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Übereinstimmung subjektiver und objektiver Refraktionsmessungen nach INTRACOR-Femtosekundenlaser-Behandlung

Agreement of subjective and objective refraction measurements following INTRACOR femtosecond laser treatment

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Zusammenfassung

Hintergrund

Ziel dieser Studie war die Prüfung der Messgenauigkeit der Autorefraktion bei Patienten nach INTRACOR intrastromaler Femtosekundenlaser-Presbyopiebehandlung.

Patienten und Methode

Für die Studie wurden die Daten von 19 Patienten (mittleres Alter 56,5±6,0 Jahre) nach INTRACOR-Behandlung verwendet. Verglichen wurden Ergebnisse aus subjektiver Refraktion und Autorefraktion mittels Nidek-660A präoperativ und 12 Monate postoperativ in Miosis. Durch das INTRACOR-Verfahren entsteht mittels Femtosekundenlaser eine Serie von 5 konzentrischen Ringen innerhalb der Hornhaut, die eine Aufsteilung der zentralen Hornhaut bewirken und damit der Presbyopie entgegenwirken sollen.

Ergebnisse

Der Vergleich zwischen subjektiver Refraktion und Autorefraktion ergab prä- und postoperativ in der Sphäre und im sphärischen Äquivalent (SÄ) keine signifikanten Unterschiede (t-Test, p>0,05 und Wilcoxon-Test, p>0,05). Die Zylinderwerte der beiden Messverfahren waren signifikant unterschiedlich (t-Test, p<0,05). Die Übereinstimmung der beiden Messungen (Werte innerhalb ±0,5 dpt) war postoperativ in der Sphäre 89%, 100% im Zylinder und 68% im sphärischen Äquivalent. Mit einer Ausnahme lagen alle Patienten prä- und postoperativ in Sphäre, Zylinder und sphärischem Äquivalent innerhalb von ±1,25 dpt. Die Durchführung der Autorefraktion mittels Nidek-660A war leicht erschwert, und es musste bei einigen Patienten häufiger gemessen werden.

Schlussfolgerung

Insgesamt war die Übereinstimmung zwischen subjektiver Refraktion und objektiv mittels Nidek-660A gemessener Refraktion bei Patienten nach einer INTRACOR-Behandlung zufriedenstellend. Ein signifikanter Unterschied zeigte sich jedoch bei den gemessenen Zylinderwerten. Die Autorefraktometerwerte sollten daher immer mit einer subjektiven Refraktion abgeglichen und hinterfragt werden.

Abstract

Background

The goal of this study was to determine the accuracy of autorefraction measurements in patients after INTRACOR intrastromal femtosecond laser treatment of presbyopia by comparing the agreement between the subjective and objective refraction.

Patients and methods

In this study the data of 19 patients with a mean age of 56.5±6.0 years following INTRACOR treatment were analyzed pre-operatively and 12 months postoperatively. Measurements of the subjective refraction and the results of the autorefractor Nidek-660A in miosis were compared. INTRACOR is a refractive intrastromal femtosecond laser treatment to correct presbyopia. During the procedure a series of five concentric rings in the central stroma are cut which cause a change in the curvature of the cornea.

Results

The differences in sphere and spherical equivalent between subjective refraction and autorefraction were not significant (t-test p>0.05 and Wilcoxon test p>0.05). Comparing the cylinder of the two measurements a significant difference (t-test p<0.05) was found. Focusing on the difference of the postoperative measurements of the subjective refraction and autorefraction a correlation (within ±0.5 D) of 89% in the sphere, 100% in cylinder and 68% in the spherical equivalent was detected. With one exception the differences in sphere, cylinder and the spherical equivalent were within ±1.25 D. In several patients the performance of the autorefraction with the Nidek-660A was somewhat complicated and the measures had to be repeated frequently.

Conclusion

The agreement between subjective refraction and objective measurements of the Nidek-660A of patients following INTRACOR-treatment was good. However there was a significant difference in the cylinder values. Therefore thorough comparison of measurements obtained with the autorefractor and the subjective refraction is recommended.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: IVCRC wurde bei der Durchführung der Studie von Technolas Perfect Vision GmbH, München, unterstützt.

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Authors and Affiliations

  1. International Vision Correction Research Centre (IVCRC), Univ.-Augenklinik, INF 400, 69120, Heidelberg, Deutschland

    A. Fitting, A. Ehmer, T.M. Rabsilber, G.U. Auffarth &  M.P. Holzer

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  1. A. Fitting
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  2. A. Ehmer
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  3. T.M. Rabsilber
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  4. G.U. Auffarth
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  5. M.P. Holzer
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Correspondence to M.P. Holzer.

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Fitting, A., Ehmer, A., Rabsilber, T. et al. Übereinstimmung subjektiver und objektiver Refraktionsmessungen nach INTRACOR-Femtosekundenlaser-Behandlung. Ophthalmologe 108, 852–858 (2011). https://doi.org/10.1007/s00347-011-2398-6

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