Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
University of California, San Francisco, San Francisco, California.
Ophthalmology. 2021 Nov;128(11):e94-e114. doi: 10.1016/j.ophtha.2020.08.010. Epub 2020 Aug 13.
The refractive outcome of cataract surgery is influenced by the choice of intraocular lens (IOL) power formula and the accuracy of the various devices used to measure the eye (including intraoperative aberrometry [IA]). This review aimed to cover the breadth of literature over the previous 10 years, focusing on 3 main questions: (1) What IOL power formulas currently are available and which is the most accurate? (2) What biometry devices are available, do the measurements they obtain differ from one another, and will this cause a clinically significant change in IOL power selection? and (3) Does IA improve refractive outcomes? A literature review was performed by searching the PubMed database for articles on each of these topics that identified 1313 articles, of which 166 were included in the review. For IOL power formulas, the Kane formula was the most accurate formula over the entire axial length (AL) spectrum and in both the short eye (AL, ≤22.0 mm) and long eye (AL, ≥26.0 mm) subgroups. Other formulas that performed well in the short-eye subgroup were the Olsen (4-factor), Haigis, and Hill-radial basis function (RBF) 1.0. In the long-eye group, the other formulas that performed well included the Barrett Universal II (BUII), Olsen (4-factor), or Holladay 1 with Wang-Koch adjustment. All biometry devices delivered highly reproducible measurements, and most comparative studies showed little difference in the average measures for all the biometric variables between devices. The differences seen resulted in minimal clinically significant effects on IOL power selection. The main difference found between devices was the ability to measure successfully through dense cataracts, with swept-source OCT-based machines performing better than partial coherence interferometry and optical low-coherence reflectometry devices. Intraoperative aberrometry generally improved outcomes for spherical and toric IOLs in eyes both with and without prior refractive surgery when the BUII and Hill-RBF, Barrett toric calculator, or Barrett True-K formulas were not used. When they were used, IA did not result in better outcomes.
白内障手术的屈光结果受到人工晶状体（IOL）屈光力计算公式和用于测量眼睛的各种设备（包括术中像差测量[IA]）的准确性的影响。本综述旨在涵盖过去 10 年的文献广度，重点关注 3 个主要问题：（1）目前有哪些可用的 IOL 屈光力计算公式，哪种最准确？（2）有哪些生物测量设备，它们的测量值是否彼此不同，这是否会导致 IOL 屈光力选择的临床显著差异？（3）IA 是否能改善屈光结果？通过在 PubMed 数据库中搜索关于这些主题的文章进行文献回顾，共确定了 1313 篇文章，其中 166 篇被纳入综述。对于 IOL 屈光力计算公式，在整个眼轴（AL）谱和短眼（AL，≤22.0mm）和长眼（AL，≥26.0mm）亚组中，Kane 公式是最准确的公式。在短眼亚组中表现良好的其他公式包括 Olsen（4 因素）、Haigis 和 Hill-径向基函数（RBF）1.0。在长眼组中，其他表现良好的公式包括 Barrett Universal II（BUII）、Olsen（4 因素）或 Holladay 1 与 Wang-Koch 校正。所有生物测量设备都提供了高度可重复的测量值，并且大多数比较研究表明，设备之间所有生物测量变量的平均测量值之间差异很小。所看到的差异导致 IOL 屈光力选择的最小临床显著影响。发现设备之间的主要区别是成功测量密集白内障的能力，基于扫频源 OCT 的机器比部分相干干涉测量和光学低相干反射测量设备表现更好。在未使用 BUII 和 Hill-RBF、Barrett toric 计算器或 Barrett True-K 公式的情况下，IA 通常可改善有或无先前屈光手术的眼球的球面和 toric IOL 的结果。当使用它们时，IA 不会导致更好的结果。
