IOL-Master的临床应用观察

Comparison of IOL-Master and conventional ultrasound biometry in intraocular lens power calculation

目的:比较Zeiss IOL-Master与传统超声生物测量在人工晶状体测量中的准确性,并探讨不同测量方法的临床应用特点。方法:分析2007-11/2008-01在我院行白内障摘除及人工晶状体植入术的患者91例147眼,根据眼轴长度(L)分别分为五组(L≤22mm,22mm<L≤24.5mm,24.5mm<L≤26mm,26mm<L≤28mm,L>28mm),术前分别用ZeissIOL-Master,超声生物测量仪及角膜曲率计测量眼轴长度,角膜曲率和计算人工晶状体度数,并将结果进行比较。结果:用ZeissIOL-Master和超声生物测量仪测得的眼轴长度:L≤22mm组分别为21.69±0.298mm和21.97±0.623mm(P>0.05);22mm<L≤24.5mm组分别为23.15±0.567mm和23.50±1.396mm(P>0.05);24.5mm<L≤26mm组分别为25.16±0.425mm和25.20±0.485mm(P>0.05);26mm<L≤28mm组分别26.88±0.637mm和26.95±0.668mm(P>0.05);L>28mm组分别为31.59±1.852mm和31.22±1.718mm(P>0.05)。两种方法测得的眼轴长度在各组间无显著差异性。用IOL-Master和超声生物测量仪测得的各组的人工晶状体度数:L≤22mm组分别为23.73±1.29D和22.94±1.44D(P>0.05);22mm<L≤24.5mm组分别为20.52±1.47D和20.44±1.51D(P>0.05);24.5mm<L≤26mm组分别14.95±2.81D和15.23±3.00D(P>0.05);L>28mm组分别为-4.28±4.52D和-3.53±4.76D(P>0.05),显示各组间无显著性差异。IOLMaster和角膜曲率计检测到的角膜曲率分别为43.65±1.62和43.70±1.71,两者比较无显著差异(P>0.05)。结论:IOL-Master用于人工晶状体度数的测量具有非接触、精确性高、操作简单、安全可靠和患者容易接受的特点。而传统的超声生物测量要接触患者角膜,对操作者的手法及患者的配合程度要求较高,但在屈光间质混浊明显的患眼测量中则明显较IOL-Master更为准确,因此临床上应根据个体情况选择不同的测量方法及计算公式以获得准确地人工晶状体度数。

AIM： To compared the power calculation of artificial intraocular lens by IOL-Master with that of conventional ultrasound biometry, and to evaluate the characteristic of these two different methods. METHODS： Ninety-one cases （ 147 eyes ） who underwent phacoemulsification cataract surgery were observed retrospectively. They were divided into five groups by ocular axial length （ L ≤ 22mm, 22mm 〈 L ≤24.5mm, 24.5mm 〈 L≤26mm, 26mm 〈 L ≤28mm, L 〉 28mm）. IOL power was measured by either partial coherence laser interferometry （IOL-Master） or the ultrasound biometry, respectively. The IOL formular used for calculating the IOL power was SRK-Ⅱ or SRK/T. The keratometric power was examined by auto-keratmetry and IOL-Master. RESULTS. The ocular axial length of five each group presented no significant difference between IOL-Master and conventional ultrasound biometry （ L≤22：21.69 ± 0.298mm vs21.97 ± 0. 623mm; 22 〈 L≤24.5. 23.15 ± 0.567mm vs23.50 ±1. 396mm; 24, 5 〈 L≤26 ： 25.16 ± 0.425mm vs25.20±0.485mm; 26〈L≤28：26.88± 0.637mm vs26.95 ± 0.668mm; L 〉 28mm. 31.59 ± 1. 852mm vs 31.22± 1. 718mm. all P〉 0.05）. The mean intraocular lens power in the IOL-Master group was 18.43 ± 6.59D as compared to 18.33 ± 1.40D in the ultrasound group （P〉 0.05）. The karetometric power in the IOL-Master group was 43.65 ± 1. 623 as compared to 43. 70 ± 1. 710 in the ultrasound group （ P〉 0.05）. CONCLUSION; The non contact IOL-Master using the partial coherence laser interferometry principle provides an accurate, easy-to-do, safe and reliable tool in the measurement of ocular axial length and calculation of the IOL power.