CASIA2优化的NK和KS公式预测ICL(V4c)拱高与实际拱高的对比研究

Comparative study on CASIA2 optimized NK and KS formulas for predicting ICL(V4c)vault and actual vault

目的研究CASIA2优化的NK和KS公式预测ICL(V4c)拱高与实际拱高的一致性。设计诊断技术评价。研究对象合肥爱尔眼科医院行ICL植入手术患者68例(68眼)。方法应用Nomogram在线公式计算68眼ICL型号,根据在线公式推荐结果分为12.1 mm、12.6 mm、13.2 mm ICL三组,再采用CASIA2测量以上三种型号组术后1天实际拱高(V1d12.1、V1d12.6、V1d13.2)、术后1个月实际拱高(V1m12.1、V1m12.6、V1m13.2),分别计算与CASIA2术前应用NK、KS公式预测拱高值的差异性、相关性和一致性,以及CASIA2内置的NK、KS公式术前推荐的ICL(V4c)型号与在线公式推荐的ICL(V4c)型号之间的符合率。主要指标实际拱高与公式预测拱高的相关性和一致性。结果全部术眼(68眼)术后1天实际拱高为(528.8±176.9)μm,术后1个月有所降低,为(476.8±161.2)μm。NK公式预测拱高为(656.2±204.5)μm,KS公式为(707.1±173.8)μm。Nomogram在线公式与NK公式之间总符合率为55.88%,与KS公式总符合率为42.65%。3种型号ICL(V4c)组术后1天实际拱高(V1d12.1、V1d12.6、V1d13.2)和1个月的实际拱高(V1m12.1、V1m12.6、V1m13.2)分别与NK公式预测拱高(VNK)、KS公式预测拱高(VKS)之间比较,除了V1d12.1组与VKS组拱高差异无统计学意义(t=-2.056,P=0.079)外,其余各型号组实际拱高均低于NK公式和KS公式预测的拱高(P均<0.05)。NK公式、KS公式的预测拱高与V1d均呈线性关系(Y=0.4728*X+218.6,Y=0.5450*X+143.4);与V1m也均呈线性关系(Y=0.3985*X+215.3,Y=0.4604*X+151.2)。68例患者术后V1d与NK公式、KS公式预测的拱高之间组内相关系数(ICC)分别为0.541、0.536,克隆巴赫系数分别为0.702、0.700;术后V1m与NK公式、KS公式预测拱高之间ICC分别为0.492、0.495,克隆巴赫系数分别为0.659、0.662。Bland-Altman分析V1d与NK公式、KS公式预测的拱高之间95%LoA分别为-486.5~231.7μm、-509.6~153.0μm,V1m与NK公式、KS公式预测的拱高之间95%LoA分别为-543.4~184.5μm、-560.6~99.86μm。结论CASIA2优化的NK和KS公式预测的ICL(V4c)拱高均较实际拱高偏高,两种公式对小型号组ICL(V4c)预测的准确性稍好。

Objective To study the consistency between actual vault and the vault predictedby NK and KS formulas optimized by CASIA2.Design Diagnostic technique evaluation.Participants 68 cases(68 eyes)of ICL implantation in Hefei Aier Eye Hospital.Methods The Nomogram online formula was used to calculate 68 eyes'ICL models,and they were divided into three groups of 12.1 mm,12.6 mm and 13.2 mm according to the recommended results of the online formula.Then CASIA2 was used to measure the actual vault.The difference,correlation and consistency were compared between the actual vault(V1d12.1,V1d12.6,V1d13.2)1 day after operation,actual vault(V1m12.1,V1m12.6,V1m13.2)1 month after operation in the above three types of groups and the vault predicted by NK and KS formulas before operation built-in CASIA2,and the coincidence rate was also compared among the ICL(V4c)model recommended by the online formula NK and KS,respectively.Main Outcome Measures Correlation and consistency between actual vault and formula predicted vault.Results One day after surgery,the actual vault of all eyes(68 eyes)was(528.8±176.9)μm.One month after operation,it decreased to(476.8±161.2)μm.The vault predicted by NK formula was(656.2±204.5)μm and KS formula was(707.1±173.8)μm.The total coincidence rate between Nomogram online formula and NK formula was 55.88%,and the total coincidence rate with KS formula was 42.65%.The actual vault(V1d12.1,V1d12.6,V1d13.2)and the actual vault(V1m12.1,V1m12.6,V1m13.2)of the three ICL(V4c)groups at one day and one month after surgery were compared with the vault predicted by NK formula(VNK)and KS formula(VKS)respectively,except that there was no statistically significant difference between the vault of V1d12.1 group and VKS group(t=-2.056,P=0.079),the actual vault of other model groups were lower than those predicted by NK formula and KS formula(all P<0.05).The predicted vault of NK formula and KS formula was linear with V1d(Y=0.4728*X+218.6,Y=0.5450*X+143.4),it was also linear with V1m(Y=0.3985*X+215.3,Y=0.4604*X+151.2).The intra group correlation coefficients(ICC)between V1d and VNK,V1d and VKS formula was 0.541 and 0.536;the Cronbach coefficients was 0.702 and 0.700,respectively.The ICC between V1m and VNK,V1m and VKS formula was 0.492 and 0.495,the Cronbach coefficient was 0.659 and 0.662,respectively.Bland-Altman analysis showed that 95%LoA between V1d and vault predicted by NK formula and KS formula was(-486.5~231.7)μm,(-509.6~153.0)μm,respectively.95%LoA between V1m and vault predicted by NK formula and KS formula was(-543.4~184.5)μm,(-560.6~99.86)μm,respectively.Conclusions The predicted vault of CASIA2 optimized NK and KS formulas is higher than the actual vault,and the accuracy of CASIA2 optimized NK and KS formulas for predicting small model group ICL(V4c)is slightly better.