IOL Master组合信号分析技术测量人工晶状体度数准确性研究

Accuracy of the IOL Master with a composite signal analysis technique in measuring artificial intraocular lens power of cataractous eyes

目的评价IOL Master组合信号分析技术测量白内障患者拟植入人工晶状体度数的准确性。方法在64例（81只眼）核性白内障患者中随机抽取41例（55只眼），按晶状体混浊程度及测量方法分为4组，即Ⅰ-Ⅱ级核IOL Master测量组（15只眼）、Ⅰ-Ⅱ级核A超测量组（10只眼）、Ⅲ-Ⅳ级核IOL Master测量组（15只眼）和Ⅲ～Ⅳ级核A超测量组（15只眼）。由同一经验丰富医师分别用IOL Master组合信号分析技术或A超法测量4组患者的人工晶状体度数。所有患者均由同一技术熟练手术医师施行白内障超声乳化吸出联合人工晶状体植入术。术后应用自动验光仪检查术眼的屈光状态，比较4组病人的平均绝对屈光误差值。结果4组病人各自的平均绝对屈光误差值为：Ⅰ～Ⅱ级核IOL Master测量组（0．392±0．170）D，Ⅰ～Ⅱ级核A超测量组（0．595±0．213）D，Ⅲ～Ⅳ级核IOL Master测量组（0．546±0．202）D，Ⅲ～Ⅳ级核A超测量组（0．639±0．229）D，4组之间的差异有统计学意义（P〈0．05）。其中Ⅰ～Ⅱ级核IOL Master测量组与Ⅰ-Ⅱ级核A超测量组之间、Ⅰ-Ⅱ级核IOL Master测量组与Ⅲ-Ⅳ级核IOL Master测量组之间以及Ⅰ～Ⅱ级核IOL Master测量组与Ⅲ～Ⅳ级核A超测量组之间的差异均有统计学意义（P〈0．05），Ⅰ-Ⅱ级核A超测量组、Ⅲ～Ⅳ级核IOL Master测量组和Ⅲ～Ⅳ级核A超测量组两两之间的差异均无统计学意义（P〉0.05）。结论应用IOL Master组合信号分析技术测量人工晶状体度数可信度及准确度较高，可在临床上推广使用。

Objective To evaluate the accuracy of the IOL Master with a composite signal analysis technique in measuring artificial intraocular lens power of cataractous eyes. Methods In a prospective clinical study, 41 patients （55 eyes） of nuclear cataract qualified for a phacoemulsification combined with artificial intraocular lens implantation were included. Eyes were randomly assigned to 4 groups according to the Emery-Little system classification and different measurement methods. Group A included 15 eyes and Group B included 10 eyes, respectively, both with lens nucleus grade Ⅰ - Ⅱ, Group C and Group D both included 15 eyes with lens nucleus grade Ⅲ-Ⅳ. The power of artificial intraocular lens was measured by IOL Master with a composite signal analysis technique in patients of both groups A and C, and A-scan was used to measure the artificial lens power in patients of both groups B and D. A skilled clinical ophthalmologist performed all the measurement and all the cataract surgery. The refractive states were measured with an auto-refractomer after surgery and the average absolute value of predictive refractive error was calculated and compared. Resuhs The average absolute value of predictive refractive error was 0.392±0.170 D in Group A, 0.595±0.213 D in Group B, 0.546±0.202 D in group C, and 0.639±0.229 D in Group D, respective-ly. There was statistically significant difference among all the four groups （P 〈0.05）. There was statistically significant difference between Group A and Group B, Group A and Group C, as well as Group A and Group D （P 〈0.05）. There was no statistically significant difference between Group B and Group C, Group B and Group D, as well as Group C and Group D （P 〉0.05）. Conclusions IOL Master with a composite signal analysis technique is reliable and accurate for power calculation of intraocular lens in cataractous eyes, which can be widely used in clinical practice.