Shin Jung Hye, Kim Seok Hwan, Oh Sohee, Lee Kyoung Min
Department of Ophthalmology, Seoul National University College of Medicine, Seoul 07061, Republic of Korea.
Department of Ophthalmology, Seoul National University Hospital, Seoul 07061, Republic of Korea.
J Clin Med. 2023 Sep 1;12(17):5706. doi: 10.3390/jcm12175706.
To compare refractive prediction errors between phacotrabeculectomy and phacoemulsification.
Refractive prediction error was defined as the difference in spherical equivalent between the predicted value using the Barrett Universal II formula and the actual value obtained at postoperative one month. Forty-eight eyes that had undergone phacotrabeculectomy (19 eyes, open-angle glaucoma; 29 eyes, angle-closure glaucoma) were matched with 48 eyes that had undergone phacoemulsification by age, average keratometry value and axial length (AL), and their prediction errors were compared. The factors associated with prediction errors were analyzed by multivariable regression analyses.
The phacotrabeculectomy group showed a larger absolute prediction error than the phacoemulsification group (0.51 ± 0.37 Diopters vs. 0.38 ± 0.22 Diopters, = 0.033). Larger absolute prediction error was associated with longer AL ( = 0.010) and higher intraocular pressure (IOP) difference ( = 0.012). Hyperopic shift (prediction error > 0) was associated with shallower preoperative anterior chamber depth (ACD) ( = 0.024) and larger IOP difference ( = 0.031). In the phacotrabeculectomy group, the prediction error was inversely correlated with AL: long eyes showed myopic shift and short eyes hyperopic shift ( = 0.002).
Surgeons should be aware of the possibility of worse refractive outcomes when planning phacotrabeculectomy, especially in eyes with high preoperative IOP, shallow ACD, and/or extreme AL.
比较晶状体小梁切除术与超声乳化术之间的屈光预测误差。
屈光预测误差定义为使用巴雷特通用II公式的预测值与术后1个月获得的实际值之间的等效球镜差值。48只接受晶状体小梁切除术的眼睛（19只开角型青光眼；29只闭角型青光眼）与48只接受超声乳化术的眼睛按年龄、平均角膜曲率值和眼轴长度（AL）进行匹配，并比较它们的预测误差。通过多变量回归分析来分析与预测误差相关的因素。
晶状体小梁切除术组的绝对预测误差大于超声乳化术组（0.51±0.37屈光度 vs. 0.38±0.22屈光度，P = 0.033）。更大的绝对预测误差与更长的AL（P = 0.010）和更高的眼压（IOP）差值（P = 0.012）相关。远视性偏移（预测误差>0）与术前前房深度（ACD）较浅（P = 0.024）和更大的IOP差值（P = 0.031）相关。在晶状体小梁切除术组中，预测误差与AL呈负相关：眼轴长的眼睛表现为近视性偏移，眼轴短的眼睛表现为远视性偏移（P = 0.002）。
外科医生在计划晶状体小梁切除术时应意识到屈光结果较差的可能性，尤其是在术前眼压高、ACD浅和/或眼轴长度极端的眼睛中。
