia. In the management of IOL dislocations, exchange surgery with small corneal incision seemed effective with improved BCVA and safety with low postoperative complications.
文摘目的比较A超与光学相干生物测量仪（IOLMASTER）测量低信噪比（signal to noise ratio，SNR）高度近视眼人工晶状体（intraocular lens，IOL）度数的精确性。方法对2015年3月至2016年2月间在我院行白内障超声乳化联合IOL植入手术并且眼轴长度大于26mm的高度近视患者57例（69眼）进行回顾性研究。SNR≤2组11眼、SNR〉2～5组23眼、SNR〉5～10组20眼，无法用IOLMASTER检出的病例设为A超测量组15眼。分别用IOLMASTER或接触式A超测算度数，计算公式采用HOLLADAY-1公式，并按各自方法植入同一类型IOL，术后3个月分别计算各组的平均绝对屈光误差值。结果SNR〉5～10组、SNR〉2～5组、SNR≤2组、A超测量组的绝对屈光误差值分别为（0．44±0．18）D、（0．46±0．26）D、（0．69±0．22）D、（O．81±0．29）D，其中SNR〉2～5组及SNR〉5～10组分别与其他2组比较，差异均有统计学意义（均为P〈0．05），而SNR〉2～5组与SNR〉5—10组以及SNR≤2组与A超测量组之间差异均无统计学意义（均为P〉0．05）。结论对于低SNR的高度近视眼患者，采用IOLMASTER测算IOL度数比传统A超方式具有更高的精确性。
