评估后房型有晶状体眼人工晶状体植入对生物测量和前节 OCT 联合应用对白内障手术 IOL 屈光力计算的影响。

Evaluation of impact of posterior phakic IOL implantation on biometry and effectiveness of concomitant use of anterior segment OCT on IOL power calculation for cataract surgery.

机构信息

Masayuki Ouchi Eye Clinic, Minami-ku, Kyoto, Japan.

出版信息

J Cataract Refract Surg. 2022 Jun 1;48(6):657-662. doi: 10.1097/j.jcrs.0000000000000811. Epub 2021 Sep 1.

DOI:10.1097/j.jcrs.0000000000000811

PMID:34486576

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9119396/

Abstract

PURPOSE

To evaluate the effects of phakic intraocular lens (pIOL) implantation on the intraocular lens (IOL) power calculation and subsequently to evaluate the effectiveness of concomitant use of anterior segment optical coherence tomography (AS-OCT) against biometric changes.

SETTING

Masayuki Ouchi Eye Clinic, Kyoto, Japan.

DESIGN

Prospective consecutive case series.

METHODS

100 patients (100 eyes) who underwent pIOL implantation were enrolled. In each eye, biometry was performed using partial coherence interferometry (PCI) and AS-OCT. Pre-pIOL and post-pIOL implantation IOL power calculation using SRK/T (S), Haigis (H), and Barret Universal II (B) formulas was compared.

RESULTS

100 patients (100 eyes) were included. Anterior chamber depth (ACD) was significantly shorter at post-pIOL implantation for both PCI (P < .001) and AS-OCT (P = .05). When using PCI, the crystalline lens surface was misidentified in 75% of eyes, and in these eyes, the ACD difference between pre-pIOL and post-pIOL implantation exceeded that with both PCI and AS-OCT. The estimated IOL power was significantly lower at post-pIOL implantation according to the H and B formulas (both P < .001) but remained unchanged by the S formula. However, no difference was observed when AS-OCT-derived ACD and lens thickness (LT) values were introduced in the H (P = .16) and B (P = .55) formulas.

CONCLUSIONS

Misidentification of the lens surface occurs in many pIOL-implanted eyes with PCI measurements and could influence the power calculation with H and B formulas while leaving the S formula unaffected. AS-OCT-derived ACD and LT value substitution is recommended for H and B formulas.

摘要

目的

评估有晶状体眼人工晶状体（pIOL）植入对人工晶状体（IOL）屈光力计算的影响，进而评估前节光学相干断层扫描（AS-OCT）与生物测量变化同时使用的效果。

设置

日本京都大串眼诊所。

设计

前瞻性连续病例系列。

方法

纳入 100 例（100 只眼）接受 pIOL 植入术的患者。每只眼均采用部分相干干涉测量法（PCI）和 AS-OCT 进行生物测量。比较术前和术后 pIOL 植入术 SRK/T（S）、Haigis（H）和 Barrett 通用 II（B）公式的 IOL 屈光力计算。

结果

共纳入 100 例（100 只眼）患者。PCI（P<0.001）和 AS-OCT（P=0.05）测量的术后前房深度（ACD）均显著缩短。在 75%的眼中，PCI 晶状体表面被错误识别，在这些眼中，术前与术后 pIOL 植入术的 ACD 差异大于 PCI 和 AS-OCT。H 和 B 公式（均 P<0.001）术后估计 IOL 屈光力显著降低，但 S 公式不变。然而，当将 AS-OCT 衍生的 ACD 和晶状体厚度（LT）值引入 H（P=0.16）和 B（P=0.55）公式时，差异无统计学意义。