IOL-Master在不同公式下对轴性高度近视眼术后屈光准确度评估

Postoperative refractive accuracy evaluation in axial high myopic eyes using IOL-Master with different formulas

目的应用IOL-Master通过不同人工晶状体计算公式,分析轴性高度近视眼患者行白内障手术后目标屈光和实际屈光的符合程度,评价不同人工晶状体计算公式的准确度。方法收集2013年1月至2014年4月在我院行白内障手术的轴性高度近视患者66例（100眼）,将其按眼轴长度（axial length,AL）分为三组,组1为26 mm≤AL〈28 mm（54眼）,组2为28≤AL〈30 mm（28眼）,组3为AL≥30 mm（18眼）;按角膜曲率（K）分为四组,组1为≤42.00 D（17眼）,组2为〉42.00~44.00 D（27眼）,组3为〉44.00~46.00 D（48眼）,组4为〉46.00 D（8眼）。术前均采用Haigis、SRK/T、Holladay I及Hoffer Q公式进行人工晶状体度数计算。应用IOL-Master的部分相干干涉测量（partial coherence interferometry,PCI）技术计算人工晶状体度数。分析Haigis、SRK/T、Holladay I及Hoffer Q四种计算公式所预估的术后目标屈光度与术后6个月的实际屈光度符合程度。结果按AL分组,组1中,四种公式对术后实际屈光的预测准确度一样,四种方法之间比较,差异无统计学意义（P〉0.05）;组2中,SRK/T公式的目标屈光与实际屈光的差值最小,准确度最高,四种方法之间比较,差异有统计学意义（P〈0.05）;组3中,Haigis公式的目标屈光与实际屈光的差值最小,准确度最高,四种方法之间比较,差异有统计学意义（P〈0.05）。按角膜曲率分组,各组中四种方法之间比较,差异无统计学意义（P〉0.05）。结论利用IOL-Master对长眼轴进行人工晶状体度数计算时,Haigis公式具有相对稳定的准确度,而随着患者眼轴的增加,准确度逐渐下降。

Objective To investigate the accuracies of different IOL prediction formulas in cataract patients with high myopia through IOL-Master,and compare the post-surgery actual refractive status and target refractive status.Methods Sixty-six cataract patients（100 eyes）with axial high myopia from January 2013 to April 2014 were recruited.According to axial length（AL）,the patients were divided into three groups：26 mm ≤ AL〉28 mm（group 1,54 eyes）,28 mm≤AL〉30 mm（group 2,28 eyes） and AL≥30 mm（group 3,18 eyes）.According to corneal curvature（K）,the patients were divided into four groups：K≤42.00 D（group 1,17 eyes）,42.00 D 〈Ks≤44.00 D（group 2,27 eyes）,44.00 D〈 K≤46.00 D（group 3,48 eyes） and K 46.00 D（group 4,8 eyes）.All subjects completed measurement of IOL before surgery,and the predicted IOL power of Haigis,SRK/T,Holladay Ⅰ and Hoffer Q formulas were both included.Results were calculated using partial coherence interferometry of IOL-Master to analyze the accuracies of Haigis,SRK/T,Holladay Ⅰ and Hoffer Q formulas at 6 months after surgery.Results According to AL four formulas performed as equally accurate to predict the postoperative refraction in group 1,the difference was not statistically significant among four formulas（P〉0.05）;In group 2,the difference between target and actual refraction of SRK/T was the smallest,and the accuracy was the best,there was statistical difference among four formulas（P〈0.05）;In group 3,the difference between target and actual refraction of Haigis was the smallest,and the accuracy was the best,there was statistical difference among four formulas（P〈0.05）.According to their corneal curvature,there was no statistical difference among four formulas（P〉0.05）.Conclusion When calculating IOL power for long axial eyes,using IOL-Master with Haigis formula has relatively stable accuracy.With AL increases,the accuracy of prediction gradually descends.