摘要目的:比较采用光学相干生物测量仪(IOLMaster)和接触式A超(AL-3000)联合角膜地形图(TMS-4)测量时,不同人工晶状体(IOL)计算公式预测的准确性.方法:前瞻性研究.选取2016年1月15日至2016年5月1日来我院行白内障超声乳化吸除联合后房型IOL植入术的白内障患者133例(133眼).术前使用IOLMaster以及AL-3000联合TMS-4进行眼轴长度(AL)、角膜曲率(K)以及前房深度(ACD)的测量,应用优化常数后的Haigis、Hoffer Q、Holladay I、SRK/T公式计算IOL度数.术后3个月行检影和主觉验光确定实际屈光结果.不同的公式和生物测量方法预测的准确性通过以下数据评估:平均误差、屈光误差的标准差、误差范围、平均绝对误差、中位绝对误差、平均绝对误差的95％置信区间和误差范围在±0.5 D、±1.0 D和±2.0 D的百分比.不同公式和测量方法间的比较采用方差同质检验(F检验).结果:使用IOLMaster测量的Haigis、Hoffer Q、Holladay I和SRK/T公式的标准差分别为0.468、0.591、0.613和0.624,Haigis公式与后3种公式比较差异有统计学意义(F=9.632,P=0.002;F=11.984,P=0.001;F=9.215,P=0.003).使用AL-3000联合TMS-4测量的标准差分别为0.580、0.624、0.642和0.700,Haigis公式与SRK/T公式比较差异有统计学意义(F=5.365,P=0.021).在AL≤22.0 mm组中,使用IOLMaster测量时,Haigis公式的标准差小于SRK/T公式,差异有统计学意义(F=7.071,P=0.012).在AL＞ 26.0 mm组中,使用IOLMaster测量时,Haigis公式的标准差小于SRK/T公式,差异有统计学意义(F=6.681,P=0.012);而Hoffer Q和HoHadayI公式分别产生0.44 D和0.43 D远视漂移.结论:使用IOLMaster测量的Haigis公式对于不同AL的患者均有较好的预测准确性.

abstractsObjective:To compare the prediction accuracy of intraocular lens (IOL) formulas using partial coherence interferometry (IOLMaster) and applanation ultrasound (AL-3000) assisted comeal topography (TMS-4).Methods:Eyes (n=133) undergoing phacoemulsification cataract surgery with posterior chamber IOL implantation in our hospital between January 15,2016 and May 1,2016 were studied proactively.Axial length (AL),K-value,and anterior chamber depth (ACD) were preoperatively measured using the IOLMaster,AL-3000,and TMS-4.Haigis,Hoffer Q,Holladay I,and SRK/T biometric formulas with optimized constants were used to calculate IOL power.Refractive outcomes were determined by streak retinoscopy and subjective manifest refraction 3 months after the surgeries.Formulas and biometers were evaluated by mean error,standard deviation (SD),range of error,mean absolute error,median absolute error,95％ confidence interval of mean absolute error,and percentage of eyes within ±0.5 diopter (D),±1.0 D,and ±2.0 D of prediction.F-tests were used to compare the results between formulas and biometers.Results:The SDs of the Haigis,Hoffer Q,Holladay I,and SRK/T formulas using IOLMaster were 0.468,0.591,0.613,and 0.624.The SDs of Hoffer Q,Holladay I,and SRK/T were significantly larger than that of Haigis (F=9.632,11.984,9.215,all P＜0.05).SDs of the AL-3000 assisted with TMS-4 were 0.580,0.624,0.642,and 0.700,respectively.The SD of SRK/T was significantly larger than that of Haigis (F=5.365,P=0.021).In short eyes,the SD of SRK/T was significantly larger than that of Haigis (F=7.071,P=0.012) using IOLMaster.In long axis eyes,the SD of SRK/T was significantly larger than that of Haigis (F=6.681,P=0.012) using IOLMaster,with hyperopic shifts of 0.44 D and 0.43 D in Hoffer Q and Holladay I.Conclusions:The Haigis formula with measurements using the IOLMaster was promising in eyes with all ranges of AL.