双眼序贯白内障手术后 2129 例患者中，初次眼预测误差改善了第二次眼屈光结果。
First eye prediction error improves second eye refractive outcome results in 2129 patients after bilateral sequential cataract surgery.
机构信息
Academic Unit of Ophthalmology, University of Bristol, Bristol Eye Hospital, Lower Maudlin Street, Bristol, United Kingdom.
出版信息
Ophthalmology. 2011 Sep;118(9):1701-9. doi: 10.1016/j.ophtha.2011.05.010. Epub 2011 Jul 16.
OBJECTIVE
To define theoretical correction factors for second-eye intraocular lens (IOL) power adjustment based on first eye refractive prediction error (PE).
DESIGN
Database study.
PARTICIPANTS
We included 2129 patients who underwent bilateral sequential phacoemulsification cataract surgery with the same IOL model.
METHODS
Retrospectively calculated PEs (Hoffer Q, Holladay 1, SRK/T) were analyzed for association between paired eyes, examining the effect of interocular differences in axial length (AL) and corneal power. A range of correction factors (CF) derived from the first eye PE were applied to the second eye PE using optimized and non-optimized IOL constants (IOLCs).
MAIN OUTCOME MEASURES
Second eye mean absolute error (MAE).
RESULTS
Prediction errors of paired eyes were correlated. Interocular corneal power differences exceeding 0.60 diopters (D) were associated with a weaker correlation but interocular AL differences did not affect the correlation. When a 50% CF was applied to second eyes of patients with a first eye PE between ±0.50 and ±1.50 D, it improved refractive outcomes from 30%, 56%, and 92% to 42%, 75%, and 96% within ±0.25 D, ±0.50 D and ±1.00 D, respectively, and reduced the MAE from 0.49 to 0.37 D (P<0.0001). For first eye PE below ±0.50 D, a 50% CF reduced the MAE from 0.32 to 0.30 D (P<0.00001). A 50% CF also reduces second eye MAE for eyes with nonoptimized IOLCs.
CONCLUSIONS
A 50% CF reduces second eye PE when either first eye optimized PE is within ±1.50 D or when nonoptimized IOLCs are used. The correlation is weaker when interocular corneal power differences are >0.60 D.
目的
基于第一只眼的屈光预测误差（PE），确定第二只眼人工晶状体（IOL）屈光力调整的理论校正因子。
设计
数据库研究。
参与者
我们纳入了 2129 例接受双侧序贯超声乳化白内障吸除术且使用相同 IOL 模型的患者。
方法
回顾性分析了 Hoffer Q、Holladay 1 和 SRK/T 等预测误差（PE），以评估双眼之间的相关性，同时检查眼轴（AL）和角膜曲率之间的眼间差异的影响。应用优化和非优化的人工晶状体常数（IOLC），从第一只眼的 PE 计算出一系列校正因子（CF），并将其应用于第二只眼的 PE。
主要观察指标
第二只眼的平均绝对误差（MAE）。
结果
配对眼的预测误差呈相关性。角膜曲率差异超过 0.60 屈光度（D）时相关性较弱，但眼轴差异不影响相关性。当对第一只眼的 PE 在±0.50 至±1.50 D 之间的患者的第二只眼应用 50%的 CF 时，在±0.25 D、±0.50 D 和±1.00 D 范围内，屈光结果分别从 30%、56%和 92%改善至 42%、75%和 96%，MAE 从 0.49 降至 0.37 D（P<0.0001）。对于第一只眼的 PE 低于±0.50 D，50%的 CF 可使 MAE 从 0.32 降至 0.30 D（P<0.00001）。50%的 CF 也可降低使用非优化 IOLC 的第二只眼的 MAE。
结论
当第一只眼的优化 PE 在±1.50 D 以内或使用非优化 IOLC 时，50%的 CF 可降低第二只眼的 PE。当眼间角膜曲率差异>0.60 D 时，相关性减弱。
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