基于扫频OCT测量的术前晶状体界面位置对于白内障术后人工晶状体真实位置的预测价值

Effect of preoperative intracrystalline interphase position measured based on swept-source optical coherence tomography in estimating the actual lens position of intraocular lens after cataract surgery

目的 探讨基于扫频OCT(SS-OCT)技术的光学生物测量仪IOLMaster 700获得的晶状体界面位置(IIP)对白内障术后人工晶状体(IOL)的真实位置(ALP)的预测价值。方法 回顾性描述性研究。选取2021年7月至2022年7月于苏州大学附属第一医院眼科接受白内障手术的年龄相关性白内障患者208例208眼为研究对象。根据植入的IOL不同分为2组:IQ组(80眼)术中植入IQ IOL;ZCB组(128眼)术中植入ZCB IOL。使用基于SS-OCT的生物测量仪IOLMaster 700在术前和术后3个月对患眼进行生物学参数的测量,获取ALP、术后前房深度(ACD)、IOL厚度等参数,并计算IOL位置误差。结果 白内障术后,208眼的绝对屈光度预测误差(ARPE)为(0.43±0.35) D,134眼(64.4%)的ARPE<0.50 D。与IQ组相比,ZCB组患眼的ALP和ALP2值更大(均为P<0.001)。与IQ组相比,ZCB组ARPE≥0.50 D患眼的IIP显著降低(P=0.028);在ZCB组患者中,与ARPE<0.50 D相比,ARPE≥0.50 D患眼的IIP显著降低(P=0.041)。两组患者的ALP与IIP均具有较好的相关性(IQ组:r=0.815,P<0.001;ZCB组:r=0.757,P<0.001);ALP2与IIP也均具有较好的相关性(IQ组:r=0.797,P<0.001;ZCB组:r=0.743,P<0.001)。通过IIP和术前参数可以获得线性表达式来预测ALP(IQ组、ZCB组的R^(2)分别为0.70、0.68)。结论 基于SS-OCT技术的IOL Master 700测量的IIP位置与白内障术后的ALP相关,可用于优化IOL度数计算。

Objective To investigate the effect of the intracrystalline interphase position(IIP)measured with IOLMaster 700 based on swept-source optical coherence tomography(SS-OCT)in estimating the actual lens position(ALP)of an intraocular lens(IOL)after cataract surgery.Methods This study was a retrospective and descriptive study.A total of 208 patients(208 eyes)with age-related cataract who underwent cataract surgery in the Ophthalmology Department of the First Affiliated Hospital of Soochow University from July 2021 to July 2022 were selected for the study.The patients were divided into 2 groups according to the type of IOL implanted:IQ group(80 eyes,implanted with IQ IOL during cataract surgery)and ZCB group(128 eyes,implanted with ZCB IOL during cataract surgery).The SS-OCT-based IOLMaster 700 was used to measure biological parameters of the affected eyes before and 3 months after surgery.The ALP,postoperative anterior chamber depth,and IOL thickness were obtained,and the IOL position error was calculated.Results After cataract surgery,the mean absolute refractive prediction error(ARPE)of 208 eyes was(0.43±0.35)D,and 134 eyes(64.4%)showed an ARPE less than 0.50 D.Significantly higher ALP and ALP2 values were found in the ZCB group compared with the IQ group(both P<0.001).Significant lower IIP values were found in the eyes with ARPE≥0.50 D in the ZCB group compared with the IQ group(P=0.028).Significant lower IIP values were found in the eyes with ARPE≥0.50 D compared with the eyes with ARPE<0.50 D in the ZCB group(P=0.041).The correlation of the ALP with the IIP was good in both groups(IQ group:r=0.815,P<0.001;ZCB group:r=0.757,P<0.001).The correlation of the ALP2 with the IIP was also good in both groups(IQ group:r=0.797,P<0.001;ZCB group:r=0.743,P<0.001).Linear expressions were obtained based on IIP and preoperative data to predict the ALP(R^(2)=0.70 and 0.68 in the IQ group and ZCB group,respectively).Conclusion The IIP measured with the SS-OCT-based IOLMaster 700 is correlated with the ALP after cataract surgery,and it can be used to optimize IOL power calculations.