马凡综合征伴晶状体异位患者行改良囊袋张力环与人工晶状体植入术后的眼轴预测。
Predicting axial length in patients with Marfan syndrome and ectopia lentis after modified capsular tension ring and intraocular lens implantation.
机构信息
From the Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China (Z.-X. Chen, Jia, Ma, T.-H. Chen, Sun, Liu, Song, Jiang); NHC Key Laboratory of Myopia, Fudan University; Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China (Z.-X. Chen, Jia, Ma, T.-H. Chen, Sun, Liu, Song, Jiang); Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China (Z.-X. Chen, Jia, Ma, T.-H. Chen, Sun, Liu, Song, Jiang); School of Computer Science, Fudan University Shanghai, China (Hong).
出版信息
J Cataract Refract Surg. 2023 Jun 1;49(6):571-577. doi: 10.1097/j.jcrs.0000000000001155.
PURPOSE
To predict the growth of axial length (AL) in patients with Marfan syndrome (MFS) and ectopia lentis (EL).
SETTING
Eye and ENT Hospital of Fudan University, Shanghai, China.
DESIGN
Consecutive retrospective case series.
METHODS
Eyes were evaluated that had modified capsular tension ring and intraocular lens (IOL) implantation. The rate of AL growth (RALG) was calculated using AL divided by log10-transformed age. A multivariate linear regression model of RALG was developed after validation.
RESULTS
128 patients with MFS and EL were enrolled with a median follow-up duration of about 3 years. RALG was independent of age between 3 years and 15 years old ( P = .799) and decreased to 0 thereafter ( P = .878). Preoperative AL was associated with RALG in patients under 15 years old ( P = .003). Beta values for the final model of RALG were as below: intercept (-9.794) and preoperative AL (0.664). The postoperative AL was predicted as: postAL = preAL + RALG × log 10 ([postAge + 0.6]/[preAge + 0.6]). The mean prediction error was -0.003 (95% CI, -0.386 to 0.3791) mm and the mean absolute percentage error was 1.93% (95% CI, 0.73% to 3.14%). A Python-based calculator was developed to use the predicted AL in selecting IOL power and setting undercorrection.
CONCLUSIONS
The AL growth of patients with MFS followed a logarithmic pattern and ceased at about age 15. A prediction model of postoperative AL was established for individual MFS patients between 3 and 15 years old, which could potentially optimize the IOL power selection.
目的
预测马凡综合征（MFS）伴晶状体异位（EL）患者眼轴（AL）的增长。
地点
中国上海复旦大学眼耳鼻喉科医院。
设计
连续回顾性病例系列。
方法
评估了接受改良后房型人工晶状体睫状沟固定术和人工晶状体（IOL）植入术的患者。AL 增长率（RALG）通过 AL 除以对数变换后的年龄计算。验证后建立 RALG 的多变量线性回归模型。
结果
纳入 128 例 MFS 伴 EL 患者，中位随访时间约 3 年。RALG 在 3 至 15 岁之间与年龄无关（P=.799），此后降至 0（P=.878）。15 岁以下患者的术前 AL 与 RALG 相关（P=.003）。RALG 最终模型的β值如下：截距（-9.794）和术前 AL（0.664）。术后 AL 预测值为：postAL = preAL + RALG × log10([postAge + 0.6]/[preAge + 0.6])。平均预测误差为-0.003（95%CI，-0.386 至 0.3791）mm，平均绝对百分比误差为 1.93%（95%CI，0.73%至 3.14%）。开发了一个基于 Python 的计算器，用于在选择 IOL 屈光力和设定欠矫度时使用预测的 AL。
结论
MFS 患者的 AL 增长呈对数模式，约在 15 岁时停止。建立了一个 3 至 15 岁 MFS 患者术后 AL 的预测模型，这可能有助于优化 IOL 屈光力的选择。
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