CN113576750A - Incision adjusting method and device for assisting cataract surgery - Google Patents

Incision adjusting method and device for assisting cataract surgery Download PDF

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CN113576750A
CN113576750A CN202110881338.2A CN202110881338A CN113576750A CN 113576750 A CN113576750 A CN 113576750A CN 202110881338 A CN202110881338 A CN 202110881338A CN 113576750 A CN113576750 A CN 113576750A
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astigmatism
incision
axis
postoperative
target
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李晶
马乾天
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/0016—Operational features thereof
    • A61B3/0025—Operational features thereof characterised by electronic signal processing, e.g. eye models
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/1005—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring distances inside the eye, e.g. thickness of the cornea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/103—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining refraction, e.g. refractometers, skiascopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/103—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining refraction, e.g. refractometers, skiascopes
    • A61B3/1035—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining refraction, e.g. refractometers, skiascopes for measuring astigmatism
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/107—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining the shape or measuring the curvature of the cornea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/18—Arrangement of plural eye-testing or -examining apparatus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F17/00—Digital computing or data processing equipment or methods, specially adapted for specific functions
    • G06F17/10—Complex mathematical operations
    • G06F17/15—Correlation function computation including computation of convolution operations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides

Abstract

The invention discloses an incision adjusting method and device for assisting cataract surgery, wherein the method comprises the following steps: step (1): acquiring preoperative eye parameters; step (2): obtaining target astigmatism after operation by a vector analysis method; and (3): performing auxiliary correction on the degree and axial position of postoperative target astigmatism by using a BarrettTorcicalculation formula; the present invention can recommend an optimal surgical incision location.

Description

Incision adjusting method and device for assisting cataract surgery
Technical Field
The invention relates to the technical field of astigmatism treatment, in particular to an incision adjusting method and device for assisting cataract surgery.
Background
At present, cataract is the first blinding eye disease worldwide, and surgery is the only effective treatment method at present. In recent years, with the increasing improvement of cataract extraction technology and the application of various novel functional IOLs in clinic, patients have higher requirements on the visual quality after cataract extraction, including postoperative naked eye vision, aphakia rate and the like. Therefore, cataract extraction has moved from the age of blind surgery to the age of refractive surgery.
However, the cataract surgeons mostly select the position of the surgical incision according to their own habits, and usually make the main incision at the positions of 120-.
Therefore, how to provide an incision adjustment method for assisting cataract surgery, which can solve the above problems, is a problem to be solved by those skilled in the art.
Disclosure of Invention
In view of this, the present invention provides an incision adjustment method and device for assisting cataract surgery, which calculate the postoperative target astigmatism at different surgical incision positions based on a vector analysis method and a Barrett Toric calibration formula, perform statistical analysis, and finally recommend an optimal surgical incision position.
In order to achieve the purpose, the invention adopts the following technical scheme:
an incision adjustment method for assisting cataract surgery, comprising:
step (1): acquiring preoperative eye parameters;
step (2): obtaining target astigmatism after operation by a vector analysis method;
and (3): and (3) carrying out auxiliary correction on the degree and the axis of the postoperative target astigmatism by using a Barrett Toric calibration formula.
Preferably, in step (3), the specific expression of the formula is:
Figure BDA0003192126090000021
in the formula, TresFor target postoperative astigmatism, TiolFor correcting astigmatic power, TprTo obtain post-operative residual astigmatism after application of the Toric IOL, the post-operative residual astigmatism axis was recorded as AprThe axis of corrected astigmatism (i.e. post-operative astigmatism axis) is denoted as Aiol。
Preferably, the preoperative ocular parameters include: eye axial length, anterior chamber depth, corneal flat axial and flat axial diopters, corneal steep axial and steep axial diopters, and preset incision location.
Preferably, the step (3) specifically comprises:
1) calculating the preoperative eye parameters obtained in the step (1) through a Barrettoric calibration formula, and then obtaining postoperative residual astigmatism degree T when the incision axis is 0 DEGprAnd axis AprToric IOL correctable corneal astigmatism TiolAnd axis Aiol；
2) Calculating target astigmatism after operation according to the formula in the step (3);
3) repeating the step 2) and the step 3) to obtain the postoperative target astigmatism of which the incision axis is positioned at each axis of 0-180 degrees, and forming a line graph.
Further, the present invention also provides an incision adjusting apparatus for assisting cataract surgery, comprising:
the eye parameter acquisition module is used for acquiring preoperative eye parameters;
the target astigmatism acquisition module is used for acquiring corresponding postoperative target astigmatism according to the preoperative ocular parameter;
and the PC processor is used for performing auxiliary correction on the incision according to the target astigmatism by using a Barrett Toric calibration formula on the degree and axial position of the postoperative target astigmatism.
Preferably, the target astigmatism obtaining module obtains the corresponding postoperative target astigmatism by adopting a vector analysis method.
According to the technical scheme, compared with the prior art, the incision adjusting method and device for assisting the cataract surgery are disclosed and provided, the postoperative target astigmatism of different surgical incision positions is calculated based on a vector analysis method and a Barrett Toric calibration formula, statistical analysis is carried out, and the optimal surgical incision position is recommended finally.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the provided drawings without creative efforts.
FIG. 1 is a schematic structural diagram of an incision adjustment device for assisting cataract surgery according to the present invention;
FIG. 2 is a line drawing of a notch location model provided by an embodiment of the invention.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
The embodiment of the invention discloses an incision adjusting method for assisting cataract surgery, which comprises the following steps:
step (1): acquiring preoperative eye parameters;
step (2): obtaining target astigmatism after operation by a vector analysis method;
and (3): and (3) carrying out auxiliary correction on the degree and the axis of the postoperative target astigmatism by using a Barrett Toric calibration formula.
In a specific embodiment, the step of obtaining preoperative ocular parameters in step (1) comprises: preoperative ocular parameters including ocular difference OD/OS, ocular axial length A, anterior chamber depth ACD, corneal plateau axial axis a1 and plateau axial diopter K were obtained by using IOLMASTER 500 or IOL Master 700 examination device from ZEISS, or Lenstar LS900 examination device from Haag-Streit1Steep axis a of cornea2And steep axis diopter K2。
In a specific embodiment, step (2) specifically includes:
A. the size and axial position of the astigmatism before operation are respectively CpreAnd ApreThe calculation formula is as follows,
Cpre＝K2k1 (original formula)
Apre＝a2
B. Calculating post-operative target astigmatism, C, by vector analysisSIAFor the magnitude of surgically-induced astigmatism, ASIAAxial position of surgically-induced astigmatism, CpostFor the postoperative target astigmatism magnitude, ApostObtaining incision axis A for postoperative target astigmatism axisSIAAt a certain value (when first calculated to be 0 deg., A)SIAThe range of (1) is 0-180 degrees), the size and axial position of the postoperative target astigmatism, and the calculation formula is as follows:
Xpre＝Cpre×cos(2×Apre)
Ypre＝Cpre×sin(2×Apre)
XSIA＝CSIA×cos(2×ASIA)
YSIA＝CSIA×sin(2×ASIA)
Figure BDA0003192126090000041
Xpost＝Xpre-XSIA
Ypost＝Ypre-YSIA
θ＝0.5×arctan(Ypost/Xpost+β)
such as Ypost≥0，Xpost＞0，Apost＝θ
Such as Ypost＜0，Xpost＞0，Apost＝θ+180°
Such as Xpost＜0，Apost＝θ+90°
Such as Ypost≥0，Xpost＝0，Apost＝180°
Such as Ypost＜0，Xpost＝0，Apost＝90°
In the formula, alpha and beta are correction parameters.
In a specific embodiment, in step (3), the specific expression of the formula is:
Figure BDA0003192126090000051
in the formula, TresFor target postoperative astigmatism, TiolFor correcting astigmatic power, TprTo obtain post-operative residual astigmatism after application of the Toric IOL, the post-operative residual astigmatism axis was recorded as AprThe axis of corrected astigmatism (i.e. post-operative astigmatism axis) is denoted as Aiol。
In a specific embodiment, step (3) specifically includes:
1) substituting the preoperative ocular parameters obtained in the step (1) into a Barrett Toxic Calculation formula on https:// ascrs.org/tools/Barrett-Toric-computer/website to obtain postoperative residual astigmatism degree T when the incision axis is 0 degreeprAnd axis AprToric IOL correctable corneal astigmatism TiolAnd axis Aiol；
2) Calculating target astigmatism after operation according to the formula in the step (3);
3) and (5) repeating the step (2) and the step (3) to obtain the postoperative target astigmatism of which the incision axis is positioned at each axis of 0-180 degrees, and forming a line graph.
Further, referring to fig. 1, an embodiment of the present invention further provides an incision adjusting apparatus for assisting cataract surgery, including:
an eye parameter obtaining module 11, configured to obtain preoperative eye parameters;
a target astigmatism obtaining module 12, configured to obtain corresponding postoperative target astigmatism according to the preoperative ocular parameter;
and the PC processor 13 is used for performing auxiliary correction on the incision according to the target astigmatism by using a Barrett Toric calibration formula on the degree and axial position of the postoperative target astigmatism.
Specifically, the ocular parameter acquiring module 11 may adopt iolmmaster 500 or IOL Master 700 examination equipment of ZEISS company, or LenstarLS900 examination equipment of hag-Streit company, and acquire preoperative ocular parameters including ocular difference OD/OS, ocular axis length a, anterior chamber depth ACD, corneal plateau axis a1And flat axis diopter K1Steep axis a of cornea2And steep axis diopter K2。
In a specific embodiment, the target astigmatism obtaining module 12 obtains the corresponding postoperative target astigmatism by using a vector analysis method.
Specifically, when the invention is used, one patient has 23mm of eye axis length, 3mm of anterior chamber depth, 40 ° of corneal flat axis position, 44D diopters, 130 ° of corneal steep axis position, 44.5D diopters and 0.5D astigmatism value induced by the operation of the operator, and the result of calculation by the software together with the above method is shown in fig. 2, and the result shows that: the size of the astigmatism of the cornea before the operation of the patient is 0.5D, the position of the operation incision is recommended to be selected to be 155 degrees or 160 degrees according to the results, the postoperative astigmatism of the patient is 0.13D, if the position of the operation incision is selected to be 10 degrees to 130 degrees, the astigmatism of the patient is obviously increased, and the position of a steep axis of the cornea is also seen to be 130 degrees, so that the postoperative astigmatism of the patient cannot be reduced by selecting 130 degrees.
The embodiments in the present description are described in a progressive manner, each embodiment focuses on differences from other embodiments, and the same and similar parts among the embodiments are referred to each other. The device disclosed by the embodiment corresponds to the method disclosed by the embodiment, so that the description is simple, and the relevant points can be referred to the method part for description.
The previous description of the disclosed embodiments is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the spirit or scope of the invention. Thus, the present invention is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.

Claims (6)

1. An incision adjustment method for assisting cataract surgery, comprising:
step (1): acquiring preoperative eye parameters;
step (2): obtaining target astigmatism after operation by a vector analysis method;
and (3): and (3) carrying out auxiliary correction on the degree and the axis of the postoperative target astigmatism by using a Barrett Toric calibration formula.
2. The incision adjustment method for assisting cataract surgery as claimed in claim 1, wherein in the step (3), the specific expression of the formula is:
Figure FDA0003192126080000011
in the formula, TresFor target postoperative astigmatism, TiolFor correcting astigmatic power, TprTo obtain post-operative residual astigmatism after application of the Toric IOL, the post-operative residual astigmatism axis was recorded as AprThe axis of corrected astigmatism (i.e. post-operative astigmatism axis) is denoted as Aiol。
3. The incision adjustment method for assisting cataract surgery as recited in claim 1, wherein the preoperative ocular parameters include: eye axial length, anterior chamber depth, corneal flat axial and flat axial diopters, corneal steep axial and steep axial diopters, and preset incision location.
4. The incision adjustment method for assisting cataract surgery as claimed in claim 2, wherein the step (3) specifically comprises:
1) calculating the preoperative eye parameters obtained in the step (1) through a Barrett Toric calibration formula, and then obtaining postoperative residual astigmatism degree T when the incision axis is 0 DEGprAnd axis AprToric IOL correctable corneal astigmatism TiolAnd axis Aiol；
2) Calculating target astigmatism after operation according to the formula in the step (3);
3) repeating the step 2) and the step 3) to obtain the postoperative target astigmatism of which the incision axis is positioned at each axis of 0-180 degrees, and forming a line graph.
5. An incision adjustment device for assisting cataract surgery, comprising:
the eye parameter acquisition module (11) is used for acquiring preoperative eye parameters;
a target astigmatism acquisition module (12) for acquiring corresponding postoperative target astigmatism according to the preoperative ocular parameter;
and the PC processor (13) is used for performing auxiliary correction on the incision according to the target astigmatism by using a Barrett Toric calibration formula on the degree and axial position of postoperative target astigmatism.
6. The incision adjustment apparatus for assisting cataract surgery as claimed in claim 2, wherein the target astigmatism obtaining module (12) obtains corresponding target astigmatism after surgery by using a vector analysis method.
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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1541610A (en) * 1995-06-07 2004-11-03 ŵ������A������ƽ˹ Device and method for evaluating surgical operation parameter for correcting astigmatism in the eye of a patient
CN105358096A (en) * 2013-08-07 2016-02-24 诺华股份有限公司 Surgical guidance and planning software for astigmatism treatment
US20190357980A1 (en) * 2018-05-22 2019-11-28 Carl Zeiss Meditec Ag Astigmatism correction
CN111796418A (en) * 2020-07-30 2020-10-20 杭州明视康眼科医院有限公司 Diopter calculation method of astigmatic intraocular lens (Toric IOL)

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1541610A (en) * 1995-06-07 2004-11-03 ŵ������A������ƽ˹ Device and method for evaluating surgical operation parameter for correcting astigmatism in the eye of a patient
CN105358096A (en) * 2013-08-07 2016-02-24 诺华股份有限公司 Surgical guidance and planning software for astigmatism treatment
CN107713980A (en) * 2013-08-07 2018-02-23 诺华股份有限公司 Surgical guidance and planning software for astigmatism treatment
US20190357980A1 (en) * 2018-05-22 2019-11-28 Carl Zeiss Meditec Ag Astigmatism correction
CN111796418A (en) * 2020-07-30 2020-10-20 杭州明视康眼科医院有限公司 Diopter calculation method of astigmatic intraocular lens (Toric IOL)

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
杨晓彤: "两种计算方法对Toric人工晶状体矫正效果的影响", 《中国优秀博硕士学位论文全文数据库（硕士） 医药卫生科技辑》 *

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