四种人工晶状体计算公式对三联白内障玻璃体切除术后屈光状态预测准确性的临床研究  

The accuracy of four artificial lens calculation formulas in predicting refractive status after vitrectomy for triple cataract patients

作　　者：何渊[1] 万修华[1] 于楚瑶 朱静芬 赵世强[1] 宋旭东[1] 刘武[1] Yuan He;Xiuhua Wan;Chuyao Yu;Jingfen Zhu;Shiqiang Zhao;Xudong Song;Wu Liu(Beijing Tongren Eye Center,Beijing Tongren Hospital,Beijing Institute of Ophthalmology,Beijing Ophthalmology and Visual Sciences Key Laboratory,Capital Medical University,Beijing 100730,China;School of Public Health,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]首都医科大学附属北京同仁医院、北京同仁眼科中心、北京市眼科研究所、眼科学与视觉科学北京市重点实验室,100730 [2]上海交通大学医学院、公共卫生学院,200025

出　　处：《中华眼科医学杂志（电子版）》2024年第1期34-40,共7页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：北京市医院管理中心临床医学发展专项经费项目(XMLX202133)。

摘　　要：目的探讨BUⅡ、Kane、EVO 2.0及LSF等4种新型人工晶状体(IOL)计算公式对超声乳化白内障吸除联合后房型IOL植入、玻璃体切除及晶状体后囊膜切除三联手术后屈光状态预测的准确性。方法收集2021年9月至2022年10月期间在首都医科大学附属北京同仁眼科中心就诊的眼科患者104例(104只眼)。其中,男性26例(26只眼),女性74例(74只眼);年龄56~87岁,平均年龄(68.4±6.3)岁。根据所行手术方式不同将患者分为对照组和三联组。对照组患者行超声乳化白内障吸除联合后房型IOL植入术,三联组患者行超声乳化白内障吸除联合后房型IOL植入、玻璃体切除及晶状体后囊膜切除三联手术。使用BUⅡ公式计算两组患者IOL的屈光度,并计算Kane、EVO 2.0及LSF等3种IOL公式的预测结果。记录患者的年龄和性别,检测患者术眼手术前和术后1个月的最佳矫正视力(BCVA)、眼轴长度、角膜曲率,前房深度、晶状体厚度、水平角膜直径及植入IOL的屈光度,计算术后1个月两组患者的屈光误差(PE)、PE的标准差(SD)、平均绝对误差(MAE)及绝对误差中位数(MedAE);计算PE在±0.25 D、±0.50 D、±0.75 D及±1.00 D范围内的百分比,BUⅡ、Kane、EVO 2.0及LSF等4种公式的公式性能指数(FPI)。年龄、眼轴长度、角膜曲率,前房深度、晶状体厚度、水平角膜直径及植入IOL的屈光度等均符合正态分布,以±s表示,组间比较采用独立样本t检验,BCVA采用中位数和四分位间距描述,组间比较采用Mann-Whitney U检验。性别和眼别采用例数和百分比描述,组间比较采用卡方检验。ME值与零取值的比较采用单样本t检验。不同公式的MAE及MedAE采用Friedman test进行比较。PE在不同范围内百分比的比较采用Cochran Q检验。结果在对照组中,BUⅡ、LSF、Kane及EVO 2.0等4种公式的PE分别为(0.032±0.405)D、(0.056±0.389)D、(0.186±0.392)D及(0.197±0.395)D,在三联组分别为(-0.084±0.656)D、(-0.041Objective To explore the accuracy of four new intraocular lens(IOL)calculation formulas,including BUⅡ,Kane,EVO 2.0,and LSF,in predicting refractive status after phacoemulsification cataract extraction combined with posterior chamber IOL implantation,vitrectomy,and posterior capsule resection triple surgery.Methods A total of 104 ophthalmic patients(104 eyes)who visited the Beijing Tongren Eye Center affiliated with Capital Medical University from September 2021 to October 2022 were collected.Among them,there were 26 males(26 eyes)and 74 females(74 eyes)with an average age of(68.4±6.3)years(ranging from 56 to 87 years old).According to the surgical methods,they were divided into a control group and a triple group.The patients of control group underwent phacoemulsification cataract extraction combined with posterior chamber IOL implantation,while those of the triple group underwent phacoemulsification cataract extraction combined with posterior chamber IOL implantation,vitrectomy,and posterior capsule resection triple surgery.The diopter of IOL for all patients using the BUⅡformula and prediction results of Kane,EVO 2.0 and LSF were calculated,respectively.The patient′s age and gender was recorded,and the best corrected visual acuity(BCVA),axial length,corneal curvature,anterior chamber depth,lens thickness,horizontal corneal diameter,and refractive error of implanted IOL before an dafter surgery for 1 month were measured,and the refractive error(PE)of the two groups of patients at 1 month after surgery and the standard deviation(SD),mean absolute error(MAE),and median absolute error(MedAE)of PE and the percentage of PE within the range of±0.25 D,±0.50 D,±0.75 D,and±1.00 D,formula performance index(FPI)for BUⅡ,Kane,EVO 2.0,and LSF formulas were calculated.Age,axial length,corneal curvature,anterior chamber depth,lens thickness,horizontal corneal diameter,and refractive index of implanted IOL all followed a normal distribution,were expressed as±s and compared by independent sample t-test for inter grou

关 键 词：白内障 玻璃体切除术 后囊膜切开术 屈光误差 人工晶状体计算公式 

分 类 号：R779.66[医药卫生—眼科]