基于NK公式和KS公式预测ICL术后早期拱高的一致性研究

Agreement study of implantable collamer lens based on NK and KS formulas in the early stage after surgery

目的探讨基于CASIA OCT的NK和KS公式预测有晶状体眼人工晶体术后拱高的一致性。方法前瞻性病例研究。选取植入ICL矫正中高度近视患者25例(50眼)。采用CAISA OCT分析术后1 d、1周、1个月拱高(Vault)变化情况以及NK、KS公式的预测拱高值和实际拱高值的差异以及一致性。各时间点拱高变化数据采用单因素重复测量方差分析。NK、KS公式预测拱高值和各时间点拱高差异采用配对t检验分析。NK、KS公式预测拱高值和各时间点一致性采用Bland-Altman分析。拱高与眼前节各参数之间采用多元线性回归进行分析。结果术后拱高随着时间的增加变低。术后1天和1周的拱高差异为(122.22±81.03)μm(P<0.001),术后1 d和1个月拱高差异为(169.04±84.20)μm(P<0.001),术后1周和1个月拱高差异为(46.83±45.70)μm(P<0.001)。NK公式预测值和术后第1天测出的实际拱高有统计学差异(P=0.001)。KS公式预测值和术后第1天和第1个月测出的实际拱高有统计学差异(P=0.013,P=0.009)。NK、KS公式预测值和术后第1周一致性最高。术后拱高和前房宽度、晶状体矢高以及角到角距离相关。NK公式的拱高预测值与术后第1天的拱高数值一致性要低于KS公式的拱高预测值与术后第1天的拱高预测值,与术后第1周、第1个月的拱高数值一致性要高于KS公式。结论ICL术后早期拱高随着时间的增加有降低的趋势。CASIA OCT的两种预测公式的术后拱高与术后第1周时的拱高一致性最高。NK公式能比较准确地预测术后拱高实际值,且NK公式在术后早期预测拱高方面要优于KS公式。

Objective To investigate the agreement of NK and KS formulas based on CASIA OCT in predicting the vault after implantation of an implantable collamer lens(ICL).Methods This prospective case study included 25 patients(50 eyes)with moderate to high myopia undergoing ICL implantation.CASIA OCT was used to analyze the vault change at one day,one week,and one month after surgery,and the difference and agreement between the vault predicted by the NK and KS formulas and the actual vault postoperatively.Variation of the vault at each follow-up was analyzed using One-way Repeated Measures Anova.NK and KS formulas were used to predict the vault and vault differences at different time points.A paired t-test was used to analyze the difference between the actual vault after surgery at each follow-up and the vault predicted by the NK/KS formulas.The agreement between the actual vault after surgery at each follow-up and the vault predicted by the NK/KS formulas were analyzed using Bland-Altman analysis.Multiple linear regression was used to analyze the relationship between the vault and the preoperative parameters of the anterior segment.Results The vault decreased with time in the early stage after surgery.The difference of the vault at one day and one week was(122.22±81.03)μm(P<0.05),at one day and one month after the operation was(169.04±84.20)μm(P<0.05),and at one week and one month after the operation was(46.83±45.70)μm(P<0.05).There was a statistical difference between the predicted value of the NK formula and the actual vault measured one day after the operation(P<0.05).There was a statistically significant difference between the predicted vault value of the KS formula and the actual vault measured one day and one month after surgery(P<0.05).The agreement between the actual vault after surgery at one week and the vault predicted by the NK/KS formulas was the highest.The postoperative vault was correlated with the anterior chamber width,crystalline lens rise,and angle to angle distance.The consistency between the vault prediction value of the NK formula and the first day after the operation was lower than the KS formula but higher than the KS formula in terms of one week and one month.Conclusion The vault decreased with time during the early postoperative period.The predicted vault of the two prediction formulas of CASIA OCT was the most consistent with the vault at one week after surgery.The NK formula could accurately predict the actual value of the postoperative vault.Furthermore,the NK formula is better than the KS formula in predicting the postoperative vault at early stage.