Kato Yukihito, Kojima Takashi, Tamaoki Akeno, Tanaka Yoshiki, Yamamoto Naoki, Ichikawa Kazuo
Chukyo Eye Clinic, Nagoya, Aichi, Japan.
Nagoya Eye Clinic, Nagoya, Aichi, Japan.
Clin Ophthalmol. 2024 May 13;18:1341-1351. doi: 10.2147/OPTH.S457627. eCollection 2024.
This study aimed to evaluate the efficacy of a majority decision algorithm that integrates intraoperative aberrometry (IA) and two intraocular lens (IOL) frequency formulas. The primary objective was to compare the accuracy of three formulas (IA; Sanders, Retzlaff, and Kraff/Theoretical (SRK/T); and Barrett Universal II (BUII)), in achieving emmetropia in eyes implanted with TFNT lenses (Alcon).
A total of 145 eyes of 145 patients were included in the evaluation. Preoperative data were obtained from IOLMaster 700, while intraoperative data were collected from ORA SYSTEMTM. Visual acuity ≥0.8 at the 3-month post-surgery mark was confirmed. We assessed refractive prediction error (RPE), which is the difference between predicted refraction (PR) and postoperative subjective refraction. This evaluation aimed to identify the optimal IOL power with the implemented algorithm.
Among the 145 eyes evaluated, 55.9%, 78.7%, and 97.2% achieved postoperative subjective refraction within ±0.13 Diopters (D), ±0.25 D, and ±0.50 D, respectively. The percentages of eyes within ±0.25 D of PR varied by formula type, with values of 57%, 57%, and 54% for IA, BUII, and SRK/T, respectively. For eyes with short to medium axial length (AL<26.00 mm), the percentages within ±0.25 D of RPE were 52%, 58%, and 58% for IA, SRK/T, and BUII, respectively. In contrast, for eyes with long axial length (≥26.00 mm) the percentages were 68%, 52%, and 45% for IA, BUII, and SRK/T, respectively.
The proposed majority decision algorithm incorporating IA and two IOL frequency formulas was effective in reducing postoperative refractive error. IA was particularly beneficial for eyes with long axial length. These findings suggest the algorithm has potential to optimize IOL power selection to improve quality of life of patients and clinical practice outcomes.
本研究旨在评估一种整合术中像差仪（IA）和两种人工晶状体（IOL）计算公式的多数决算法的疗效。主要目的是比较三种公式（IA；桑德斯、雷茨拉夫和克拉夫/理论公式（SRK/T）；以及巴雷特通用II公式（BUII））在植入TFNT人工晶状体（爱尔康）的眼中实现正视化的准确性。
共有145例患者的145只眼纳入评估。术前数据来自IOLMaster 700，术中数据则从ORA SYSTEMTM收集。确认术后3个月时视力≥0.8。我们评估了屈光预测误差（RPE），即预测屈光度（PR）与术后主观验光之间的差值。该评估旨在通过所实施的算法确定最佳的人工晶状体度数。
在评估的145只眼中，分别有55.9%、78.7%和97.2%的眼术后主观验光在±0.13屈光度（D）、±0.25 D和±0.50 D范围内。PR在±0.25 D范围内的眼的百分比因公式类型而异，IA、BUII和SRK/T分别为57%、57%和54%。对于眼轴长度短至中等（AL<26.00 mm）的眼，IA、SRK/T和BUII的RPE在±0.25 D范围内的百分比分别为52%、58%和58%。相比之下，对于眼轴长度长（≥26.00 mm）的眼，IA、BUII和SRK/T的百分比分别为68%、52%和45%。
所提出的整合IA和两种IOL计算公式的多数决算法在减少术后屈光不正方面是有效的。IA对眼轴长度长的眼特别有益。这些发现表明该算法有潜力优化人工晶状体度数选择，以改善患者的生活质量和临床实践结果。
