Kern C, Kortüm K, Müller M, Kampik A, Priglinger S, Mayer W J
Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
J Ophthalmol. 2018 Jan 10;2018:2840246. doi: 10.1155/2018/2840246. eCollection 2018.
To compare two calculators for toric intraocular lens (IOL) calculation and to evaluate the prediction of refractive outcome.
Sixty-four eyes of forty-five patients underwent cataract surgery followed by implantation of a toric intraocular lens (Zeiss Torbi 709 M) calculated by a standard industry calculator using front keratometry values. Prediction error, median absolute error, and refractive astigmatism error were evaluated for the standard calculator. The predicted postoperative refraction and toric lens power values were evaluated and compared after postoperative recalculation using the Barrett calculator.
We observed a significant undercorrection in the spherical equivalent (0.19 D) by using a standard calculator ( ≤ 0.05). According to the Baylor nomogram and the refractive influence of posterior corneal astigmatism (PCA), undercorrection of the cylinder was lower for patients with WTR astigmatism, because of the tendency of overcorrection. An advantage of less residual postoperative SE, sphere, and cylinder for the Barrett calculator was observed when retrospectively comparing the calculated predicted postoperative refraction between calculators ( ≤ 0.01).
Consideration of only corneal front keratometric values for toric lens calculation may lead to postoperative undercorrection of astigmatism. The prediction of postoperative refractive outcome can be improved by using appropriate methods of adjustment in order to take PCA into account.
比较两种用于计算有晶状体眼人工晶状体（IOL）的计算器，并评估屈光结果的预测情况。
45例患者的64只眼接受了白内障手术，随后植入了一枚有晶状体眼人工晶状体（蔡司Torbi 709 M），该人工晶状体使用标准行业计算器根据角膜前表面曲率计测量值进行计算。对标准计算器的预测误差、平均绝对误差和屈光性散光误差进行评估。在术后使用巴雷特计算器重新计算后，对预测的术后屈光和有晶状体眼人工晶状体屈光度值进行评估和比较。
使用标准计算器时，我们观察到等效球镜有显著的欠矫（0.19 D）（P≤0.05）。根据贝勒列线图以及后角膜散光（PCA）的屈光影响，对于顺规散光患者，柱镜的欠矫程度较低，因为存在过矫的趋势。在回顾性比较计算器之间计算出的预测术后屈光时，观察到巴雷特计算器在术后残余等效球镜、球镜和柱镜方面具有优势（P≤0.01）。
仅考虑角膜前表面曲率计测量值来计算有晶状体眼人工晶状体可能会导致术后散光欠矫。通过使用适当的调整方法以考虑PCA，可以改善术后屈光结果的预测。
