正常眼轴5种新型Toric IOL度数计算公式的准确性比较

A Comparison of the Accuracy of Five Modern Toric IOL Formulas with Average Axial Lengths

目的:比较Barrett[基于预计的角膜后表面散光(PPCA)]、Barrett[基于测量的PCA(Measured PCA,MPCA)]、EVO 2.0、Kane、N?ser-Savini散光矫正型(Toric)人工晶状体(IOL)度数计算公式在正常眼轴的预测准确性。方法:回顾性连续病例研究。收集2015年5月至2021年6月在温州医科大学附属眼视光医院杭州院区行白内障超声乳化吸除联合AcrySof Toric IOL植入术的患者304例(304眼)。术前使用IOL Master 500/700测量眼轴长度(AL)和角膜散光,术后1~3个月使用综合验光仪进行主觉验光。用矢量分析的方法计算散光预测误差(PE)、平均绝对预测误差(MAE)、中位数绝对预测误差、绝对预测误差的标准差以及PE在±0.25 D、±0.50 D、±0.75 D和±1.00 D以内的眼的百分比,使用非参数Friedman检验评估公式之间MAE的差异。结果:Kane的MAE均低于所有公式(P<0.001)并且PE在±0.50 D以内的比例最高,为54%,其次是N?ser-Savini(47%),Barrett(MPCA)(44%),Barrett(PPCA)(42%),EVO 2.0(39%)。N?ser-Savini、Barrett(MPCA)、Barrett(PPCA)和EVO 2.0的MAE之间差异没有统计学意义。结论:与N?ser-Savini、Barrett(PPCA)、Barrett(MPCA)和EVO 2.0相比,对于正常眼轴白内障患者采用Kane计算器计算Toric IOL度数可以减小PE,提高Toric IOL矫正效果。

Objective:To compare the prediction accuracy of the Barrett(predicted posterior corneal astigmatism,PPCA),the Barrett(measured PCA,MPCA),the EVO 2.0,the Kane,the Næser-Savini toric intraocular lens(IOL)power formulas of toric IOL refractive outcomes in eyes of average axial lengths.Methods:This retrospective consecutive case study included 304 patients(304 eyes)who underwent microincision phacoemulsification and AcrySof toric intraocular lens implantation from May 2015 to June 2021 at the Eye Hospital,Wenzhou Medical University at Hangzhou.Using vector analysis,the astigmatism prediction error(PE),the mean absolute prediction error(MAE),the median absolute prediction error(MedAE),the standard deviation of the prediction error,and the percentage of eyes with PE within±0.25 diopter(D),±0.50 D,±0.75 D and±1.00 D were calculated.The differences between the MAE between formulas was assessed using the nonparametric Friedman test.Results:The Kane formula showed a statistically significantly lower MAE(P<0.001)comparing with all other formulas.The Kane formula showed the highest proportion of eyes with PE within±0.50 D with 54%,followed by the Næser-Savini formula(47%),Barrett(MPCA)formula(44%),Barrett(PPCA)formula(42%),and EVO 2.0 formula(39%).No statistically significant difference existed among the MAE calculated from the Næser-Savini,Barrett(MPCA),Barrett(PPCA)and EVO 2.0 toric formulas.Conclusion:Compared with the Barrett(PPCA),Barrett(MPCA),Næser-Savini,and EVO 2.0 toric formulas,the application of Kane calculator in calculating toric IOL dioptor could reduce PE and improve toric IOL refaractive outcomes.