六种新一代人工晶状体屈光力计算公式的预测准确性比较

Comparison of the prediction accuracy of six new generation intraocular lens power calculation formulas

目的:比较六种新一代人工晶状体(intraocular lens,IOL)屈光力计算公式[Barrett UniversalⅡ(BUⅡ)、Emmetropia Verifying Optical(EVO)、Hill-Radial Basis Function(Hill-RBF)、Kane、Ladas Super Formula(LSF)、T2]和传统公式(Haigis、Hoffer Q、Holladay 1、SRK/T)的准确性。方法:纳入2022年1-6月于温州医科大学附属眼视光医院接受白内障手术患者。收集患者的年龄、性别、眼轴(axial length,AL)、平均角膜曲率(mean keratometry,Kmean)、前房深度、IOL常数和屈光力,术后医学验光结果。对上述10种公式进行准确性分析,包括平均预测误差(mean prediction error,ME)及其标准差、平均绝对预测误差(mean absolute prediction error,MAE)、绝对预测误差中位数(median absolute prediction error,MedAE)、绝对预测误差最大值(maximum absolute prediction error,MaxAE)、预测误差落在±0.25、±0.5、±0.75、±1.00 D范围内的百分比(%±0.25 D、%±0.50 D、%±0.75 D、%±1.00 D)。结果:共纳入506例(506眼)。Kane的MAE最低(0.411)。Hill-RBF的%±0.25 D最高(40.91%),EVO的%±0.50 D或%±0.75 D最高(分别为69.37%、86.17%),BUⅡ和Hill-RBF的%±1.00 D最高(均为94.07%)。总体上各种公式间,MAE、%±0.50 D、%±0.75 D、%±1.00 D比较差异存在统计学意义(P<0.05),但两两比较仅发现%±0.75 D中,EVO(86.17%)、Hill-RBF(85.97%)、Kane(85.57%)与HofferQ(81.42%)比较差异存在统计学意义(均P<0.05)。AL亚组中,长AL组的EVO(0.390)、Hill-RBF(0.388)、T2(0.423)、Kane(0.393)四种公式的MAE与HofferQ(0.681)、Holladay 1(0.654)比较差异存在统计学意义(均P<0.05),EVO(74.47%)的%±0.50 D与Hoffer Q(46.81%)比较差异存在统计学意义(P=0.017)。结论:新一代IOL屈光力计算公式在IOL屈光力计算上均具有较好的准确性,但对于不同的眼轴长度与角膜曲率值的眼球,需要选择适合的计算公式,以进一步提高预测准确性。

Objective:This study aimed to compare the accuracy of six new generation intraocular lenses(IOL)refractive power calculation formulas(Barrett UniversalⅡ[BUⅡ],Emmetropia Verifying Optical[EVO],Hill-Radial Basis Function[Hill-RBF],Kane,Ladas Super Formula[LSF],T2)and traditional formulas(Haigis,Hoffer Q,Holladay 1,SRK/T).Methods:The patients who received cataract surgery in the Eye Hospital of Wenzhou Medical University from January 2022 to June 2022 were included in this study.Age,gender,axial length(AL),mean keratometry,anterior chamber depth,IOL constant and power,and postoperative refraction results were collected.The prediction accuracy of these ten IOL power calculation formulas was analyzed,including mean prediction error(ME)and its standard deviation,mean absolute prediction error(MAE),median absolute prediction error(MedAE),maximum absolute prediction error(MaxAE),the percentage of eyes of PE within the range of±0.25 D,±0.5 D,±0.75 D,±1.0 D(%±0.25 D,%±0.50 D,%±0.75 D,%±1.00 D).Results:506 eyes of 506 patients were included.Kane has the lowest MAE(0.411).%±0.25 D of Hill-RBF was the highest(40.91%),%±0.50 D or%±0.75 D of EVO was the highest(69.37%,86.17%),and%±1.00 D of BUⅡand Hill-RBF was the highest(94.07%).There are significant differences in MAE,%±0.50 D,%±0.75 D,and%±1.00 D among all formulas(P<0.05).Still,pairwise comparison only found differences between EVO(86.17%),Hill-RBF(85.97%),Kane(85.57%),and Hoffer Q(81.42%)in%±0.75 D(all P<0.05).In AL subgroup,the MAE of EVO(0.390),Hill-RBF(0.388),T2(0.423)and Kane(0.393)in long AL group was different from that of Hoffer Q(0.681)and Holladay 1(0.654)(all P<0.05),the difference of%±0.50D of EVO(74.47%)compared with Hoffer Q(46.81%)(P=0.017).Conclusion:The new generation of IOL power calculation formulas have good accuracy in IOL power prediction,but for eyes with different axial lengths and keratometry,it is necessary to optimize the selection of formulas to improve the prediction accuracy further.