Probability Model of the Inaccuracy of Residual Stromal Thickness Prediction to Reduce the Risk of Ectasia After LASIK Part I: Quantifying Individual Risk

角膜刀 激光手术 烧蚀 标准差 残余物 医学 光学 眼科 角膜磨镶术 角膜 数学 统计 算法 物理 内科学
作者
Dan Z. Reinstein,Sabong Srivannaboon,Timothy J. Archer,Ronald H. Silverman,Hugo Sutton,D. Jackson Coleman
出处
期刊:Journal of Refractive Surgery [Slack Incorporated (United States)]
卷期号:22 (9): 851-860 被引量:51
标识
DOI:10.3928/1081-597x-20061101-04
摘要

ABSTRACT PURPOSE: To measure the imprecision of microkeratome cuts, preoperative corneal pachymetry, and laser ablation depth and develop a statistical model to describe the probability of the residual stromal bed thickness (RST) after myopic LASIK being significantly thinner than predicted. METHODS: Preoperative corneal thickness, flap thickness, ablation depth, and RST were measured in 36 eyes by a prototype three-dimensional very high-frequency (VHF) 50 MHz digital ultrasound scanning device (<1.2 µm precision), precursor to the commercially available Artemis 2. All eyes had undergone LASIK with the Moria LSK-One microkeratome and the NIDEK EC-5000 excimer laser. Based on the statistically combined uncertainty (standard deviation) and bias (accuracy to intended value) of corneal thickness measurement, flap thickness, and ablation depth, a continuous probability function was devised describing the chance of obtaining an actual RST less than a specified "cut-off." The model was applied using the data collected from the cohort of eyes. The model was also applied using published flap thickness statistics on a series of microkeratomes. RESULTS: Precision (standard deviation) was 0.74 µm for VHF digital ultrasound measurement of pachymetry, 30.3 µm for Moria LSK-One flap thickness, and 11.2 µm for NIDEK EC-5000 ablation depth. Assuming negligible laser ablation depth bias, the model found the probability that the actual RST will be <200 µm given a target RST of 250 µm is 7.56% with the Moria LSK-One. The model applied to published flap statistics revealed a range of probabilities of leaving <200 µm given a target RST of 250 µm from <0.01% to 33.6%. CONCLUSIONS: The choice of microkeratome, laser, and pachymeter has a significant impact on the variation of the depth of keratectomy and thus on the risk of ectasia. This model together with high-precision microkeratomes, preoperative pachymetry, and knowledge of laser ablation precision would enable surgeons to determine the specific imprecision of RST prediction for individual LASIK cases and minimize the risk of ectasia. [J Refract Surg. 2006;22:851-860.]

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
脑洞疼应助伍思光采纳,获得10
1秒前
2秒前
2秒前
Lyn发布了新的文献求助10
2秒前
lizhen发布了新的文献求助10
4秒前
FashionBoy应助怕孤单的破茧采纳,获得10
4秒前
slj发布了新的文献求助10
5秒前
zpeng完成签到,获得积分10
6秒前
1区冲啊完成签到,获得积分10
7秒前
眨眨眼完成签到,获得积分20
8秒前
丘比特应助ZY采纳,获得10
9秒前
9秒前
贰鸟应助drzz采纳,获得10
10秒前
11秒前
11秒前
lizhen完成签到,获得积分10
12秒前
英俊的铭应助lalala采纳,获得10
13秒前
善学以致用应助jessiefuli采纳,获得10
13秒前
13秒前
打打应助认真跳跳糖采纳,获得10
13秒前
淡定荧完成签到,获得积分10
13秒前
随波逐流完成签到,获得积分10
14秒前
hhh发布了新的文献求助10
14秒前
YUMI发布了新的文献求助10
14秒前
14秒前
张部长发布了新的文献求助10
15秒前
善学以致用应助郭志倩采纳,获得10
15秒前
奥特超曼应助幽默贞采纳,获得10
16秒前
幸福大白发布了新的文献求助10
16秒前
xyx发布了新的文献求助10
16秒前
积极的誉发布了新的文献求助10
17秒前
Georges-09发布了新的文献求助10
18秒前
xn201120发布了新的文献求助10
18秒前
好好好发布了新的文献求助10
19秒前
小哈完成签到,获得积分20
20秒前
顾矜应助我的小宝贝采纳,获得10
20秒前
ioio发布了新的文献求助20
21秒前
22秒前
幸福大白发布了新的文献求助30
25秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989510
求助须知:如何正确求助?哪些是违规求助? 3531756
关于积分的说明 11254536
捐赠科研通 3270255
什么是DOI,文献DOI怎么找? 1804947
邀请新用户注册赠送积分活动 882113
科研通“疑难数据库(出版商)”最低求助积分说明 809176