AIM : To evaluate the prediction error in intraocular lens(IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation...AIM : To evaluate the prediction error in intraocular lens(IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position(ELP).METHODS: Retrospective study including a total of 25 eyes of 13 patients(age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL(Oculentis Gmb H, Germany). In all cases, an adjusted IOL power(P IOLadj) was calculated based on Gaussian optics using a variable keratometric index value(n kadj) for the estimation of the corneal power(P kadj) and on a new value for ELP(ELP adj) obtained by multiple regression analysis.This P IOLadj was compared with the IOL power implanted(P IOLReal) and the value proposed by three conventional formulas(Haigis, Hoffer Q and Holladay Ⅰ).RESULTS: P IOLReal was not significantly different than P IOLadj and Holladay IOL power(P 】0.05). In the Bland and Altman analysis, P IOLadj showed lower mean difference(-0.07 D) and limits of agreement(of 1.47 and-1.61 D)when compared to P IOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELP adj was significantly lower than ELP calculated with other conventional formulas(P 【0.01) and was found to be dependent on axial length, anterior chamber depth and P kadj. CONCLUSION: Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing thekeratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors.展开更多
目的利用IOLMaster700对比分析飞秒激光辅助超声乳化术后3种多焦点人工晶状体术后有效位置和轴向移动量的变化趋势。方法选取2018年3月至12月就诊于潍坊眼科医院的年龄相关性白内障患者79例(92只眼)进行研究。所有患者均接受同一术者飞...目的利用IOLMaster700对比分析飞秒激光辅助超声乳化术后3种多焦点人工晶状体术后有效位置和轴向移动量的变化趋势。方法选取2018年3月至12月就诊于潍坊眼科医院的年龄相关性白内障患者79例(92只眼)进行研究。所有患者均接受同一术者飞秒激光辅助超声乳化术,依据植入多焦点人工晶状体的类型将患者分为Lisa组、Restor组及Oculentis组3组,并分别植入AT Lisa tri839MP、AcrySof Restor及Oculentis LS-313型人工晶状体。使用IOLmaster700测量患者术后1周、1个月及3个月人工晶状体的有效位置(ELP),计算每个时间段ELP的移动量。ELP的移动量以各时间段ELP变化的均方根表示。术前三组性别的描述采用例数和百分比,组间比较采用卡方检验。术前三组患者的年龄、前房深度、晶状体厚度及人工晶状体度数符合正态分布,以x±s描述,组间比较采用单因方差分析。三组不同时间点ELP的比较,采用两因素重复测量方差分析。当差异具有统计学意义时,进一步采用SNK法两两比较。结果三组患者性别的比较,差异无统计学意义(χ^(2)=0.96,P>0.05);三组患者年龄、前房深度、晶状体厚度及人工晶状体屈光度的比较,差异无统计学意义(F=1.38,0.16,2.40,0.35,0.89;P>0.05)。Lisa组患者术后1周、1个月及3个月的ELP均值分别为(4.84±0.14)mm、(4.95±0.17)mm及(4.97±0.17)mm。三者比较的差异具有统计学意义(F=2.29,P<0.05);术后1个月与术后3个月的比较,差异无统计学意义(F=0.38,P>0.05)。Restor组患者术后1周、1个月及3个月的ELP均值分别为(4.94±0.25)mm、(4.95±0.28)mm及(4.92±0.27)mm。术后1周和术后3个月与术后1个月ELP均值的比较,差异均无统计学意义(F=0.13,0.37;P>0.05)。Oculentis组患者术后1周、1个月及3个月的ELP均值分别为(4.72±0.25)mm、(4.80±0.23)mm及(4.80±0.22)mm。术后1周与术后1个月ELP均值的比较,差异有统计学意义(F=2.35,P<0.05);术后1个月与术后3个月的比较,差异无统计学意义(F=0.08,P>0.05)。三组患者术后1周、1个月及3个月ELP均值组间的比较,差异均无统计学意义(F=1.56,1.78,1.45;P>0.05)。Lisa组、Restor组及Oculentis组ELP变化的均方根分别为(0.08±0.07)mm、(0.04±0.04)mm及(0.06±0.06)mm,三组比较的差异无统计学意义(F=2.16,P>0.05)。结论3种不同设计的人工晶状体在囊袋内达到稳定状态所需的时间不同。其中,AcrySof Restor在术后1周稳定,AT Lisa tri 839MP和Oculentis LS-313在术后1个月稳定。ELP变化的均方根能够体现人工晶状体轴向的微小移动量,扫频源断层相干光成像技术是评估人工晶状体植入术后有效位置和位移量变化的有效方法。展开更多
文摘AIM : To evaluate the prediction error in intraocular lens(IOL) power calculation for a rotationally asymmetric refractive multifocal IOL and the impact on this error of the optimization of the keratometric estimation of the corneal power and the prediction of the effective lens position(ELP).METHODS: Retrospective study including a total of 25 eyes of 13 patients(age, 50 to 83y) with previous cataract surgery with implantation of the Lentis Mplus LS-312 IOL(Oculentis Gmb H, Germany). In all cases, an adjusted IOL power(P IOLadj) was calculated based on Gaussian optics using a variable keratometric index value(n kadj) for the estimation of the corneal power(P kadj) and on a new value for ELP(ELP adj) obtained by multiple regression analysis.This P IOLadj was compared with the IOL power implanted(P IOLReal) and the value proposed by three conventional formulas(Haigis, Hoffer Q and Holladay Ⅰ).RESULTS: P IOLReal was not significantly different than P IOLadj and Holladay IOL power(P 】0.05). In the Bland and Altman analysis, P IOLadj showed lower mean difference(-0.07 D) and limits of agreement(of 1.47 and-1.61 D)when compared to P IOLReal than the IOL power value obtained with the Holladay formula. Furthermore, ELP adj was significantly lower than ELP calculated with other conventional formulas(P 【0.01) and was found to be dependent on axial length, anterior chamber depth and P kadj. CONCLUSION: Refractive outcomes after cataract surgery with implantation of the multifocal IOL Lentis Mplus LS-312 can be optimized by minimizing thekeratometric error and by estimating ELP using a mathematical expression dependent on anatomical factors.
文摘目的利用IOLMaster700对比分析飞秒激光辅助超声乳化术后3种多焦点人工晶状体术后有效位置和轴向移动量的变化趋势。方法选取2018年3月至12月就诊于潍坊眼科医院的年龄相关性白内障患者79例(92只眼)进行研究。所有患者均接受同一术者飞秒激光辅助超声乳化术,依据植入多焦点人工晶状体的类型将患者分为Lisa组、Restor组及Oculentis组3组,并分别植入AT Lisa tri839MP、AcrySof Restor及Oculentis LS-313型人工晶状体。使用IOLmaster700测量患者术后1周、1个月及3个月人工晶状体的有效位置(ELP),计算每个时间段ELP的移动量。ELP的移动量以各时间段ELP变化的均方根表示。术前三组性别的描述采用例数和百分比,组间比较采用卡方检验。术前三组患者的年龄、前房深度、晶状体厚度及人工晶状体度数符合正态分布,以x±s描述,组间比较采用单因方差分析。三组不同时间点ELP的比较,采用两因素重复测量方差分析。当差异具有统计学意义时,进一步采用SNK法两两比较。结果三组患者性别的比较,差异无统计学意义(χ^(2)=0.96,P>0.05);三组患者年龄、前房深度、晶状体厚度及人工晶状体屈光度的比较,差异无统计学意义(F=1.38,0.16,2.40,0.35,0.89;P>0.05)。Lisa组患者术后1周、1个月及3个月的ELP均值分别为(4.84±0.14)mm、(4.95±0.17)mm及(4.97±0.17)mm。三者比较的差异具有统计学意义(F=2.29,P<0.05);术后1个月与术后3个月的比较,差异无统计学意义(F=0.38,P>0.05)。Restor组患者术后1周、1个月及3个月的ELP均值分别为(4.94±0.25)mm、(4.95±0.28)mm及(4.92±0.27)mm。术后1周和术后3个月与术后1个月ELP均值的比较,差异均无统计学意义(F=0.13,0.37;P>0.05)。Oculentis组患者术后1周、1个月及3个月的ELP均值分别为(4.72±0.25)mm、(4.80±0.23)mm及(4.80±0.22)mm。术后1周与术后1个月ELP均值的比较,差异有统计学意义(F=2.35,P<0.05);术后1个月与术后3个月的比较,差异无统计学意义(F=0.08,P>0.05)。三组患者术后1周、1个月及3个月ELP均值组间的比较,差异均无统计学意义(F=1.56,1.78,1.45;P>0.05)。Lisa组、Restor组及Oculentis组ELP变化的均方根分别为(0.08±0.07)mm、(0.04±0.04)mm及(0.06±0.06)mm,三组比较的差异无统计学意义(F=2.16,P>0.05)。结论3种不同设计的人工晶状体在囊袋内达到稳定状态所需的时间不同。其中,AcrySof Restor在术后1周稳定,AT Lisa tri 839MP和Oculentis LS-313在术后1个月稳定。ELP变化的均方根能够体现人工晶状体轴向的微小移动量,扫频源断层相干光成像技术是评估人工晶状体植入术后有效位置和位移量变化的有效方法。
