比较新一代人工晶状体计算公式中使用和不使用可选变量对白内障手术预后的影响OACSTPCD
Comparison of the effects on cataract surgery with and without the utilization of optional parameters in the new generation intraocular lens calculation formulas
目的 应用新一代人工晶状体计算公式Emmetropia Verifying Optical(EVO)、Kane公式评估晶状体厚度(LT)和中央角膜厚度(CCT)这两个可选变量对白内障术后目标屈光度预测误差的影响.方法 回顾性病例对照研究.收集2021年7~12月在苏州大学附属第一医院进行白内障手术的203例(203只眼)连续白内障患者的资料进行回顾性分析.应用IOLMaster 700生物测量仪进行眼部生物参数的测量.人工晶状体度数应用EVO和Kane公式进行计算,首先使用所有变量进行计算,然后将可选变量逐个删除后进行计算.按照眼轴长度(AL)进行分组,比较不同情况下计算结果的差异及对术后目标屈光度预测误差的影响.结果 EVO、Kane公式显示出与BUII公式相似的预测误差分布范围.无论是EVO公式还是Kane公式,在忽略LT和同时忽略LT、CCT的情况下计算获得的目标屈光度平均绝对误差(MAE)值,与使用全部变量相比,差异均有统计学意义(均P<0.01).可选变量CCT在上述两个公式中几乎没有价值(当忽略CCT与全部变量相比平均绝对差异:EVO公式为0.01 D;Kane为0.03 D).当忽略LT和同时忽略LT、CCT时,可选变量对长AL眼(AL≥26 mm)的影响最小(平均绝对差异:EVO公式均为0.07 D;Kane公式均为0.05 D),而对短AL眼(AL≤22 mm)的影响最大(平均绝对差异:EVO公式均为0.24 D;Kane公式也均为0.24 D),当忽略LT和同时忽略LT、CCT时,在AL≤22 mm组中,MAE值≥0.50 D的眼百分比最高(66.7%).结论 可选变量CCT在EVO、Kane公式的计算后对白内障手术预后的影响几乎没有价值.使用部分可选变量或不使用可选变量对EVO、Kane公式进行计算时,对于较短AL的眼(AL≤22 mm),与使用全部可选变量相比,白内障手术后目标屈光度预测误差存在临床显著差异.相比之下,对于AL超过22 mm的眼睛,可选变量对术后目标屈光度的预测误差的影响并不重要.
Objective To evaluate the contribution of lens thickness(LT)and central corneal thickness(CCT)measurements to the prediction error of target refraction after cataract surgery using the Emmetropia Verifying Optical(EVO)and Kane formula.Methods A retrospective case-control study.Measurements taken with the intraocular lens(IOL)Master 700 swept-source biometry of 203 right eyes of 203 consecutive patients undergoing cataract extraction sur-gery in the First Affiliated Hospital of Soochow University from July to December 2021 were collected and analyzed.The IOL power was calculated using EVO and Kane formula,first through the inclusion of all measured variables and then by using partial biometry data.The patients were divided into groups according to the axial length(AL),and the differences in calculation results under different conditions and the influence on the prediction error of postoperative target refraction were compared.Results EVO and Kane formulas showed similar prediction error distribution range to BUII formula.No matter EVO or Kane formula,the difference in MAE value of target refraction calculated under the condition of omitting LT,omitting LT and CCT at the same time were significant compared with all variables(P<0.01).The optional variable CCT had little value in the above two formulas(the mean absolute of all variables when omitting CCT compared with all variables:EVO formula was 0.01 D;Kane was 0.03 D).When omitting LT and omitting LT,CCT,the optional variables have the least impact in long AL eyes(AL≥26 mm)(mean absolute difference:EVO formula was 0.07 D;Kane formula was 0.05 D),while they have the greatest impact in short AL eyes(AL≤22 mm)(mean absolute difference:EVO for-mula was 0.24 D;Kane formula was also 0.24 D).When omitting LT and omitting LT,CCT,the percentage of eyes with MAE≥0.50 D in AL≤22 mm group was the highest(66.7%).Conclusions the optional variable CCT has little value on the prognosis of cataract surgery after the calculation of IOL power using EVO and Kane formula.When the EVO and Kane formulas are calculated with partial optional variables or without optional variables,for the eyes with short AL(AL≤22 mm),there is a clinically significant difference in the prediction error of target refraction compared with all optional vari-ables after cataract surgery.In contrast,for eyes with AL more than 22 mm,the effect of optional variables on the predic-tion error of postoperative target refraction is not so important.
李晨
215000 苏州,苏州大学附属第一医院眼科
人工晶状体计算EVO公式Kane公式白内障手术
Intraocular lens calculationEVO formulaKane formulaCataract surgery
《临床眼科杂志》 2024 (6)
481-486,6
评论