Kutschan A, Wiegand W
Abteilung für Augenheilkunde, Klinikum Nord/Heidberg, Hamburg.
Klin Monbl Augenheilkd. 2004 Sep;221(9):743-8. doi: 10.1055/s-2004-813385.
Optical biometry with the IOL-Master is an innovative technique that claims to improve the refractive results of cataract surgery compared to acoustical biometry.
In 140 consecutive non-selected eyes prior to cataract surgery firstly an optical biometry (IOL-Master, Zeiss, V.2.02) and secondly an ultrasound biometry (Sonomed) were carried out. Cataract surgery was performed using either a PMMA-IOL (n = 56) or an acrylic IOL (n = 84). The PMMA-IOL's were implanted in the capsular bag via a scleral tunnel. The acrylic-IOL's were implanted via a clear cornea incision in the capsular bag. The length of the globe was analysed and the deviations between the postoperative refraction after 3 month and the preoperative planned refraction were compared.
The mean axial length difference between optical biometry and acoustical biometry was 0.19 mm in the PMMA-lens group and 0.16 mm in the acrylic-lens group. The deviation of postoperative refraction (spherical mean) from the planned refraction was 0.46 +/- 0.88 D in the PMMA-IOL group and 0.25 +/- 0.77 D in the acrylic IOL group when biometry was performed by ultrasonography. When optical biometry was performed the respective values were 1.15 +/- 0.83 D in the PMMA-IOL group and 0.84 +/- 0.75 D in the acrylic IOL group. The differences in mean postoperative refraction of optical and acoustical biometry can be compensated by adaptation of the A constants. The standard deviation of the difference between the postoperative refraction and the preoperatively planned refraction - that means the individual deviations between postoperative refraction and preoperatively planned refraction - were almost identical in optical and acoustical biometry.
Optical biometry represents a significant simplification in the course of investigation prior to cataract surgery. The claim of optical biometry, however, to gain a higher precision and thus a significantly better prediction of individual postoperative refraction after cataract surgery is not yet fulfilled.
使用IOL-Master进行光学生物测量是一项创新技术，据称与声学生物测量相比，它能改善白内障手术的屈光效果。
在140例连续的、未经过挑选的白内障手术前的眼睛中，首先进行光学生物测量（IOL-Master，蔡司，V.2.02），其次进行超声生物测量（Sonomed）。白内障手术使用PMMA人工晶状体（n = 56）或丙烯酸人工晶状体（n = 84）进行。PMMA人工晶状体通过巩膜隧道植入囊袋内。丙烯酸人工晶状体通过透明角膜切口植入囊袋内。分析眼轴长度，并比较术后3个月的屈光与术前计划屈光之间的偏差。
在PMMA晶状体组中，光学生物测量与声学生物测量之间的平均眼轴长度差异为0.19mm，在丙烯酸晶状体组中为0.16mm。当通过超声检查进行生物测量时，PMMA人工晶状体组术后屈光（球镜平均值）与计划屈光的偏差为0.46±0.88D，丙烯酸人工晶状体组为0.25±0.77D。当进行光学生物测量时，PMMA人工晶状体组的相应值为1.15±0.83D，丙烯酸人工晶状体组为0.84±0.75D。光学和声学生物测量术后平均屈光的差异可通过调整A常数来补偿。术后屈光与术前计划屈光之间差异的标准差——即术后屈光与术前计划屈光之间的个体偏差——在光学和声学生物测量中几乎相同。
光学生物测量在白内障手术前的检查过程中代表了一种显著的简化。然而，光学生物测量所宣称的获得更高精度并因此显著更好地预测白内障手术后个体术后屈光的目标尚未实现。
