School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China.
Key Laboratory of Vision Science, Ministry of Health, Wenzhou, China.
Ophthalmic Res. 2021;64(6):1048-1054. doi: 10.1159/000512753. Epub 2020 Nov 3.
The aim of the study was to compare the accuracy of refractive outcomes in children undergoing secondary in-the-bag or cilliary sulcus intraocular lens (IOL) implantation, using aphakic refraction (AR)-based formulae (Hug and Khan) and biometry-based formulae (Holladay 1, Hoffer Q, SRK/T, and SRK II).
In this retrospective study, a total of 65 eyes of 44 patients who underwent secondary in-the-bag or cilliary sulcus IOL implantation were included and divided into 2 groups: 39 eyes of the in-the-bag IOL group and the other 26 eyes of the sulcus-implanted IOL group. Holladay 1, Hoffer Q, SRK/T, and SRK II formulae were employed depending on the biometric data, while Hug and Khan formulae were used based on preoperative AR. The prediction error (PE) and the absolute value of predicted error (APE) were compared between the 2 groups and formulae.
In the in-the-bag IOL group, nonsignificant differences of APE were found among the 6 formulae, while the Holladay 1, Hoffer Q, SRK/T, and SRK II all demonstrated a significant hyperopic shift of median PE value compared to the Hug formula (p < 0.05, all), and Holladay 1 and SRK II also showed a significant hyperopic shift of PE compared to the Khan formula (p < 0.05, both). Higher percentages of eyes with PE <1 D were found using Hoffer Q and SRK/T. In the sulcus-implanted group, the Holladay 1, Hoffer Q, and SRK/T had a significantly smaller median value of APE than the Hug and Khan formulae (p < 0.05, all), and the SRK II had a significantly smaller median value of APE than the Hug formula (p < 0.05), while Holladay 1 had the lowest value of APE. Higher percentages of eyes within PE <1 D were found using Holladay 1, Hoffer Q, and SRK/T, while the highest one was SRK/T. Significantly larger hyperopic shifts of median PE value using all the 6 formulae were found in eyes with sulcus-implanted IOL than eyes with in-the-bag implanted IOL (p < 0.05, all). In the eyes of with in-the-bag implanted IOL, the Hug and Khan formulae had significantly smaller APE values when compared with the eyes with sulcus-implanted IOL (p < 0.05, both).
Whether IOL was in the bag or implanted in the sulcus, almost all the formulae showed hyperopic shift, SRK/T showed the best accuracy. Biometry-based formulae were superior to AR-based formulae in accuracy of IOL power calculation, especially when IOL was implanted in the sulcus. In-the-bag IOL implantation should always be with higher priorities, especially when using AR-based formulae in IOL power calculation.
本研究旨在比较囊袋内或睫状沟内植入后发性眼内晶状体（IOL）的儿童，使用无晶状体眼屈光（AR）公式（Hug 和 Khan）和基于生物测量的公式（Holladay 1、Hoffer Q、SRK/T 和 SRK II）的屈光结果的准确性。
在这项回顾性研究中，共纳入了 44 名患者的 65 只眼，这些患者接受了二次囊袋内或睫状沟内 IOL 植入术，并将其分为两组：39 只眼为囊袋内 IOL 组，另 26 只为睫状沟植入 IOL 组。根据生物测量数据使用 Holladay 1、Hoffer Q、SRK/T 和 SRK II 公式，而 Hug 和 Khan 公式则基于术前 AR 使用。比较了两组和公式之间的预测误差（PE）和预测误差绝对值（APE）。
在囊袋内 IOL 组中，6 种公式的 APE 差异无统计学意义，而 Holladay 1、Hoffer Q、SRK/T 和 SRK II 与 Hug 公式相比，中位 PE 值均表现出明显的远视漂移（p<0.05，均），Holladay 1 和 SRK II 与 Khan 公式相比，PE 值也表现出明显的远视漂移（p<0.05，均）。Hoffer Q 和 SRK/T 有更高比例的 PE<1 D 的眼。在睫状沟植入组中，Holladay 1、Hoffer Q 和 SRK/T 的 APE 中位数明显小于 Hug 和 Khan 公式（p<0.05，均），SRK II 的 APE 中位数明显小于 Hug 公式（p<0.05），而 Holladay 1 的 APE 中位数最小。Holladay 1、Hoffer Q 和 SRK/T 的 PE<1 D 的眼比例更高，而 SRK/T 的比例最高。与囊袋内植入 IOL 的眼相比，睫状沟植入 IOL 的眼的所有 6 种公式的中位 PE 值均有明显的远视漂移（p<0.05，均）。在囊袋内植入 IOL 的眼中，与睫状沟植入 IOL 的眼相比，Hug 和 Khan 公式的 APE 值明显更小（p<0.05，均）。
无论 IOL 是否植入囊袋内或睫状沟内，几乎所有公式均表现出远视漂移，SRK/T 表现出最佳准确性。基于生物测量的公式在 IOL 屈光力计算的准确性方面优于基于 AR 的公式，尤其是当 IOL 植入睫状沟内时。囊袋内 IOL 植入术应始终优先考虑，特别是在使用基于 AR 的公式计算 IOL 屈光力时。
