Intraoperative Refraktionsmessung mit einem handgehaltenen Autorefraktometer

 

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Zusammenfassung

Hintergrund: Ziel der Studie war es, zu untersuchen, ob eine intraoperative Messung der objektiven Refraktion mittels eines handgehaltenen Retinomax eine genaue Vorhersage über die postoperativ zu erwartende Refraktion treffen kann. Material und Methoden: Bei Kataraktoperationen wurde am Ende der Operation eine objektive Refraktion im Liegen (mittels Retinomax) durchgeführt. Am 1. postoperativen Tag wurden die Messungen mit dem gleichen Gerät und einem Standardautorefraktometer wiederholt. Zur Auswertung wurde das sphärische Äquivalent (SE) und die Jackson-Kreuzzylinder bei 0° (J0) und 45° (J45) berechnet. Ergebnisse: 103 Augen, von denen 95 mit einer Standardkataraktoperation behandelt wurden, wurden eingeschlossen. Die Differenz des SE zwischen Retinomax am OP-Tag und objektivem Standgerät ergab 0,68 ± 2,58 dpt, die Differenz des J0 0,05 ± 1,4 dpt und die Differenz des J45 0,05 ± 1,4 dpt. Es fanden sich keine statistisch signifikanten Unterschiede zwischen den Gruppen. Schlussfolgerung: Die intraoperative Refraktionsmessung mittels Retinomax kann die postoperative Refraktion im Mittel sehr genau voraussagen. Bei einzelnen Patienten kam es jedoch zu starken Abweichungen.

Abstract

Purpose: The aim of this study was to evaluate an intraoperative measurement of objective refraction with a hand-held retinomax instrument. Methods: At the end of cataract surgery objective refraction in a lying position was measured with a retinomax instrument. On the first postoperative day the same measurement was performed with a retinomax and a standard autorefractometer. To evaluate the differences between measurements, the spherical equivalent (SE) and Jacksonʼs cross cylinder at 0° (J0) and 45° (J45) was used. Results: 103 eyes were included. 95 of them had normal cataract surgery. Differences between retinomax at the operative day and the standard autorefractometer were 0.68 ± 2.58 D in SE, 0.05 ± 1.4D in J0 and 0.05 ± 1.4D in J45. There were no statistically significant differences between the groups. Conclusion: Intraoperative measurement of the refraction with a retinomax can predict the postoperative refraction. Nevertheless, in a few patients great differences may occur.

• Literatur

• 1 Cordonnier M, Dramaix M. Screening for refractive errors in children: accuracy of the hand held refractor Retinomax to screen for astigmatism. Br J Ophthalmol 1999; 83: 157-161
  CrossrefPubMedGoogle Scholar
• 2 Paff T, Oudesluys-Murphy AM, Wolterbeek R et al. Screening for refractive errors in children: the plusoptiX S08 and the Retinomax K-plus2 performed by a lay screener compared to cycloplegic retinoscopy. J AAPOS 2010; 14: 478-483
  CrossrefPubMedGoogle Scholar
• 3 Ying GS, Maguire M, Quinn G et al. Vision In Preschoolers (VIP) Study Group. ROC analysis of the accuracy of noncycloplegic retinoscopy, Retinomax Autorefractor, and SureSight Vision Screener for preschool vision screening. Invest Ophthalmol Vis Sci 2011; 52: 9658-9664
  CrossrefPubMedGoogle Scholar
• 4 Cordonnier M, Dramaix M. Screening for abnormal levels of hyperopia in children: a non-cycloplegic method with a hand held refractor. Br J Ophthalmol 1998; 82: 1260-1264
  CrossrefPubMedGoogle Scholar
• 5 Thibos LN, Horner D. Power vector analysis of the optical outcome of refractive surgery. J Cataract Refract Surg 2001; 27: 80-85
  CrossrefPubMedGoogle Scholar
• 6 Leccisotti A. Intraoperative autorefraction for combined phakic intraocular lens explantation and cataract surgery. J Refract Surg 2007; 23: 931-934
  PubMedGoogle Scholar
• 7 Leccisotti A. Intraocular lens calculation by intraoperative autorefraction in myopic eyes. Graefes Arch Clin Exp Ophthalmol 2008; 246: 729-733
  CrossrefPubMedGoogle Scholar
• 8 Wong AC, Mak ST, Tse RK. Clinical evaluation of the intraoperative refraction technique for intraocular lens power calculation. Ophthalmology 2010; 117: 711-716
  CrossrefPubMedGoogle Scholar
• 9 Lombardo M, Lombardo G. New methods and techniques for sensing the wave aberrations of human eyes. Clin Exp Optom 2009; 92: 176-186
  CrossrefPubMedGoogle Scholar
• 10 Pesudovs K, Parker KE, Cheng H et al. The precision of wavefront refraction compared to subjective refraction and autorefraction. Optom Vis Sci 2007; 84: 387-392
  CrossrefPubMedGoogle Scholar
• 11 Reinstein DZ, Archer TJ, Couch D. Accuracy of the WASCA aberrometer refraction compared to manifest refraction in myopia. J Refract Surg 2006; 22: 268-274
  PubMedGoogle Scholar
• 12 Huelle JO, Katz T, Draeger J et al. Accuracy of wavefront aberrometer refraction vs. manifest refraction in cataract patients: impact of age, ametropia and visual function. Graefes Arch Clin Exp Ophthalmol 2013; 251: 1163-1173
  CrossrefPubMedGoogle Scholar
• 13 Chen M. Correlation between ORange (Gen 1, pseudophakic) intraoperative refraction and 1-week postcataract surgery autorefraction. Clin Ophthalmol 2011; 5: 197-199
  PubMedGoogle Scholar
• 14 Packer M. Effect of intraoperative aberrometry on the rate of postoperative enhancement: retrospective study. J Cataract Refract Surg 2010; 36: 747-755
  CrossrefPubMedGoogle Scholar