基于对侧眼眼轴计算硅油眼人工晶体度数的准确性

Accuracy of intraocular lens power based on fellow-eye axis length in silicone oil eye

目的:探讨使用对侧眼眼轴计算硅油眼患者人工晶体度数的准确性。方法:将拟行硅油取出联合白内障超声乳化吸除及人工晶体植入术的患者60例(60眼)随机分为A、B、C组。A组20例,硅油填充眼直接使用光学相干生物测量仪IOL-Master计算人工晶体度数;B组20例,使用IOL-Master测量对侧眼眼轴长度和硅油眼角膜曲率,计算人工晶体度数;C组20例,使用患眼硅油填充前IOL-Master测量的眼轴长度和硅油眼角膜曲率,计算人工晶体度数。三组均使用SRK/T公式计算人工晶体度数并植入相应度数晶体。术后1个月测量实际屈光度,并与预期屈光度比较,计算绝对屈光误差(MAE),观察使用三种方法计算人工晶体度数的准确性。结果:角膜曲率:纳入研究患者硅油填充前、硅油填充后角膜曲率分别为(43.29±0.85)D、(43.52±1.05)D,差异无统计学意义(t=1.690,P>0.05);A、B、C三组硅油填充眼角膜曲率分别为(43.26±0.57)D、(43.53±1.04)D、(43.78±1.39)D,差异无统计学意义(F=1.238,P>0.05)。眼轴长度:纳入患者硅油填充前、硅油取出前眼轴长度分别为(23.04±0.99)mm、(23.13±0.94)mm,差异有统计学意义(t=3.600,P<0.05);A、B、C三组硅油填充眼眼轴长度分别为(23.11±0.85)mm、(23.05±0.87)mm、(23.26±1.11)mm,差异无统计学意义(F=0.244,P>0.05)。MAE:A、B、C三组MAE分别为(0.56±0.24)D、(0.42±0.20)D、(0.75±0.33)D,差异有统计学意义(F=7.880,P<0.05);A组和B组MAE差异无统计学意义(t=1.965,P>0.05);A组和C组MAE差异有统计学意义(t=2.096,P<0.05);B组和C组MAE差异有统计学意义(t=3.788,P<0.05)。结论:使用对侧眼眼轴计算硅油眼患者人工晶体度数是一个好的替代选择,术后屈光误差较小,可以根据实际情况选择合适的测量方法。

Objective:To investigate accuracy of intraocular lens power based on axis length of the fellow eye in silicone oil eye.Methods:Sixty patients(60 eyes)with silicone oil eye received silicone oil removal combined with phacoemulsification and intraocular lens implantation were randomly divided into Group A,Group B,and Group C.In Group A(n=20),the intraocular lens power was calculated directly with optical coherence interferometry IOL-Master in the silicone oil eye.In Group B(n=20),the intraocular lens power was calculated with the axis length of the fellow eye and the corneal curvature of the silicone oil eye measured by IOL-Master.In Group C(n=20),the intraocular lens power was calculated with the axis length of the eye before vitrectomy with silicone oil filled and the corneal curvature of the silicone oil eye measured by IOL-Master.All the patients were implanted with intraocular lens calculated according to SRK/T formula.The results of mean absolute refractive error(MAE)were based on a comparison between the diopter of one month after operation and expected diopter.The accuracy of intraocular lens power calculated by the three methods were compared.Results:The corneal curvature of the eye before vitrectomy with silicone oil filled and the silicone oil eye were(43.29±0.85)D and(43.52±1.05)D,respectively,and no significant difference was found(t=1.690,P>0.05).The corneal curvature of the silicone oil eye of Group A,Group B and Group C were(43.26±0.57)D,(43.53±1.04)D,and(43.78±1.39)D,respectively,and no significant difference was found between the three groups(F=1.238,P>0.05).The axis length of the eye before vitrectomy with silicone oil filled and the silicone oil eye were(23.04±0.99)mm and(23.13±0.94)mm,respectively,with significant difference(t=3.600,P<0.05).The axis length of the silicone oil eye of Group A,Group B,and Group C were(23.11±0.85)mm,(23.05±0.87)mm,and(23.26±1.11)mm,respectively,without significant difference(F=0.244,P>0.05).The MAE of Group A,Group B,and Group C were(0.56±0.24)D,(0.42±0.20)D,and(0.75±0.33)D,respectively,with significant difference between the three groups(F=7.880,P<0.05).No significant difference was found between Group A and Group B(t=1.965,P>0.05),but there was significant difference between Group A and Group C(t=2.096,P<0.05),and between Group B and Group C(t=3.788,P<0.05).Conclusion:It’s a good alternative to calculate the intraocular lens power of patients with silicone oil eye by using axis length of the fellow eye.The postoperative refractive error is small,and we should choose appropriate measurement method according to the actual situation.