不同人工晶状体计算公式预测高度近视白内障术后屈光度的准确性比较  

Accuracy comparison of different intraocular lens formulas in predicting the postoperative diopter of high myopia cataract

作　　者：蔡金彪 王剑锋[1] 周琦[1] 李娟[1] 李娜[1] 许澈 郭娟娟 Cai Jinbiao;Wang Jianfeng;Zhou Qi;Li Juan;Li Na;Xu Che;Guo Juanjuan(Department of Ophthalmology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院第一附属医院眼科,233000

出　　处：《临床眼科杂志》2022年第3期200-205,共6页Journal of Clinical Ophthalmology

基　　金：蚌埠医学院自然科学重点课题(2020byzd141);蚌埠医学院研究生科研创新计划(Byycx20102)。

摘　　要：目的比较SRK/T、Haigis、Hoffer Q、Holladay 2、Barrett UniversalⅡ五种不同人工晶状体(IOL)度数计算公式预测高度近视白内障术后屈光度的准确性。方法前瞻性病例研究。选择白内障超声乳化吸除联合IOL植入术的患者50例(80只眼)。术前通过IOL Master 700检查,分别用五种IOL度数计算公式(SRK/T、Haigis、Hoffer Q、Holladay 2、Barrett UniversalⅡ)计算IOL度数,记录术前理论预测屈光度,术后随访3个月,用专业自动电脑验光仪测量术后实际屈光度数,屈光度数用等效球镜(SE=球镜+1/2柱镜)表示,计算术前预留与术后实际屈光度的差值的绝对值,即平均绝对误差(MAE)。根据眼轴长度(AL)将患者分为26 mm≤AL<28 mm(28只眼)、28 mm≤AL<30 mm(20只眼)、AL≥30 mm(32只眼)共3组,比较在不同AL组的MAE,计算每个公式的屈光误差在±0.25 D,±0.50 D,±1.00 D,1.50 D和±2.00D范围内的百分比。结果在全AL范围内整体误差Barrett Universal II公式MAE(0.46±0.39)D最低,屈光误差在±0.25D,±0.50 D,±1.00 D,1.50 D和±2.00 D范围内百分比均最高(30%、54%、92%、100%、100%),Haigis公式MAE为(0.59±0.56)D,屈光误差百分比为(27%、44%、77%、95%、100%),结果与Barrett Universal II结果相近(P>0.05),Hoffer Q公式表现最差(P<0.05),MAE为(1.00±0.80)D,屈光误差百分比为(17%、27%、50%、74%、90%)。Barrett Universal II公式在26 mm≤AL<28 mm组、28 mm≤AL<30 mm组、AL≥30 mm组MAE值分别为(0.30±0.25、0.56±0.55、0.55±0.32),其次为Haigis公式分别为(0.32±0.23、0.60±0.67、0.82±0.59),其结果与Barrett Universal II接近,SRK/T公式和Holladay 2公式的MAE偏高,Hoffer Q公式的MAE最高。相关性分析显示各公式的MAE与AL均呈正相关(P<0.001)。结论Barrett Universal II公式能更准确地预测高度近视白内障患者术后实际屈光度,且术后屈光状态最稳定,对于AL>30 mm的患者具有较高临床应用价值。Objective To compare the accuracy of five intraocular lens(IOL)including SRK/T,Haigis,Hoffer Q,Holladay 2,and Barrett Universal in predicting the postoperative diopter of high myopia cataract.Methods A prospective study.A total of 50 patients(80 eyes)who underwent phacoemulsification combined with intraocular lens implantation.The IOL degree was calculated by five formulas(SRK/T,Haigis,Hoffer Q,Holladay 2,and Barrett Universal AT),and the preoperative theoretical prediction of diopter was recorded.The postoperative follow-up was 3 months.The postoperative refractive diopter was measured with a professional automatic optometer,and the refractive diopter was expressed by spherical equivalent(SE=spherical lens+1/2 cylindrical lens).The absolute value of the difference between the pre-operative reserve and the actual refractive diopter after surgery was calculated,that is,mean absolute error(MAE).According to axial length(AL),the patients were divided into three groups:26 mm≤AL<28 mm(28 eyes),28 mm≤AL<30 mm(20 eyes),and AL≥30 mm(32 eyes).Then the MAE of different AL groups was compared,and the percentage that the absolute refractive error of each formula was in the scope of±0.25 D,±0.50 D,±1.00 D,±1.50 D and±2.00 D was calculated.Results The MAE of Barrett Universal II formula(0.46±0.39)D had the lowest in the three AL goups.The absolute value of refractive error in the range of±0.25 D,±0.50 D,±1.00 D,1.50 D and±2.00 D had the highest percentage(30%,54%,92%,100%,100%),which was close to the calculation results of Haigis formula(P>0.05).The MAE was 0.59±0.56D,and percentage of the absolute value of refractive error in the range of±0.25 D,±0.50 D,±1.00 D,1.50 D and±2.00 D was 27%,44%,76%,95%,100%.Hoffer Q formula had the worst performance(P<0.05).The MAE was 1.00±0.80 D,and the percentage of refractive error was(17%,27%,50%,74%,90%).Among different AL groups,the performance of Barrett Universal II formula MAE was the lowest(0.30±0.25,0.55±0.55,0.56±0.32,respectively),followed by Haigis formula(

关 键 词：高度近视 白内障 人工晶状体度数 计算公式 屈光误差 

分 类 号：R57[医药卫生—消化系统]