高度近视合并白内障患者后巩膜葡萄肿类型对白内障术后屈光误差的影响  

Effect of posterior staphyloma types on the postoperative refractive error in patients with high myopia and cataract

作　　者：刘灿 蒋紫园 徐方 向菁 刘芳[1,2] LIU Can;JIANG Ziyuan;XU Fang;XIANG Jing;LIU Fang(Chongming Branch of the Tenth People’s Hospital Affiliated to Tongji University,Shanghai 202150,China;The Tenth People’s Hospital Affiliated to Tongji University,Shanghai 200040,China)

机构地区：[1]同济大学附属第十人民医院崇明分院,上海市202150 [2]同济大学附属第十人民医院,上海市200040

出　　处：《眼科新进展》2023年第7期542-546,共5页Recent Advances in Ophthalmology

基　　金：上海市科委共享配套设备和应用项目研究(编号:20142203200);上海申康临床研究培育项目(编号:SHDC12019X30)。

摘　　要：目的 研究不同类型后巩膜葡萄肿(PS)对高度近视合并白内障患者术后屈光误差的影响,从而选择合适的计算方法减少因PS带来的术后屈光误差。方法 回顾性分析自2019年12月至2021年12月于同济大学附属第十人民医院行白内障摘除联合人工晶状体(IOL)植入术的高度近视合并白内障患者97例97眼,依据PS类型不同分为宽黄斑型PS组(A组)、窄黄斑型PS组(B组)和其他类型PS组(C组)。采用IOLMaster700系统中的5种IOL屈光度计算公式(Haigis、Holladay1、SRK/T、Holladay2和Barrett UniversalⅡ)预测各组患者的术后理论屈光度,并与术后3个月得到的实际屈光度进行比较,计算平均绝对屈光误差(MAE)。采用Bland-Altman法分析5种IOL屈光度计算公式对应的术后理论屈光度与术后3个月实际屈光度的一致性。结果 依据Haigis、Holladay1、SRK/T、Holladay2等4种IOL屈光度计算公式对术后3个月MAE进行预测,A组MAE最大,与B组和C组相比差异均有统计学意义(均为P<0.05),而依据Barrett UniversalⅡ公式在三组患者IOL屈光度计算中MAE差异无统计学意义(P>0.05);在A组患者中,依据Haigis、Holladay1、SRK/T、Holladay2和Barrett UniversalⅡ公式计算的术后3个月MAE分别为(0.61±0.38)D、(1.00±0.52)D、(0.62±0.53)D、(0.83±0.55)D、(0.32±0.30)D,其中Barrett UniversalⅡ公式偏差最小,Holladay1公式偏差最大,差异均有统计学意义(均为P<0.05);在B组和C组患者中,依据Holladay1公式计算的术后3个月MAE出现较大偏差,B组、C组患者MAE分别为(0.67±0.46)D、(0.58±0.40)D,并与依据Haigis、SRK/T、Holladay2、Barrett UniversalⅡ公式计算的术后3个月MAE相比差异均有统计学意义(均为P<0.05)。Bland-Altman分析结果表明,术后3个月实际屈光度与Barrett UniversalⅡ公式对应的术后理论屈光度一致性最好。结论 在窄黄斑型PS以及其他型PS患者中,术后MAE相对较小,但使用Holladay1公式会产生相对较大的MAE;而在宽黄�Objective To study the influence of different types of posterior staphyloma(PS)on the refractive error after high myopia and cataract surgery,so as to choose an appropriate calculation method to reduce the postoperative refractive error caused by PS.Methods In this study,clinical data of 97 patients(97 eyes)with high myopia and cataract who underwent phacoemulsification combined with intraocular lens(IOL)implantation from December 2019 to December 2021 in the Tenth People’s Hospital of Tongji University were retrospectively analyzed.According to the PS type,these patients were divided into group A(wide macular type),group B(narrow macular type),and group C(other types).Five IOL diopter calculation formulas(Haigis,Holladay1,SRK/T,Holladay2,and Barrett UniversalⅡ)in the IOLMaster 700 system were used to predict the postoperative diopters of patients in each group and compare them with the actual diopters obtained 3 months after surgery.The mean absolute error(MAE)of the diopters was calculated.The Bland\|Altman method was adopted to evaluate the consistency between the theoretical diopters predicted by the five IOL diopter formulas and the actual diopters obtained 3 months after surgery.Results The MAE was predicted with the Haigis,Holladay1,SRK/T,and Holladay2 formulas at 3 months after surgery,and it was the largest in group A,significantly higher than that in groups B and C(both P<0.05).However,the MAE predicted with the Barrett UniversalⅡformula showed no significant difference among the three groups(P>0.05).In group A,the MAE obtained by the Haigis,Holladay1,SRK/T,Holladay2,and Barrett Universal II formulas was(0.61±0.38)D,(1.00±0.52)D,(0.62±0.53)D,(0.83±0.55)D,and(0.32±0.30)D,respectively,among which the MAE obtained by the Barrett UniversalⅡformula showed the smallest deviation,and that obtained by the Holladay1 formula showed the largest deviation,and the difference was statistically significant(P<0.05).In groups B and C,the MAE obtained by the Holladay1 formula at 3 months after surgery showed

关 键 词：后巩膜葡萄肿 屈光误差 人工晶状体 高度近视 Barrett UniversalⅡ公式 

分 类 号：R778[医药卫生—眼科]