[基于新型扫频源光学相干断层扫描生物测量法的人工晶状体屈光力计算公式准确性比较]
[Comparison of the accuracy of intraocular lens power calculation formulas based on the new swept-source optical coherence tomography biometry].
作者信息
Deng X H, Chang P J, Huang J H, Wang D D, Zhao Y Y, Ding X X, Zhao Y E
机构信息
Eye Hospital of Wenzhou Medical University, Hangzhou Branch, Hangzhou 310020, China.
出版信息
Zhonghua Yan Ke Za Zhi. 2021 Jul 11;57(7):502-511. doi: 10.3760/cma.j.cn112142-20200729-00511.
To compare the accuracy of 6 intraocular lens power calculation formulas based on the new swept-source optical coherence tomography biometry and to analyze the prediction error. Retrospective case series study. Clinical data were collected from 599 patients (599 eyes) who had underwent uncomplicated phacoemulsification and the IOLMaster 700 examination at the Eye Hospital of Wenzhou Medical University between November 2018 and November 2019. Among the patients, there were 208 males and 391 females with an age of (69±10) years. According to the axial length (AL), eyes were divided into the short AL group (≤22.5 mm, =100), the normal AL group (>22.5 mm and<25.5 mm, =375); and the long AL group (≥25.5 mm, =124). Eyes were also grouped based on the mean keratometry (Km) as flat (≤42.00 D, =47), normal (>42.00 D to<46.00 D, =461), and steep (≥46.00 D, =91), and by anterior chamber depth (ACD) as shallow (≤2.5 mm, =71), normal (>2.5 mm to<3.5 mm, =436), and deep (≥3.5 mm, =92). The median absolute errors (MedAEs) of the Barrett Universal Ⅱ, Haigis, Hoffer Q, Holladay Ⅰ, Holladay Ⅱ, and SRK/T formulas in different AL, Km, and ACD groups were compared using the Friedman test. The differences in MedAE among the 6 formulas of 599 patients (599 eyes) were statistically significant (χ²=120.549, <0.001). The MedAE of the Barrett Universal Ⅱ formula was smallest (0.35 D), followed by the SRK/T formula (0.36 D). There was no significant difference between the MedAEs of the Barrett universal Ⅱ and Haigis, SRK/T formula (all =1.000), but there were statistically significant differences among the other formulas (all <0.01). In different AL groups, the MedAE of each formula was statistically different (χ²=38.307, 38.779, 112.997; all <0.01).The Barrett Universal Ⅱ formula resulted in the lowest MedAE in the short AL group (0.40 D) and the long AL group (0.31 D). The MedAE of the SRK/T in the normal AL group was lowest (0.35 D). The 6 formulas showed significant differences in MedAE values in different Km groups (χ²=12.284, 90.924, 39.387; all <0.05).The Haigis formula achieved the lowest MedAE in the flat Km group (0.26 D) and the steep Km group (0.34 D). The Barrett UniversalⅡ formula achieved the lowest MedAE in the normal Km group (0.33 D). The differences in MedAE values of the 6 formulas in different ACD groups were statistically significant (χ²=37.389, 57.643, 52.845; all <0.01), and the MedAE values of the Barrett Universal Ⅱ in different ACD groups were smallest (0.46, 0.33, 0.31 D). The Barrett Universal Ⅱ formula perform the best over the entire AL range, followed by the Haigis and SRK/T formulas. The Barrett Universal Ⅱ formula result in the lowest prediction error in the short AL group, the long AL group, and all ACD groups. The Haigis formula may be more accurate when the Km was ≤42.00 D or ≥46.00 D. .
比较基于新型扫频源光学相干断层扫描生物测量法的6种人工晶状体屈光力计算公式的准确性,并分析预测误差。回顾性病例系列研究。收集了2018年11月至2019年11月在温州医科大学附属眼视光医院接受单纯白内障超声乳化手术并进行IOLMaster 700检查的599例患者(599只眼)的临床资料。患者中,男性208例,女性391例,年龄为(69±10)岁。根据眼轴长度(AL),将眼分为短眼轴组(≤22.5 mm,n = 100)、正常眼轴组(>22.5 mm且<25.5 mm,n = 375)和长眼轴组(≥25.5 mm,n = 124)。还根据平均角膜曲率(Km)将眼分为扁平组(≤42.00 D,n = 47)、正常组(>42.00 D至<46.00 D,n = 461)和陡峭组(≥46.00 D,n = 91),并根据前房深度(ACD)分为浅前房组(≤2.5 mm,n = 71)、正常前房组(>2.5 mm至<3.5 mm,n = 436)和深前房组(≥3.5 mm,n = 92)。采用Friedman检验比较Barrett UniversalⅡ、Haigis、Hoffer Q、HolladayⅠ、HolladayⅡ和SRK/T公式在不同AL、Km和ACD组中的中位数绝对误差(MedAE)。599例患者(599只眼)的6种公式的MedAE差异有统计学意义(χ² = 120.549,P < 0.001)。Barrett UniversalⅡ公式的MedAE最小(0.35 D),其次是SRK/T公式(0.36 D)。Barrett UniversalⅡ与Haigis、SRK/T公式的MedAE之间无显著差异(P均 = 1.000),但其他公式之间有统计学差异(P均 < 0.01)。在不同AL组中,各公式的MedAE有统计学差异(χ² = 38.307、38.779、112.997;P均 < 0.01)。Barrett UniversalⅡ公式在短眼轴组(0.40 D)和长眼轴组(0.31 D)中MedAE最低。SRK/T公式在正常眼轴组中的MedAE最低(0.35 D)。6种公式在不同Km组中的MedAE值有显著差异(χ² = 12.284、90.924、39.387;P均 < 0.05)。Haigis公式在扁平Km组(0.26 D)和陡峭Km组(0.34 D)中MedAE最低。Barrett UniversalⅡ公式在正常Km组中MedAE最低(0.33 D)。6种公式在不同ACD组中的MedAE值有统计学差异(χ² = 37.389、57.643、52.845;P均 < 0.01),Barrett UniversalⅡ在不同ACD组中的MedAE值最小(0.46、0.33、0.31 D)。Barrett UniversalⅡ公式在整个AL范围内表现最佳,其次是Haigis和SRK/T公式。Barrett UniversalⅡ公式在短眼轴组、长眼轴组和所有ACD组中预测误差最低。当Km≤42.00 D或≥46.00 D时,Haigis公式可能更准确。