三种新型人工晶状体计算公式在长眼轴白内障患者中的应用

Application of three new intraocular lens calculation formulas in patients with long axis cataract

目的:比较Barrett UniversalⅡ、Haigis和Wang-Koch优化眼轴SRK/T公式在长眼轴白内障患者中计算人工晶状体屈光度的准确性。方法:选择2018-01/2019-07于我院行白内障手术的长眼轴白内障患者99例132眼。按眼轴长度(AL)将患者分为3组,分别为A组:26.0<AL≤28.0mm;B组:28.0<AL≤30.0mm;C组:AL>30.0mm。所有患者行常规超声乳化白内障手术同时植入折叠型后房型人工晶状体,术后3mo,根据验光结果计算出各公式的预测屈光误差(PE)和绝对预测误差(AE)并分析眼轴、角膜曲率及前房深度与PE值的相关性。结果:Barrett UniversalⅡ、Haigis和Wang-Koch优化眼轴SRK/T公式的平均预测屈光误差分别为0.37±0.78、0.77±0.88、0.36±0.82D。在A组和B组中,三种公式的PE和AE值均无差异(P>0.05)。但在C组中,Barrett UniversalⅡ和Wang-Koch优化眼轴SRK/T公式的PE值和AE值均明显低于Haigis公式(P<0.05)。在长眼轴白内障患者中,Haigis公式的PE值与眼轴和角膜曲率均存在明显的相关性,而Barrett UniversalⅡ和Wang-Koch优化眼轴SRK/T公式的PE值与眼轴没有明显相关性。结论:在AL为26.0~30.0mm的患者中,三种公式对人工晶状体屈光度的预测准确性均可;而在AL>30.0mm的超长眼轴患者中,Barrett UniversalⅡ和Wang-Koch优化眼轴SRK/T公式的准确性最佳。

AIM:To compare the accuracy of Barrett UniversalⅡ,Haigis and modified Wang-Koch SRK/T formulas in calculating intraocular lens(IOL)power in eyes with long axial length(AL).METHODS:Eyes were divided into three AL groups as follows:26.0 to 28.0mm(group A),28.0 to 30.0mm(group B),and 30.0mm or more(group C).All eyes underwent phacoemulsification cataract surgery.In the 3mo after operation,IOL powers that would have resulted in emmetropia were calculated according to results of subjective refraction.The predictive error(PE)and absolute error(AE)of each formulas were calculated and compared and the factors(AL,keratometry value,the anterior chamber depth)associated with PEs were analyzed.RESULTS:The average PE of Barrett UniversalⅡ,Haigis and modified Wang-Koch SRK/T formulas were 0.37±0.78D,0.77±0.88D and 0.36±0.82D respectively.In groups A and B,the PEs and AEs of three formulas were not statistically significant(P>0.05).However,in group C,the PEs and AEs of Barrett UniversalⅡand modified Wang-Koch SRK/T formula were significantly less than Haigis formula(P<0.05).The PEs of Haigis formula in cataract eyes with long AL was affected by AL and keratometry value,whereas the PEs of Barrett UniversalⅡand modified Wang-Koch SRK/T formula was not affected by AL.CONCLUSION:In eyes with an AL of 26.0 to 30.0mm,all three formulas are acceptable.In eyes with AL of 30.0mm or more,the accuracy of Barrett UniversalⅡand modified Wang-Koch SRK/T formula are better than Haigis formula.