IOL-Master对高度近视眼人工晶状体度数测量的临床研究

Clinical study of IOL-Master for intraocular lens calculation of high myopia

目的通过比较非接触式光学相干生物测量仪(intraocular len-master,IOL-Master)与传统超声生物测量法联合角膜曲率计测量法对高度近视眼人工晶状体度数测量的准确性及特点,评价IOL-Master的临床应用价值。方法高度近视且患有老年性白内障的患者19例30眼,术前分别用IOL-Master、超声波生物测量仪联合角膜曲率计测量眼轴长度和角膜曲率,使用SRK/T公式计算人工晶状体度数。对患者施行白内障超声乳化摘出术,按照超声波检查法得出的人工晶状体度数植入可折叠人工晶状体。术后1个月随诊检查视力及眼屈光度。结果超声波检查法和IOL-Master检查得出的眼轴分别是(28.789±1.853)mm和(29·057±1·828)mm,2者相比差异有统计学意义(P=0.001<0·05);角膜曲率计和IOL-Master测量角膜曲率分别为43·336±1·439和43.548±1.445,2者相比差异有统计学意义(P=0·02<0.05)。术后1个月患者平均绝对屈光误差值(meanabsolute refractive error,MAFE):IOL-Master为0～1.25D,平均(0.517±0.273)D,A超联合角膜曲率计为0～1.75D,平均(0.792±0.386)D,2者相比差异有统计学意义(P=0.001<0.05)。IOL-Master和A超联合角膜曲率计的MAFE为0～0·50D者分别占70.0%和43·3%,χ2检验差异有统计学意义(χ2=4.019,P<0·05)。IOL-Master和A超联合角膜曲率计的MAFE为0～1.00D者分别占86.7%和73.3%,χ2检验差异无统计学意义(χ2=1·531,P>0.05)。结论IOL-Mas-ter是一种高精确性、非接触性、操作简单、安全可靠的人工晶状体度数测量工具。与A超相比,IOL-Master对眼轴长度测量精确性较高,尤其是对高度近视眼患者。

Objective To compare intraocular len-master （ IOL-Master ） with traditional ultrasonic biometry and photokeratometer in the accuracy and characteristics for intraocular lens calculation of high myopia. Methods Nineteen cases （30 eyes） with senile cataract of high myopia were comprised in this study. Before the surgery, axial length and corneal curvature were measured with IOL-Master and combined application of ultrasonic biometry and photokeratometer,respectively. Intraocular lens power calculdation was carried out according to the SRK/T formula on the basis of ultrasound data. Cataract phacoemulsification was performed, and foldable intraocular was implanted according to intraocular degree with ultrasound examination. Visual acttity and ocular diopter were examined during the follow-up time with one month. Results There was significant difference between the two methods in axial length measurement, which was （ 28. 789 ± 1. 853 ） man by ultrasound and （29. 057 ± 1. 828）mm by IOL-Master （P = 0.001 〈 0.05 ） ; And in corneal power measurement,which was 43.336 1. 439 by manual keratometry, and 43. 548 ± 1. 445 by IOL-Master（P =0.02 〈 0.05 ）. Mean absolute refractive error （MAFE） after one month postoperation was （0.792 ± 0. 386） D （0 - 1.75 D） by IOL-Master, and （0. 517 ± 0. 273 ） D （ 0 - 1.25 D） by ultrasonic biometry and manual keratometry. There was a significant difference between the two groups（ P = 0. 001 〈 0.05 ）. MAFE within 0 - 0.50 D was 70.0% for the IOL-Master and 43.3% for A-scan with photokeratometer. There was significant difference between the two groups（χ^2 = 4. 019,P〈0. 05）.MAFE within 0 - 1.00 D was 86.7% for the IOL-Master and 73.3% for A-scan with phkotokeratometer. There was no significant difference between the two groups （χ^2 = 1. 531, P 〉 0.05 ）. Conclusion IOL-Master is a non-contact, accurate, safe and reliable tool for calculating IOL power,and it is more accurate than A-scan,especially for high myopia.