六种人工晶状体计算公式预测三焦点人工晶状体屈光度准确性的比较

Comparison of Six Intraocular Lens Power Calculation Formulas for a Trifocal Intraocular Lens

目的:评估Barrett Universal Ⅱ计算公式预测三焦点人工晶状体(IOL,AT Lisa tri.839MP)屈光度的准确性,并与其他5种IOL计算公式(Haigis、Hoffer Q、SRK/T、SRK II和HolladayⅠ)进行对比。方法:前瞻性临床研究。选择2016年12月至2018年8月于武汉爱尔眼科医院行飞秒激光辅助超声乳化白内障吸除联合三焦点IOL植入术的患者。术前使用Lenstar LS 900进行光学生物测量,并通过该仪器内置的其中6种IOL计算公式预测术后屈光度,IOL优化常数取自ULIB网站。随访至术后3个月行主觉验光,比较各IOL计算公式平均绝对屈光误差(MAE)的差异,并对各公式绝对屈光误差中值(MedAE)、绝对屈光误差最大值(MaxAE)以及术后屈光误差在±0.5 D、±1.0 D和±2.0 D范围内患眼的百分比进行评估比较。数据采用Kruskal-Wallis H检验进行分析。结果:本研究最终纳入患者55例(78眼)。根据各公式MAE值由小到大排序,依次为Barrett universal Ⅱ(0.332 D)、SRK/T(0.420 D)、Haigis(0.480 D)、HolladayⅠ(0.607 D),Hoffer Q(0.626 D)以及SRK Ⅱ(0.822 D)。各公式MAE差异有统计学意义(P<0.001)。Barrett Universal Ⅱ公式中MaxAE小于其他IOL计算公式。术后屈光误差在±0.5 D、±1.0 D以及±2.0 D范围内患眼所占百分比,Barrett Universal Ⅱ公式最高,分别为73%、95%以及100%。结论:Barrett Universal Ⅱ、SRK/T、Haigis公式能相对更准确地预测患者术后实际屈光结果。对于植入三焦点IOL的患者我们推荐使用Barrett Universal Ⅱ、SRK/T或者Haigis公式。

Objective:To evaluate the accuracy of the Barrett Universal Ⅱ for calculating the power of a trifocal intraocular lens(IOL,AT LISA tri839 MP),and compare it with existing formulas(Haigis,Hoffer Q,SRK/T,SRK II and HolladayⅠ).Methods:This was a prospective clinical study.Consecutive patients who underwent phacoemulsification cataract surgery with implantation of a trifocal IOL at our institution from December 2016 to August 2018 were enrolled.Preoperative optical biometrics were measured by a Lenstar 900,and the Lenstar software was used to calculate the IOL power and predict the refractive outcome for every formula using User Group for Laser Interference Biometry(ULIB)constants.Subject manifest refraction was performed at 3 months or later postoperatively.The primary outcomes were the differences in mean absolute prediction error(MAE)between the formulas.Median and maximum absolute prediction errors(MedAE and MaxAE)were evaluated as well as the percentage of eyes within the prediction errors of±0.5 D,±1.0 D and±2 D.A Kruskal-Wallis non-parameter test was used to analyze the data.Results:The study was comprised of 78 eyes of 55 patients.The formulas were ranked by the MAE as follows:Barrett Universal II(0.332 D),SRK/T(0.420 D),Haigis(0.480 D),HolladayⅠ(0.607 D),Hoffer Q(0.626 D)and SRK Ⅱ(0.822 D).The differences in absolute errors with the formulas were significant(P<0.001).MaxAE of the Barrett Universal Ⅱ was the lowest among all formulas.The highest percentage of eyes within the prediction errors of±0.5 D,±1.0 D and±2.0 D was also obtained with the Barrett Universal II(73%,95%and 100%respectively).Conclusions:The most accurate predictions of actual postoperative refraction are achieved using the Barrett Universal Ⅱ,SRK/T and Haigis formulas.Thus,one of these formulas should be used for the IOL power calculation of a trifocal IOL.