Lin Peimin, Xu Jie, Miao Ao, Xu Canqing, Qian Dongjin, Lu Yi, Zheng Tianyu
From the Department of Ophthalmology, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Department of Ophthalmology and the Eye Institute,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Key Laboratory of Myopia, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Ministry of Health, Shanghai, China; the Shanghai Key Laboratory of Visual Impairment and Restoration,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Shanghai, China.
From the Department of Ophthalmology, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Department of Ophthalmology and the Eye Institute,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Eye and ENT Hospital, Fudan University, Shanghai, China; Key Laboratory of Myopia, (P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Ministry of Health, Shanghai, China; the Shanghai Key Laboratory of Visual Impairment and Restoration,(P.M.L., J.X., A.M., C.Q.X., D.J.Q., Y.L., T.Y.Z.) Shanghai, China.
Am J Ophthalmol. 2023 Jan;245:61-69. doi: 10.1016/j.ajo.2022.08.023. Epub 2022 Sep 7.
We sought to compare the prediction accuracy of 6 intraocular lens (IOL) formulas, namely, the Haigis, Hoffer Q, Holladay I, SRK/T, Barrett Universal II and Hoffer QST formulas, in microphthalmic eyes, including those with nanophthalmos and relative anterior microphthalmos (RAM).
Retrospective case series.
Twenty-six eyes with nanophthalmos (axial length [AL] 16.84 ± 1.36 mm, range 15.25 mm-19.82 mm) and 12 eyes with RAM (corneal diameter 8.41 ± 0.92 mm, range 7.00 mm-9.50 mm) receiving cataract surgery were included. The IOL Master 500 was used for biometry; thus, lens thickness (LT) was omitted in the IOL power calculation. The mean and median arithmetic and absolute prediction errors (PEs) of the 6 original calculation formulas, the absolute PEs of the 6 formulas after optimization, and the proportion of PEs within ±0.25 diopters (D), ±0.5 D, ±1 D, and ±2 D with each formula were compared. The factors influencing PE were analyzed by multivariate regression.
In the nanophthalmos group, the overall prediction results were shifted to myopia. The original Haigis formula had the smallest median absolute PE (1.61 D, P < 0.001), and the optimized Haigis formula had the highest proportion of PEs within ±0.25 D, ±0.5 D, and ±1 D. In the RAM group, the overall prediction results were not significantly different from 0 (P > .05). No significant difference was found among the formulas before optimization (P = .146) and after optimization (P = .161), but the optimized Barrett Universal II formula had the highest proportion of PEs within ±1 D and ±2 D.
When omitting the LT parameter in the calculation, the Haigis formula was the most accurate in cataract patients with nanophthalmos (AL <20 mm) among the 6 IOL calculation formulas, and the Barrett Universal II formula had the highest accuracy in cataract patients with RAM (corneal diameter ≤9.5 mm).
我们试图比较6种人工晶状体（IOL）计算公式，即海吉斯公式（Haigis）、霍弗Q公式（Hoffer Q）、霍拉迪I公式（Holladay I）、SRK/T公式、巴雷特通用II公式（Barrett Universal II）和霍弗QST公式，在小眼球眼中的预测准确性，包括真性小眼球和相对性前部小眼球（RAM）患者。
回顾性病例系列研究。
纳入26例真性小眼球患者（眼轴长度[AL]16.84±1.36mm，范围15.25mm - 19.82mm）和12例RAM患者（角膜直径8.41±0.92mm，范围7.00mm - 9.50mm），均接受白内障手术。使用IOL Master 500进行生物测量；因此，在IOL屈光度计算中未考虑晶状体厚度（LT）。比较6种原始计算公式的算术平均和中位数预测误差（PE）、绝对预测误差，6种公式优化后的绝对预测误差，以及各公式预测误差在±0.25屈光度（D）、±0.5D、±1D和±2D范围内的比例。通过多因素回归分析影响预测误差的因素。
在真性小眼球组中，总体预测结果偏向近视。原始的海吉斯公式中位数绝对预测误差最小（1.61D，P<0.001），优化后的海吉斯公式在±0.25D、±0.5D和±1D范围内的预测误差比例最高。在RAM组中，总体预测结果与0无显著差异（P>.05）。优化前各公式之间（P = 0.146）和优化后各公式之间（P = 0.161）均未发现显著差异，但优化后的巴雷特通用II公式在±1D和±2D范围内的预测误差比例最高。
在计算中忽略LT参数时，在6种IOL计算公式中，海吉斯公式在真性小眼球（AL<20mm）白内障患者中预测准确性最高，巴雷特通用II公式在RAM（角膜直径≤9.5mm）白内障患者中准确性最高。
