Yang Qing-Hua, Zhang Hong-Tao, Li Xiao-Qi, Chen Bing, Li Zhao-Hui, Huang Yi-Fei, Jin Xin, Zhang Ying, Wang Li-Qiang
Senior Department of Ophthalmology, the Third Medical Center of PLA General Hospital, Beijing 100039, China.
Int J Ophthalmol. 2022 May 18;15(5):793-799. doi: 10.18240/ijo.2022.05.16. eCollection 2022.
To evaluate the accuracy of segmented measurement of axial length (AL) in high myopia filled with silicone oil by immersion B-scan ultrasonography (immersion B-scan).
From June 2016 to June 2020, a total of 67 ultra-high myopia inpatients (67 eyes) who underwent silicone oil removal combined with cataract extraction and intraocular lens (IOL) implantation were retrospectively enrolled. The preoperative axial length (AL) of 31 patients with severe cataract were segmented measured using immersion B-scan (B-scan group) and another 36 patients with mild or moderate cataract were measured using IOLMaster 500 (IOLMaster group). The post-operative ALs in two groups were both measured using IOLMaster 500. The IOL power was calculated with Haigis formula. The differences in ALs between pre- and post-surgery, as well as the postoperative refractive spherical equivalent, absolute refractive error, the prediction deviation of postoperative refraction and best corrected visual acuity (BCVA) were compared.
The pre- and post-operative ALs were 30.46±1.63 mm (range 28.09-33.51 mm) and 30.42±1.70 mm (range 28.03-33.90 mm) in B-scan group (=0.644, =0.542) and 30.51±1.21 mm (range 28.03-33.90 mm) and 30.43±1.27mm (range 28.54-33.50 mm) in IOLMaster group (=1.843, =0.074), respectively. Three months after surgery, BCVA were 0.45±0.13 (range 0.3-0.9) and 0.44±0.20 (range 0.2-1.0) in B-scan and IOLMaster group respectively (=0.086, =0.932). There was no significant difference of the postoperative spherical equivalent (-3.11±0.65 D -3.21±0.51 D, =0.671, =0.505) and the absolute refractive error (0.589±0.340 0.470±0.245 D, =1.615, =0.112) between two groups. In B-scan group, absolute refractive error within ±0.50 D was found in 18 eyes (58.1%), within ±1.00 D in 26 eyes (83.9%), and within ±1.50 D in 31 eyes (100%). In IOLMaster group, absolute refractive error within ±0.50 D was found in 23 eyes (63.9%), within ±1.00 D in 34 eyes (94.4%), and within ±1.50 D in 36 eyes (=0.757, =0.449).
The segmented measurement of ALs by immersion B-scan shows comparable measurement accuracy with that of IOLMaster 500 in ultra-high myopia patients with severe cataract secondary to silicone oil filling and can obtain an ideal postoperative refractive state.
通过浸泡式B超扫描（ immersion B-scan）评估硅油填充的高度近视患者眼轴长度（AL）分段测量的准确性。
回顾性纳入2016年6月至2020年6月期间67例接受硅油取出联合白内障摘除及人工晶状体（IOL）植入术的超高度近视住院患者（67只眼）。对31例重度白内障患者术前眼轴长度（AL）采用浸泡式B超扫描进行分段测量（B超扫描组），另外36例轻度或中度白内障患者采用IOLMaster 500测量（IOLMaster组）。两组术后眼轴长度均采用IOLMaster 500测量。使用Haigis公式计算人工晶状体度数。比较两组手术前后眼轴长度的差异，以及术后等效球镜度、绝对屈光不正、术后屈光预测偏差和最佳矫正视力（BCVA）。
B超扫描组手术前后眼轴长度分别为30.46±1.63mm（范围28.09 - 33.51mm）和30.42±1.70mm（范围28.03 - 33.90mm）（t = 0.644，P = 0.542），IOLMaster组分别为30.51±1.21mm（范围28.03 - 33.90mm）和30.43±1.27mm（范围28.54 - 33.50mm）（t = 1.843，P = 0.074）。术后3个月，B超扫描组和IOLMaster组的BCVA分别为0.45±0.13（范围0.3 - 0.9）和0.44±0.20（范围0.2 - 1.0）（t = 0.086，P = 0.932）。两组术后等效球镜度（-3.11±0.65D vs -3.21±0.51D，t = 0.671，P = 0.505）和绝对屈光不正（0.589±0.340D vs 0.470±0.245D，t = 1.615，P = 0.112）无显著差异。B超扫描组中，18只眼（58.1%）绝对屈光不正在±0.50D以内，26只眼（83.9%）在±1.00D以内，31只眼（100%）在±1.50D以内。IOLMaster组中，23只眼（63.9%）绝对屈光不正在±0.50D以内，34只眼（94.4%）在±1.00D以内，36只眼在±1.50D以内（χ² = 0.757，P = 0.449）。
对于硅油填充继发重度白内障的超高度近视患者，浸泡式B超扫描测量眼轴长度的准确性与IOLMaster 500相当，且能获得理想的术后屈光状态。
