Irfani Irawati, Wahyu Tri, Oktarima Primawita, Caesarya Sesy, Sari Maya, Karfiati Feti
Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia.
Pediatric Ophthalmology & Strabismus Division, Cicendo National Eye Hospital, Bandung, West Java, Indonesia.
Clin Optom (Auckl). 2023 Jan 4;15:1-8. doi: 10.2147/OPTO.S390994. eCollection 2023.
Determining IOL power is an important step in achieving the desired postoperative refractive target, but this determination remains challenging, as currently the used formulas were developed using IOL power calculations derived from adults.
This is a retrospective analytical study with the period of June 2018 to May 2019. All of the data were taken from medical records in referral tertiary eye hospital in Indonesia. All type of cataracts underwent uncomplicated surgeries and in-the-bag IOL implantation were included in this study, while aphakia, secondary IOL implantation, primary sulcus implantation, and history of ocular disorders were excluded. The data were analyzed using Wilcoxon sign-rank, paired t, and Kruskal-Wallis tests.
Sixty-seven patients (106 eyes) were found to meet the inclusion criteria, average age was 7.35 ± 4.61 years (1.00 to 17.00 years). Average targeted refraction was 1.69 ± 2.06 D (-0.38-+6.99 D), and spherical equivalent (actual postoperative refraction) was -0.90 ± 1.45 D (-4.38 to +2.75 D). There was statistically significant difference between preoperative targeted refraction and actual postoperative refraction (p < 0.001). Mean absolute prediction error (APE) in general was 1.34 ± 1.18 D, 1.22 ± 0.88 D (in short eyes), 1.52 ± 1.37 D (in moderate eyes), and 0.69 ± 0.52 D (in long eyes) (p = 0.202). Mean APE in age group <7 years old was 1.27 ± 1.18 D and ≥7 years-old was 1.42 ± 1.19 D (p = 0.429).
SRK/T formula is fairly accurate in calculating IOL power in pediatric cataract surgery. Mean APE in this study was within the range of accurate mean APE in pediatric patients despite differentiated axial length and age.
确定人工晶状体(IOL)的度数是实现理想术后屈光目标的重要一步,但这一确定过程仍然具有挑战性,因为目前使用的公式是基于从成人中得出的IOL度数计算方法开发的。
这是一项回顾性分析研究,时间跨度为2018年6月至2019年5月。所有数据均取自印度尼西亚一家三级转诊眼科医院的病历。本研究纳入了所有类型的白内障且接受了无并发症手术并植入囊袋内IOL的患者,而无晶状体眼、二期IOL植入、一期睫状沟植入以及有眼部疾病史的患者被排除在外。数据采用Wilcoxon符号秩和检验、配对t检验和Kruskal-Wallis检验进行分析。
发现67例患者(106只眼)符合纳入标准,平均年龄为7.35±4.61岁(1.00至17.00岁)。平均目标屈光度为1.69±2.06 D(-0.38至+6.99 D),球镜等效度(实际术后屈光度)为-0.90±1.45 D(-4.38至+2.75 D)。术前目标屈光度与实际术后屈光度之间存在统计学显著差异(p<0.001)。总体平均绝对预测误差(APE)为1.34±1.18 D,短眼为1.22±0.88 D,中等眼为1.52±1.37 D,长眼为0.69±0.52 D(p = 0.202)。年龄<7岁组的平均APE为1.27±1.18 D,≥7岁组为1.42±1.19 D(p = 0.429)。
SRK/T公式在计算儿童白内障手术的IOL度数方面相当准确。尽管眼轴长度和年龄存在差异,但本研究中的平均APE仍在儿童患者准确平均APE的范围内。