比较五种计算公式在超高度近视白内障患者中预测术后屈光度的准确性

Comparison of the accuracy of five formulas for predicting postoperative refractive error in patients with ultrahigh myopic cataract

目的 比较在超高度近视白内障患者术后,五种计算公式(SRK/T公式、优化眼轴后的SRK/T公式、Haigis公式、在线计算公式Barrett UniversalⅡ以及Hill-RBF Calculator Version 3.0)其术后屈光度的预测准确性。方法 共收集超高度近视白内障(AL> 27.00mm)患者82例(111眼),由同一位经验丰富的手术医生行白内障超声乳化摘除联合后房型人工晶状体(intraocular lens,IOL)植入术。术后1个月通过平均预测误差、平均绝对预测误差等比较5组公式的预测准确性。结果 SRK/T公式,Haigis公式,眼轴优化后的SRK/T公式,Barrett UniversalⅡ公式及Hill-RBF Calculator Version 3.0的平均绝对屈光误差分别为0.81D (0.45D,1.01D),0.74D (0.47D,0.92D),0.42D (0.20D,0.46D),0.39D (0.13D,0.47D),0.36D (0.12D,0.41D)。Barrett UniversalⅡ公式、Hill-RBF Calculator Version 3.0与眼轴优化后的SRK/T公式,Haigis公式与SRK/T公式对比,两两相比均无统计学差异(所有P>0.05),而Barrett UniversalⅡ公式、Hill-RBF Calculator Version 3.0、眼轴优化后的SRK/T公式与Haigis公式、SRK/T公式两两相比,差异均有统计学意义(所有P<0.05)。平均中位绝对误差从低到高依次为:Barrett UniversalⅡ公式0.22D,Hill-RBF Calculator Version 3.0 0.23D,眼轴优化后的SRK/T公式0.33D,Haigis公式0.65D,及SRK/T公式0.67D,MedAE最低的公式(Barrett UniversalⅡ公式)分别在53,15%、77,48%和92.79%的病例中产生了±0.25、±0.50和±1.00D的预测误差。结论 Barrett UniversalⅡ公式、和Hill-RBF Calculator Version3.0以及眼轴优化调整后的SRK/T公式,在超高度近视白内障群体中的人工晶体预测准确性较好。

Objective To ccompare the accuracy of several formulas(SRK/T formula,SRK/T formula after optimization of the eye axis,Haigis formula,online formula Barrett Universal Ⅱ and Hill-RBF Calculator Version 3.0) with the optical coherence biometry(IOL-Master) to predict the postoperative refraction in patients with ultra-high myopic cataracts.Methods A total of 82 patients(111 eyes) with ultra-high myopic cataract(AL> 27.00 mm) were collected and underwent cataract ultrasound emulsion extraction combined with posterior chamber IOL(intraocular lens) implantation by the same experienced surgeon.The prediction accuracy of the five formulae was compared by mean prediction error and mean absolute prediction error at 1 month after surgery.Results The mean absolute refractive errors for the SRK/T formula,Haigis formula,axial-length-optimized SRK/T formula,Barrett Universal Ⅱ formula and Hill-RBF Calculator Version 3.0 were 0.81 D(0.45 D,1.01 D),0.74 D(0.47 D,0.92 D),0.42 D(0.20 D,0.46 D),0.39 D(0.13 D,0.47 D),0.36 D(0.12 D,0.41 D).The Barrett Universal Ⅱ formula,Hill-RBF Calculator Version 3.0 and the SRK/T formula after eye axis optimization,the Haigis formula and the SRK/T formula,there was no statistical difference between the two comparisons(all P> 0.05),while the Barrett Universal Ⅱ formula,Hill-RBF Calculator Version 3.0,and the axial-lengthoptimized SRK/T formula were statistically significant(all P <0.05) compared with the Haigis formula and the SRK/T formula between the two comparisons.The mean median absolute error(MedAE) was,in ascending order,0.22 D for the Barrett Universal Ⅱ formula,0.23 D for the Hill-RBF Calculator Version 3.0,0.33 D for the axial-length-optimized SRK/T formula,0.65 D for the Haigis formula,and 0.67 D for the SRK/T formula.The formula with the lowest MedAE(Barrett Universal Ⅱ formula) yielded prediction errors of ±0.25,±0.50,and ±1.00 D in 53.15%,77.48%,and 92.79% of cases,respectively.Conclusion The Barrett Universal Ⅱformula,and Hill-RBF Calculator Version 3.0,as well as the axial-length-optimized SRK/T formula,have better IOL prediction accuracy in the ultrahigh myopic cataract population.