白内障合并眼后段玻璃体切割术后患者人工晶状体计算公式的选择。
Choice of intraocular lens calculation formula for cataract patients with prior pars plana vitrectomy.
机构信息
From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (J. Zhang, Han, Chen, Z. Liu, Y. Zhang, Qiu, Tan, Luo, Y. Liu); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (J. Zhang, Han, Chen, Z. Liu, Y. Zhang, Qiu, Tan, Luo, Y. Liu).
出版信息
J Cataract Refract Surg. 2023 Sep 1;49(9):956-963. doi: 10.1097/j.jcrs.0000000000001253.
PURPOSE
To determine the optimal intraocular lens (IOL) calculation formula for vitrectomized eyes with diverse surgical and biometric characteristics.
SETTING
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
DESIGN
Retrospective consecutive case series study.
METHODS
This study included 974 vitrectomized eyes (974 patients) scheduled for phacoemulsification with IOL implantation. 11 formulas were evaluated: Barrett Universal II (BUII), Emmetropia Verifying Optical, Hoffer-QST, Kane, Ladas Super Formula, Pearl-DGS, Radial Basis Function (RBF), Haigis, HofferQ, Holladay1, and SRK/T. Risk factors for prediction error (PE) exceeding 1 diopter (D) were determined using multiple logistic regression. Subgroup analyses were performed based on surgical history and biometric parameters.
RESULTS
The risk of hyperopic PE (>1 D) was higher in patients with silicone oil tamponade (odds ratio [OR], 1.82) and longer axial length (AL) (OR, 1.55), while patients with previous scleral buckling (OR, 2.43) or ciliary sulcus IOL implantation (OR, 6.65) were more susceptible to myopic PE (<-1 D). The Kane formula had the highest overall prediction accuracy, and also the best in silicone oil-filled eyes and the flat cornea subgroup. The BUII and RBF displayed the optimal performance in eyes with previous scleral buckle and steep cornea, respectively. In eyes with an AL ≥ 26 mm, the Holladay1 with the nonlinear version of the Wang-Koch AL adjustment (Holladay1-WKn) showed the lowest absolute PE and highest percentage within ± 1.0 D of PE.
CONCLUSIONS
The Kane achieved the highest overall prediction accuracy in vitrectomized eyes. The optimal formula for eyes with previous scleral buckle, steep cornea, or long AL was BUII, RBF, and Holladay1-WKn, respectively.
目的
确定不同手术和生物测量特征的玻璃体切割眼中最佳的人工晶状体（IOL）计算公式。
设置
中山大学中山眼科中心，广州，中国。
设计
回顾性连续病例系列研究。
方法
本研究纳入了 974 只接受白内障超声乳化吸除术联合 IOL 植入术的玻璃体切割眼（974 例患者）。评估了 11 种公式：Barrett Universal II（BUII）、Emmetropia Verifying Optical、Hoffer-QST、Kane、Ladas Super Formula、Pearl-DGS、Radial Basis Function（RBF）、Haigis、HofferQ、Holladay1 和 SRK/T。使用多因素逻辑回归确定预测误差（PE）超过 1 屈光度（D）的风险因素。根据手术史和生物测量参数进行亚组分析。
结果
硅油填充（比值比 [OR]，1.82）和较长眼轴（AL）（OR，1.55）的患者发生远视性 PE（>1 D）的风险更高，而有巩膜扣带术（OR，2.43）或睫状沟 IOL 植入术（OR，6.65）史的患者则更容易发生近视性 PE（<-1 D）。Kane 公式的总体预测准确性最高，在硅油填充眼中和扁平角膜亚组中表现最佳。BUII 和 RBF 在有巩膜扣带术史和陡峭角膜的眼中表现最佳。在 AL≥26 mm 的眼中，Wang-Koch AL 调整的非线性版本 Holladay1（Holladay1-WKn）的绝对 PE 最低，PE 在±1.0 D 范围内的百分比最高。
结论
Kane 公式在玻璃体切割眼中的总体预测准确性最高。对于有巩膜扣带术史、陡峭角膜或长 AL 的眼，最佳公式分别为 BUII、RBF 和 Holladay1-WKn。
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