三种方法测算硅油填充状态下人工晶状体屈光度数准确性分析

Precision in predicting intraocular lens refraction with three different methods after silicone oil tamponade

目的：比较三种不同方法测算硅油填充状态下人工晶状体的屈光度数的准确性。方法选取2012年3月～2012年12月在本院施行硅油取出联合白内障超声乳化（或囊外摘除）并人工晶状体植入手术的患者42例42只眼。按术前人工晶状体设计的方法不同分成3组，A组12例，采用硅油填充术前测定人工晶状体度数的结果作为参考值；B组17例，采用硅油填充状态下健侧眼眼轴长度，硅油填充眼角膜曲率，计算出人工晶状体度数。 C组13例，采用IOL-Master测量硅油填充眼眼轴计算人工晶状体度数。分析A、B、C三组术后屈光度与预期值的差值分布情况，并比较三组之间的差异。结果术后屈光度与预期值的差值A组（2.33±1.02）D，B组（4.03±1.52）D，C组（0.46±0.38）D。三组之间有显著差异（F＝36.522，P＝0.000＜0.01）。 C组优于A组和B组，A组优于B组。结论 IOL-Master测算硅油眼并发白内障状态下人工晶状体度数的准确性高于玻璃体切割硅油填充术前测定人工晶状体度数，而根据健侧眼眼轴测算人工晶状体度数的准确性最低。

Objective To compare the precision of three different methods in predicting the in-traocular lens diopter in silicone oil-filled eyes.Methods Forty-two cases （42 eyes） who un-derwent the surgery of silicone oil removal combined with phacoemulsification or extracapsular cataract extraction , and intraocular lens implantation from March 2012 to December 2012 were selected and divided into three groups （A, B and C） according to the methods of design on preoperative intraocular lens .Group A （ n=12 ）：reference value was determined according to the degree of intraocular lens before vitrectomy with silicone oil filled; group B （ n=17 ）： the degree of intraocular lens was calculated in which the axial length of healthy eyes and the cor -neal curvature of silicone oil-filled eyes was used;group C （ n=13 ）：The degree of intraocular lens was calculated directly with IOL-Master in the silicone oil-filled eyes.The distribution sta-tus of difference value between postoperative refraction and expected value were analyzed in the three groups , and the difference was compared .Results The deviation of postoperative refrac-tion from predicted refraction in group A , B and C were （2.33 ±1.02 ） D, （4.03 ±1.52 ） D,＆nbsp;（0.46 ±0.38 ） D, respectively （ F=35.522 , P〈0.01 ） .Group C was superi to group B and group C , and group A was better than group B .Conclusion The accuracy of predicting the intraocular lens diopter in silicone-filled eyes with cataract by the method of IOL-Master is high-er than that by measurement of the intraocular lens diopter before vitrectomy , and that accord-ing to the axial length of healthy eyes is the lowest .