Shen Xin, Chen Zexu, Jia Wannan, Wang Yalei, Chen Xinyao, Chen Tianhui, Liu Yan, Song Linghao, Huo Qiuyi, Jiang Yongxiang
From the Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China (Shen, Z. Chen, Jia, Wang, X. Chen, T. Chen, Liu, Song, Huo, Jiang); Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China (Shen, Z. Chen, Jia, Wang, X. Chen, T. Chen, Liu, Song, Huo, Jiang); Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China (Shen, Z. Chen, Jia, Wang, X. Chen, T. Chen, Liu, Song, Huo, Jiang).
J Cataract Refract Surg. 2025 Mar 1;51(3):188-195. doi: 10.1097/j.jcrs.0000000000001592.
To improve the accuracy of intraocular lens (IOL) power calculation formulas by modifying the effective lens position (ELP) equations for patients with Marfan syndrome (MFS) and ectopia lentis (EL) undergoing in-the-bag IOL implantation.
Eye and ENT Hospital of Fudan University, Shanghai, China.
Retrospective cohort study.
The formula-specific ELP was obtained from the SRK/T, T2, Holladay 1, and HofferQ formulas. The back-calculated ELP was obtained based on the vergence formula using preoperative biometry, postoperative refraction, and IOL power. The generalized linear models (GLMs) or gradient boosting machines were used to predict ELP or ELP error.
255 patients (255 eyes) were assigned randomly into a training set and a validation set (7:3 ratio). Linear correlation identified axial length (AL), corneal height, and white-to-white distance as predictors of ELP and ELP error for patients with shorter AL (AL ≤24 mm). For those with longer AL (AL >24 mm), AL and the central corneal radius were identified as the primary predictors. Incorporating these predictors into the modified ELP formula significantly improved the accuracy in the validation set, including SRK/T, T2, Haigis, Holladay 1, and HofferQ formulas. The improvement was more pronounced in patients with shorter AL. In addition, the GLM-modified formulas outperformed both the Barrett Universal II and Kane formulas. The accuracy across different ocular dimensions was comparable among the modified formulas, based on which an online calculator was developed.
Using the more accurately predicted ELP can significantly improve the accuracy of existing formulas in patients with MFS.
通过修改马凡综合征（MFS）和晶状体异位（EL）患者行囊内人工晶状体植入术时的有效晶状体位置（ELP）方程，提高人工晶状体（IOL）屈光力计算公式的准确性。
中国上海复旦大学附属眼耳鼻喉科医院。
回顾性队列研究。
从SRK/T、T2、Holladay 1和HofferQ公式中获取特定公式的ELP。基于术前生物测量、术后屈光和IOL屈光力，使用 Vergence公式获得反算的ELP。使用广义线性模型（GLM）或梯度提升机预测ELP或ELP误差。
255例患者（255只眼）被随机分为训练集和验证集（7:3比例）。线性相关分析确定，对于眼轴长度（AL）较短（AL≤24mm）的患者，眼轴长度、角膜高度和白对白距离是ELP和ELP误差的预测因素。对于眼轴长度较长（AL>24mm）的患者，眼轴长度和中央角膜半径被确定为主要预测因素。将这些预测因素纳入修改后的ELP公式，显著提高了验证集中的准确性，包括SRK/T、T2、Haigis、Holladay 1和HofferQ公式。在眼轴长度较短的患者中，这种改善更为明显。此外，GLM修改后的公式优于Barrett Universal II和Kane公式。不同眼部尺寸的准确性在修改后的公式中相当，基于此开发了一个在线计算器。
使用预测更准确的ELP可以显著提高MFS患者现有公式的准确性。
