不同人工晶状体屈光力计算公式在短眼轴白内障患者中准确性的荟萃分析  

Meta-analysis of the accuracy of different intraocular lens calculation formulas in cataract patients with short axial length

作　　者：王泠蓁 高铃 叶剑 Wang Lingzhen;Gao Ling;Ye Jian(Department of Ophthalmology,Army Medical Center of PLA(Daping Hospital),Chongqing 400042,China)

机构地区：[1]解放军陆军特色医学中心(大坪医院)眼科,重庆400042

出　　处：《中华眼科杂志》2025年第4期287-297,共11页Chinese Journal of Ophthalmology

摘　　要：目的系统评价不同人工晶状体(IOL)屈光力计算公式在短眼轴(≤22.5 mm)白内障患者中的预测准确性。方法荟萃分析。检索PubMed、Web of Science、Cochrane Library、Embase及中国知网数据库(建库至2023年8月),纳入比较≥2种IOL屈光力计算公式的病例对照研究。文献涉及12个IOL屈光力计算公式,包括Barrett UniversalⅡ、EVO、Haigis、HillRBF、Hoffer Q、Holladay 1、Kane、Olsen、PEARLDGS、SRK/T、T2、VRF。主要结局指标为预测误差在±0.25 D、±0.50 D、±1.00 D范围内的病例。由2名研究者独立筛选文献、提取数据并评估偏倚风险(QUADAS-2工具)。采用RevMan 5.3进行传统荟萃分析(固定和随机效应模型),Stata 14进行网状荟萃分析,以预测误差在±0.50 D、±1.00 D范围内的占比为主要指标。采用比值比(OR)及其95%置信区间(CI)对不同公式的预测误差进行对比评估。结果共纳入8项研究(785只眼)。传统荟萃分析显示,±1.00 D范围内Hoffer Q(93.4%;648/694)与Kane(95.7%;426/445)显著优于SRK/T(OR=1.50,95%CI:1.01~2.25,P=0.020;OR=2.00,95%CI:1.73~3.43,P=0.007),Kane优于T2(OR=2.09,95%CI:1.15~3.80,P=0.020);±0.50 D范围内PEARL-DGS优于SRK/T(OR=1.34,95%CI:1.00~1.80,P=0.050);±0.25 D范围内EVO(46.1%;94/204)占比最高,显著优于Hoffer Q(OR=0.62,95%CI:0.41~0.91,P=0.020)。网状荟萃分析(累积排序曲线下面积排序)表明,EVO(±0.50 D排名第1)、Kane(±1.00 D排名第1)综合表现最优,SRK/T各范围均最差(P<0.05)。结论传统光学折射公式中Haigis、Hoffer Q准确性较好,SRK/T不推荐使用;新一代公式(EVO、Kane)在短眼轴患者中预测精度更优,推荐临床优先选择。Objective To systematically evaluate the predictive accuracy of different intraocular lens(IOL)power calculation formulas in cataract patients with short axial length(≤22.5 mm).Methods This is a meta-analysis.Databases including PubMed,Web of Science,Cochrane Library,Embase,and CNKI(from the establishment of the database to August 2023)were searched,and case-control studies comparing≥2 IOL formulas were included.The literature involves 12 intraocular lens(IOL)power calculation formulas,including Barrett UniversalⅡ,EVO,Haigis,Hill RBF,Hoffer Q,Holladay 1,Kane,Olsen,PEARL DGS,SRK/T,T2,and VRF.The primary outcome measures were cases with prediction errors within the ranges of±0.25 D,±0.50 D,and±1.00 D.Two researchers independently screened the literature,extracted data,and evaluated the risk of bias(using the QUADAS-2 tool).Traditional meta-analysis(fixed/random-effect model)was performed using RevMan 5.3,and network meta-analysis was carried out using Stata 14.The proportion of predictive errors within the ranges of±0.50 D and±1.00 D were the main indicators.The odds ratio(OR)and its 95%confidence interval(CI)were used to compare and evaluate the predictive error situations of different formulas.Results A total of 8 studies(785 eyes)were included.Traditional meta-analysis showed that within the±1.00 D range,Hoffer Q(93.4%;648/694)and Kane(95.7%;426/445)were significantly better than SRK/T(OR=1.50,95%CI:1.01-2.25,P=0.020;OR=2.00,1.73-3.43,P=0.007).Kane was signifficantly better than T2(OR=2.09,1.15-3.80,P=0.020);within the±0.50 D range,PEARL-DGS was better than SRK/T(OR=1.34,1.00-1.80,P=0.050);within the±0.25 D range,EVO(46.1%;94/204)had the highest proportion and was significantly better than Hoffer Q(OR=0.62,0.41-0.91,P=0.020).Network meta-analysis(ranked by the area under the cumulative ranking curve)indicated that EVO(ranked first within±0.50 D)and Kane(ranked first within±1.00 D)had the best overall performance,and SRK/T was the worst in all ranges(P<0.05).Conclusion Among the traditional optica

关 键 词：白内障 轴长度 眼 晶体 人工 算法 屈光 眼 META分析 

分 类 号：R779.66[医药卫生—眼科]