超高度近视白内障人工晶状体屈光度测算及目标屈光度的选择  

Analysis of intraocular lens power calculation and target refraction selection for cataract patients with superhigh axial myopia

作　　者：钱益勇[1] 张济明[1] 

机构地区：[1]苏州大学附属第一医院眼科,215006

出　　处：《中华眼外伤职业眼病杂志》2015年第12期907-910,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：苏州大学青年教师自然科学基金项目（Q3122030LO）

摘　　要：目的探讨轴性超高度近视白内障患者人工晶状体屈光度测算的影响因素及目标屈光度的选择。方法回顾性研究。2014年1月至2014年12月于苏州大学附属第一医院眼科行白内障超声乳化吸出联合人工晶状体植入术、眼轴长度〉29．0mm的轴性超高度近视白内障72例（84眼）。术前使用IOL？ Master进行生物测量，应用优化Haigis公式计算人工晶状体屈光度，并个性化选择患者目标屈光度。术后3个月计算平均绝对屈光度误差值（MAE）及患者满意度。结果术后3个月，MAE为（0．37±0．25）D，其中65眼（77．38％）〈0．50D，患者总体满意度为97．22％。若以A超测量眼轴结果计算人工晶状体屈光度，MAE为（1．52±0．59）D，与IOL Master测量眼轴计算结果（0．37±0．25）D相比，差异具有统计学意义（t=-18．137，P〈0．01）；若使用Haigis公式优化前人工晶状体常数计算，MAE为（0．90±0．35）D，与使用优化后常数计算结果（0．37±0．25）D相比，差异具有统计学意义（t=-24．300，P〈0．01）。结论对于轴性超高度近视白内障患者，应用光学相干生物测量仅进行术前测量、优化人工晶状体常数计算并个性化选择目标屈光度，则测算误差小、患者满意度高。Objective To investigate the factors that influence the intraocular lens （IOL） power calculation and selection of target refraction for cataract patients with superhigh axial myopia. Methods A retrospective study was done. From January 2014 to December 2014, 84 eyes of 72 patients of superhigh myopia with axial length greater than 29.0 mm who recieved phacoemulsifieation with IOL implantation at the First Affiliated Hospital of Soochow University were enrolled in this study. The preoperative biological measurements were performed by 1OL Master, and the IOL power was determined with optimized Haigis formula. The personalized target refraction was selected. The mean absolute error （MAE） and patient satisfaction were evaluated 3 months after the operation. Results The MAE was （0.37 ± 0. 25 ） D, and 65 eyes （77.4%） were within an error of ± 0.50 D, and the rate of patient satisfaction was 97.2% three months after the operation. The MAE was （ 1.52 ± 0.59 ） D when the IOL power was calculated with axial length measured by A scan. The difference was statistically significant compared with that when the IOL power was calculated with axial length measured by IOL Master （t = - 18. 137, P 〈0. 01 ）. The MAE was （0.90 ± 0.35 ） D when the IOL power was calculated without using optimized Haigis formula, and the difference was statistically significant compared with that when the IOL power was calculated by optimized Haigis formula （ t = - 24. 300, P 〈 0. 01 ）. Conclusion For cataract patients with superhigh axial myopia, preoperative optical coherence biometry, optimized IOL power calculation and personalized target refraction selection are recommended which bring low IOL calculation error and high rate of patient satisfaction.

关 键 词：近视 轴性 超高度 白内障 晶状体 人工 生物测量 

分 类 号：R779.66[医药卫生—眼科]