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基于新型光学生物测量仪的人工晶状体屈光度数计算公式准确性比较

Comparison of the accuracy of intraocular lens power calculation formulas based on the new swept-source optical coherence tomography biometry

摘要目的:比较基于IOLMaster 700新型扫频光学生物测量仪的6个人工晶状体(IOL)屈光度数计算公式的准确性。方法:回顾性系列病例研究。收集2018年11月至2019年11月在温州医科大学附属眼视光医院杭州院区接受白内障摘除手术前曾行IOLMaster 700检查的白内障患者599例(599只眼)临床资料,其中男性208例,女性391例,年龄(69±10)岁。根据眼轴长度分为短眼轴组(≤22.5 mm,100只眼)、正常眼轴组(>22.5 mm且<25.5 mm,375只眼)及长眼轴组(≥25.5 mm,124只眼);根据角膜屈光力分为平坦组(≤42.00 D,47只眼)、正常组(>42.00 D且<46.00 D,461只眼)及陡峭组(≥46.00 D,91只眼);根据前房深度分为浅前房组(≤2.5 mm,71只眼)、正常前房组(>2.5 mm且<3.5 mm,436只眼)、深前房组(≥3.5 mm,92只眼)。比较整体及不同分组间Barrett Universal Ⅱ、Haigis、Hoffer Q、Holladay Ⅰ、Holladay Ⅱ和SRK/T公式计算的IOL屈光度数绝对预测误差中位数(MedAE)的差异。统计学分析主要采用Friedman检验。结果:599例患者(599只眼)6个公式间IOL屈光度数MedAE值差异有统计学意义(χ2=120.549, P<0.001),Barrett Universal Ⅱ公式的MedAE值最小(0.35 D),SRK/T公式次之(0.36 D),进一步两两比较显示除Barrett Universal Ⅱ与Haigis、SRK/T公式比较差异无统计学意义外(均 P=1.000),其余两公式间比较差异均有统计学意义(均 P<0.01)。不同眼轴分组中,6个公式间IOL屈光度数MedAE值差异均有统计学意义(χ2=38.307,38.779,112.997;均 P<0.01),Barrett Universal Ⅱ公式在短眼轴组及长眼轴组中MedAE值均最小,分别为0.40、0.31 D,SRK/T公式在正常眼轴组中MedAE值最小(0.35 D)。不同角膜屈光力分组中,6个公式间IOL屈光度数MedAE值差异均有统计学意义(χ2=12.284,90.924,39.387;均 P<0.05),Haigis公式在平坦组及陡峭组中的MedAE值最小,分别为0.26、0.34 D,Barrett Universal Ⅱ公式在正常组中的MedAE值最小(0.33 D)。不同前房深度分组中,6个公式间IOL的MedAE值差异均有统计学意义(χ2=37.389,57.643,52.845;均 P<0.01),Barrett Universal Ⅱ公式在前房深度各分组中的MedAE值均最小,分别为0.46、0.33、0.31 D。 结论:基于IOLMaster 700扫频光学生物测量仪,6个IOL屈光度数计算公式中Barrett Universal Ⅱ公式预测性最佳,尤其对于短眼轴、长眼轴及不同前房深度患者预测误差值低;Haigis、SRK/T公式次之。当角膜屈光力≤42.00 D或≥46.00 D时,Haigis公式可能更为准确。 (中华眼科杂志,2021,57:502-511)

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abstractsObjective:To compare the accuracy of 6 intraocular lens power calculation formulas based on the new swept-source optical coherence tomography biometry and to analyze the prediction error.Methods:Retrospective case series study. Clinical data were collected from 599 patients (599 eyes) who had underwent uncomplicated phacoemulsification and the IOLMaster 700 examination at the Eye Hospital of Wenzhou Medical University between November 2018 and November 2019. Among the patients, there were 208 males and 391 females with an age of (69±10) years. According to the axial length (AL), eyes were divided into the short AL group (≤22.5 mm, n=100), the normal AL group (>22.5 mm and<25.5 mm, n=375); and the long AL group (≥25.5 mm, n=124). Eyes were also grouped based on the mean keratometry (Km) as flat (≤42.00 D, n=47), normal (>42.00 D to<46.00 D, n=461), and steep (≥46.00 D, n=91), and by anterior chamber depth (ACD) as shallow (≤2.5 mm, n=71), normal (>2.5 mm to<3.5 mm, n=436), and deep (≥3.5 mm, n=92). The median absolute errors (MedAEs) of the Barrett Universal Ⅱ, Haigis, Hoffer Q, Holladay Ⅰ, Holladay Ⅱ, and SRK/T formulas in different AL, Km, and ACD groups were compared using the Friedman test. Results:The differences in MedAE among the 6 formulas of 599 patients (599 eyes) were statistically significant (χ2=120.549, P<0.001). The MedAE of the Barrett Universal Ⅱ formula was smallest (0.35 D), followed by the SRK/T formula (0.36 D). There was no significant difference between the MedAEs of the Barrett universal Ⅱ and Haigis, SRK/T formula (all P=1.000), but there were statistically significant differences among the other formulas (all P<0.01). In different AL groups, the MedAE of each formula was statistically different (χ2=38.307, 38.779, 112.997; all P<0.01).The Barrett Universal Ⅱ formula resulted in the lowest MedAE in the short AL group (0.40 D) and the long AL group (0.31 D). The MedAE of the SRK/T in the normal AL group was lowest (0.35 D). The 6 formulas showed significant differences in MedAE values in different Km groups (χ2=12.284, 90.924, 39.387; all P<0.05).The Haigis formula achieved the lowest MedAE in the flat Km group (0.26 D) and the steep Km group (0.34 D). The Barrett UniversalⅡ formula achieved the lowest MedAE in the normal Km group (0.33 D). The differences in MedAE values of the 6 formulas in different ACD groups were statistically significant (χ2=37.389, 57.643, 52.845; all P<0.01), and the MedAE values of the Barrett Universal Ⅱ in different ACD groups were smallest (0.46, 0.33, 0.31 D). Conclusions:The Barrett Universal Ⅱ formula perform the best over the entire AL range, followed by the Haigis and SRK/T formulas. The Barrett Universal Ⅱ formula result in the lowest prediction error in the short AL group, the long AL group, and all ACD groups. The Haigis formula may be more accurate when the Km was ≤42.00 D or ≥46.00 D. (Chin J Ophthalmol, 2021, 57: 502-511)

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中华眼科杂志

中华眼科杂志

2021年57卷7期

502-511页

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