American journal of ophthalmology · 2026
Ablation-Guided K Measurements Improve the Accuracy of IOL Power Calculation After Clinically Decentered Myopic LASIK.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Zhang Min, Lin Peimin, Chen Tianhui, Chen Zexu, Miao Aizhu, Li Ruohong, Jiang Yongxiang
Аннотация
PURPOSES: Define clinical ablation decentration and construct personalized areas for K measurements to improve the accuracy of intraocular lens (IOL) power calculation after myopic laser in situ keratomileusis (LASIK).
DESIGN: Retrospective, observational case series.
METHODS: Ablation areas were delineated on smoothed corneal topographies (Pentacam AXL). Personalized areas for K measurements were constructed as the overlap between the corneal ablation area and a given apex-centered circle. K values were calculated on these personalized areas using the ring or zone method. Ablation decentration was evaluated by (1) index P: the percentage of the personalized area in the corresponding circle, and (2) index D: the distance from its maximum inscribed circle center to the corneal apex. Their absolute predictive errors (AE) were compared with those of IOLMaster-reported K in 60 cataract eyes from 48 patients with prior LASIK.
RESULTS: Ablation-guided K values derived from the 3.5 mm-diameter circle and the ring methods, namely K3.5ring, had the best predictive accuracy (Mean AE = 0.64D, Median AE = 0.47D). This method had better performance with smaller index P (ρ = -0.473, P = .006) and larger index D (ρ = 0.432, P = .014). Personalized areas with index P < 95.02% (P = .013) or index D ≥ 1.0975 mm (P = .007) showed greater accuracy improvements, and were defined as clinical ablation decentration.
CONCLUSIONS: This study developed a novel ablation-guided K measurement method for IOL calculation in eyes with clinically decentered myopic ablation. We also provide a ready-to-use tool (https://boluo-baba-ablation-guided-k-measurements.share.connect.posit.cloud) based on this method for clinical convenience.
DESIGN: Retrospective, observational case series.
METHODS: Ablation areas were delineated on smoothed corneal topographies (Pentacam AXL). Personalized areas for K measurements were constructed as the overlap between the corneal ablation area and a given apex-centered circle. K values were calculated on these personalized areas using the ring or zone method. Ablation decentration was evaluated by (1) index P: the percentage of the personalized area in the corresponding circle, and (2) index D: the distance from its maximum inscribed circle center to the corneal apex. Their absolute predictive errors (AE) were compared with those of IOLMaster-reported K in 60 cataract eyes from 48 patients with prior LASIK.
RESULTS: Ablation-guided K values derived from the 3.5 mm-diameter circle and the ring methods, namely K3.5ring, had the best predictive accuracy (Mean AE = 0.64D, Median AE = 0.47D). This method had better performance with smaller index P (ρ = -0.473, P = .006) and larger index D (ρ = 0.432, P = .014). Personalized areas with index P < 95.02% (P = .013) or index D ≥ 1.0975 mm (P = .007) showed greater accuracy improvements, and were defined as clinical ablation decentration.
CONCLUSIONS: This study developed a novel ablation-guided K measurement method for IOL calculation in eyes with clinically decentered myopic ablation. We also provide a ready-to-use tool (https://boluo-baba-ablation-guided-k-measurements.share.connect.posit.cloud) based on this method for clinical convenience.