基于全角膜屈光力计算角膜异常B/F值的白内障患者人工晶状体屈光力  

Calculation of Intraocular Lens Power in Cataract Patients with an Abnormal B/F Ratio Based on Total Corneal Refractive Power

作　　者：王世明[1] 文燕[2] 何志刚 Shiming Wang;Yan Wen;Zhigang He(Xiangshan Aier Eye Hospital,Ningbo 315000,China;Chongqing Aier Eye Hospital,Chongqing 400000,China)

机构地区：[1]象山爱尔眼科医院,宁波315000 [2]重庆爱尔眼科医院,重庆400000

出　　处：《中华眼视光学与视觉科学杂志》2020年第2期104-110,共7页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：爱尔眼科医院集团科研基金(AF1602D1)。

摘　　要：目的:研究基于全角膜屈光力(TCRP)的人工晶状体(IOL)屈光力计算公式计算异常角膜后前曲率半径比(B/F)值的白内障患者IOL屈光力的精确性。方法:前瞻性临床研究。连续选取角膜异常B/F值的白内障患者51例(51眼)。高B/F值组:B/F值≥85%,24例(24眼),B/F值为(86.2±0.5)%;低B/F值组:B/F值≤78%,27例(27眼),B/F值为(76.6±0.6)%。使用TCRP Method计算,角膜屈光力采用Pentacam测量的以瞳孔为中心,中央3 mm范围的区域性的TCRP,采用IOLMaster 500测量眼轴长度和前房深度。术后3个月行裸眼视力(UCVA,logMAR)、电脑验光检查。所有患者、高B/F值组、低B/F值组这3组,组内TCRP Method、Higis、Hoffer Q、SRK/T、HolladyⅠ公式的绝对预测误差(APE)总体比较采用非参数检验中的Friedman检验法。各组中TCRP Method的APE分别与Haigis、Hoffer-Q、SRK-T、Holladay-Ⅰ进行两两比较,采用Wilcoxon符号秩和检验。结果:术后3个月UCVA:高B/F值组为0.19±0.09,低B/F值组为0.19±0.08,2组间差异无统计学意义(t=0.787,P=0.435)。术后3个月采用TCRP Method计算的平均绝对误差(MAE):高B/F值组为(0.38±0.16)D,低B/F值组为(0.42±0.19)D。所有术眼术后3个月按照TCRP Method、Higis、Hoffer Q、SRK/T、HolladyⅠ公式计算的MAE分别为(0.40±0.17)D、(0.64±0.25)D、(0.73±0.27)D、(0.98±0.32)D、(0.84±0.25)D,5种公式的APE总体比较差异有统计学意义(χ^2=12.47,P=0.023)。进一步将TCRP Method的APE与Haigis、Hoffer Q、SRK/T、HolladayⅠ公式两两比较,差异均有统计学意义(Z=2.97、3.53、4.01、3.75,均P<0.05)。高B/F值组和低B/F值组:5种公式的APE总体比较,差异均有统计学意义(χ^2=12.35、13.21,均P<0.05)。结论:对于角膜异常B/F值的白内障患者,使用常规公式计算IOL屈光力的精确性较差,使用基于TCRP的IOL屈光力计算公式精确性高,术后视力佳。Objective:To research the accuracy of an intraocular lens(IOL)refractive power calculation formula based on total corneal refractive power(TCRP)in calculating the IOL refractive power in cataract patients with an abnormal B/F ratio.Methods:This was a prospective clinically study.Fifty-one cataract patients(51 eyes)with an abnormal corneal B/F ratio were selected consecutively.Patients were divided into two groups:A high B/F ratio group,B/F≥85%,24 patients(24 eyes),mean=86.2±0.5%;a low B/F ratio group,B/F≤78%,27 patients(27 eyes),mean=76.6±0.6%.The TCRP measured by the Pentacam(3 mm,pupil center,zone),the axial length(AL)and anterior chamber depth(ACD)measured by the IOLMaster 500 were used in the self-developed IOL refractive power calculation formula.Uncorrected distance visual acuity(logMAR)and optometric testing with a computer were performed 3 months after surgery.Results:The uncorrected visual acuity(UCVA)at 3 months after surgery was 0.19±0.09 in the high B/F ratio group and 0.19±0.08 in the low B/F ratio group.There was no significant difference between the two groups(t=0.787,P=0.435).The mean absolute error(MAE)at 3 months after surgery was 0.38±0.16 D in the high B/F ratio group and 0.42±0.19 D in the low B/F ratio group calculate by TCRP Method.Three months after surgery,the MAEs of all patients calculated by the TCRP Method,Higis,Hoffer Q,SRK-T,and Hollady-Ⅰformulas were 0.40±0.17 D,0.64±0.25 D,0.73±0.27 D,0.98±0.32 D and 0.84±0.25 D,respectively.The differences in the absolute prediction error(APE)of the five formulas were statistically significant(χ^2=12.47,P=0.023).Furthermore,the APE of the TCRP Method was compared with the Haigis,Hoffer-Q,SRK-T,and Holladay-Ⅰformulas,and the differences were statistically significant(Z=2.97,3.53,4.01,3.75,all P<0.05).The overall comparisons of the five formulas of the APE were statistically significant for the high B/F ratio group and low B/F ratio group(χ^2=12.35,P=0.037;χ^2=13.21,P=0.025).Conclusions:For cataract patients with an abnormal B

关 键 词：白内障 人工晶状体 屈光力计算 角膜后前曲率半径比 

分 类 号：R77[医药卫生—眼科]