Bristol Eye Hospital, Bristol, United Kingdom.
J Cataract Refract Surg. 2011 Jan;37(1):50-62. doi: 10.1016/j.jcrs.2010.07.037.
To assess the benefits of intraocular lens (IOL)-constant optimization for IOLMaster biometry on refractive outcomes after cataract surgery for all surgeons and individual surgeons, define acceptable levels of error in IOL-constant optimization, and calculate the minimum number of eyes required for IOL-constant optimization.
Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom.
Database study.
Hypothetical prediction errors were retrospectively calculated on prospectively collected data extracted from electronic medical records using manufacturers' and optimized IOL constants with Hoffer Q, Holladay 1, and SRK/T formulas for 2 IOLs. The acceptable IOL-constant optimization error margins, personalized IOL constants for individual surgeons, and minimum sample sizes for IOL-constant optimization were evaluated.
Optimization of IOL constants reduced the mean absolute errors from 0.66 diopters (D) and 0.52 D to 0.40 D and 0.42 D for the Sofport AO IOL and Akreos Fit IOL, respectively. The percentage of eyes within ±0.25 D, ±0.50 D, and ±1.00 D of target refraction improved from for both IOL models. The IOL-constant errors exceeding 0.09 for the Hoffer Q, 0.09 for the Holladay 1, and 0.15 for the SRK/T produced inferior outcomes. Differences in personalized IOL constants between most surgeons were clinically insignificant. Calculating IOL constants to within 0.06, 0.06, and 0.10 for the Hoffer Q, Holladay 1, and SRK/T, respectively, required 148 to 257 eyes.
Optimizing IOL constants for IOLMaster biometry substantially improved refractive outcomes, far exceeding any additional benefit of personalizing IOL constants for individual surgeons.
No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes.
评估白内障手术后所有外科医生和个别外科医生的 IOLMaster 生物测量中 IOL 常数优化对屈光结果的益处，确定 IOL 常数优化中可接受的误差水平，并计算 IOL 常数优化所需的最小眼数。
英国格洛斯特郡医院 NHS 基金会信托基金眼科。
数据库研究。
使用制造商提供的假设预测误差，从前瞻性收集的数据中回顾性计算，从电子病历中提取，并使用 Hoffer Q、Holladay 1 和 SRK/T 公式对 2 种 IOL 进行优化。评估可接受的 IOL 常数优化误差范围、个别外科医生的个性化 IOL 常数和 IOL 常数优化的最小样本量。
优化 IOL 常数将 Sofport AO IOL 和 Akreos Fit IOL 的平均绝对误差从 0.66 屈光度（D）和 0.52 D 分别降低到 0.40 D 和 0.42 D。两种 IOL 模型的目标屈光度的±0.25 D、±0.50 D 和±1.00 D 范围内的眼数百分比均有所提高。Hoffer Q 为 0.09、Holladay 1 为 0.09、SRK/T 为 0.15 的 IOL 常数误差超过 0.09 会产生较差的结果。大多数外科医生的个性化 IOL 常数之间的差异在临床意义上并不显著。Hoffer Q、Holladay 1 和 SRK/T 的 IOL 常数分别精确到 0.06、0.06 和 0.10 时，需要 148 至 257 只眼。
IOLMaster 生物测量中 IOL 常数的优化极大地改善了屈光结果，远远超过了为个别外科医生个性化 IOL 常数的任何额外益处。
