PDF(Pubmed)
Abstract：
UNASSIGNED: To determine the prevalence of subclinical keratoconus (SKCN) among individuals undergoing routine, uncomplicated age-related cataract surgery and its impact on visual and refractive outcomes.
UNASSIGNED: At a major academic ophthalmology department in the United States, we reviewed records of patients aged 50 years and older who underwent surgery from January 2011 to June 2022. We excluded patients who had poor-quality or unreliable tomographic data, previous corneal surgery, keratorefractive procedures, and significant vision-limiting ocular pathology. We defined SKCN if an eye had a Belin-Ambrósio enhanced ectasia index (BAD-D) ≥1.7, which was based on the results of a meta-analysis of large studies. In addition to the BAD-D cutoff, the eye had to deviate significantly on at least one of seven additional parameters: 1) posterior elevation at thinnest point, 2) index of vertical asymmetry, 3) index of surface variation, 4) total front higher order aberrations, 5) front vertical coma, 6) front secondary vertical coma, 7) back vertical coma. An individual had SKCN if at least one eye met the tomography-based classification and did not have manifest KCN in either eye. Visual and refractive outcomes data were acquired from patients of one experienced cataract surgeon with cases done from July 2021 to June 2022. Statistical significance was set at p < 0.05.
UNASSIGNED: Among 5592 eyes from 3828 individuals, the prevalence of SKCN was 24.7% (95% CI, 23.4 - 26.1, 945 individuals), and the prevalence of KCN was 1.9% (95% CI, 1.6 - 2.4, 87 individuals). The prevalence of SKCN did not increase with age and was more prevalent among females and non-white races. Median post-operative month one distance-corrected visual acuity (DCVA) and proportion of eyes with improvement in DCVA were similar between normal and SKCN eyes. The proportion of eyes reaching ±0.5 and ±1.0 diopter within the refractive target were similar between normal and SKCN eyes.
UNASSIGNED: SKCN is highly prevalent and should be detected but is unlikely to have a significant deleterious effect on outcomes in routine, uncomplicated cataract surgery.
UNASSIGNED: At a major academic ophthalmology department in the United States, we reviewed records of patients aged 50 years and older who underwent surgery from January 2011 to June 2022. We excluded patients who had poor-quality or unreliable tomographic data, previous corneal surgery, keratorefractive procedures, and significant vision-limiting ocular pathology. We defined SKCN if an eye had a Belin-Ambrósio enhanced ectasia index (BAD-D) ≥1.7, which was based on the results of a meta-analysis of large studies. In addition to the BAD-D cutoff, the eye had to deviate significantly on at least one of seven additional parameters: 1) posterior elevation at thinnest point, 2) index of vertical asymmetry, 3) index of surface variation, 4) total front higher order aberrations, 5) front vertical coma, 6) front secondary vertical coma, 7) back vertical coma. An individual had SKCN if at least one eye met the tomography-based classification and did not have manifest KCN in either eye. Visual and refractive outcomes data were acquired from patients of one experienced cataract surgeon with cases done from July 2021 to June 2022. Statistical significance was set at p < 0.05.
UNASSIGNED: Among 5592 eyes from 3828 individuals, the prevalence of SKCN was 24.7% (95% CI, 23.4 - 26.1, 945 individuals), and the prevalence of KCN was 1.9% (95% CI, 1.6 - 2.4, 87 individuals). The prevalence of SKCN did not increase with age and was more prevalent among females and non-white races. Median post-operative month one distance-corrected visual acuity (DCVA) and proportion of eyes with improvement in DCVA were similar between normal and SKCN eyes. The proportion of eyes reaching ±0.5 and ±1.0 diopter within the refractive target were similar between normal and SKCN eyes.
UNASSIGNED: SKCN is highly prevalent and should be detected but is unlikely to have a significant deleterious effect on outcomes in routine, uncomplicated cataract surgery.
摘要：
■为了确定接受常规治疗的个体中亚临床圆锥角膜（SKCN）的患病率，无并发症的年龄相关性白内障手术及其对视力和屈光结果的影响。
■在美国的一个主要学术眼科，我们回顾了2011年1月至2022年6月接受手术的50岁及以上患者的记录.我们排除了断层摄影数据质量差或不可靠的患者，以前的角膜手术，角膜屈光手术，和显著的视觉限制眼部病理。如果一只眼睛的Belin-Ambrósio增强扩张指数（BAD-D）≥1.7，我们定义了SKCN，这是基于大型研究的荟萃分析结果。除了BAD-D截止，眼睛必须在七个附加参数中的至少一个上发生显着偏离：1）最薄点的后高度，2)垂直不对称指数，3）表面变化指数，4）总前端高阶像差，5）前垂直昏迷，6）前二次垂直昏迷，7）背部垂直昏迷。如果至少一只眼睛符合基于断层摄影术的分类，并且两只眼睛都没有明显的KCN，则个体患有SKCN。视觉和屈光结果数据来自一位经验丰富的白内障外科医生的患者，病例从2021年7月至2022年6月。统计学显著性设定为p<0.05。
■在3828个人的5592只眼睛中，SKCN的患病率为24.7%(95%CI，23.4-26.1，945人)，KCN的患病率为1.9％（95％CI，1.6-2.4，87例）。SKCN的患病率不随年龄增长而增加，在女性和非白人种族中更为普遍。术后一个月的中位矫正视力（DCVA）和DCVA改善的眼睛比例在正常和SKCN眼睛之间相似。在正常和SKCN眼之间，屈光目标内达到±0.5和±1.0屈光度的眼睛比例相似。
■SKCN非常普遍，应该检测，但不太可能对常规结局产生重大有害影响，简单的白内障手术.
■在美国的一个主要学术眼科，我们回顾了2011年1月至2022年6月接受手术的50岁及以上患者的记录.我们排除了断层摄影数据质量差或不可靠的患者，以前的角膜手术，角膜屈光手术，和显著的视觉限制眼部病理。如果一只眼睛的Belin-Ambrósio增强扩张指数（BAD-D）≥1.7，我们定义了SKCN，这是基于大型研究的荟萃分析结果。除了BAD-D截止，眼睛必须在七个附加参数中的至少一个上发生显着偏离：1）最薄点的后高度，2)垂直不对称指数，3）表面变化指数，4）总前端高阶像差，5）前垂直昏迷，6）前二次垂直昏迷，7）背部垂直昏迷。如果至少一只眼睛符合基于断层摄影术的分类，并且两只眼睛都没有明显的KCN，则个体患有SKCN。视觉和屈光结果数据来自一位经验丰富的白内障外科医生的患者，病例从2021年7月至2022年6月。统计学显著性设定为p<0.05。
■在3828个人的5592只眼睛中，SKCN的患病率为24.7%(95%CI，23.4-26.1，945人)，KCN的患病率为1.9％（95％CI，1.6-2.4，87例）。SKCN的患病率不随年龄增长而增加，在女性和非白人种族中更为普遍。术后一个月的中位矫正视力（DCVA）和DCVA改善的眼睛比例在正常和SKCN眼睛之间相似。在正常和SKCN眼之间，屈光目标内达到±0.5和±1.0屈光度的眼睛比例相似。
■SKCN非常普遍，应该检测，但不太可能对常规结局产生重大有害影响，简单的白内障手术.
