目的：评估新一代基于人工智能(artificial intelligence,AI)的人工晶状体(intraocular lens,IOL)计算公式的准确性。方法：本研究为回顾性研究，纳入因白内障行晶状体超声乳化联合IOL植入术的262例患者262眼。在术前，通过IOLMaster700获取角膜曲率、角膜白到白、中央角膜厚度、前房深度、晶状体厚度以及眼轴长度。使用第三代公式(SRK/T、Holladay 1和Hoffer Q)、Barrett UniversalⅡ(BUⅡ)、新一代AI公式(Kane、Pearl-DGS、Hill-RBF 3.0、Hoffer QST和Jin-AI)对术后屈光状态进行计算，并与术后实际的屈光状态进行比较。在将预测误差(prediction error,PE)归零后，分析了各公式的标准差(standard deviation,SD)、绝对误差均值(mean absolute error,MAE)、绝对误差中位数(median absolute error,MedAE)以及PE在±0.25、±0.50、±1.00、±2.00 D范围内的百分比。结果：基于AI的IOL屈光力计算公式的SD、MAE和MedAE的范围分别为0.37 D(Kane和Jin-AI)至0.39 D(Hoffer QST)、0.28 D(Hill-RBF 3.0和Jin-AI)至0.31 D(Hoffer QST)以及0.21 D(Hill-RBF3.0和Jin-AI)至0.24 D(HofferQST)；均低于第三代公式(SD：0.43 D~0.45 D；MAE：0.34 D；MedAE：0.25 D~0.28 D)。在所有公式中，Jin-AI公式预测误差在±0.50 D的比例最高，为84.73%，Kane(84.35%)和BUⅡ(83.97%)公式次之。结论：在IOL屈光力预测上，与传统第三代公式相比，新一代基于AI的公式表现出更高的准确性，可以使更多的患者在术后获得预期的屈光状态。

Objective: To evaluate the accuracy of new generation artificial intelligence (AI)-based intraocular lens (IOL)power calculation formulas. Methods: This retrospective study included a total of 262 eyes from 262 patients with cataract who underwent uneventful phacoemulsification combined with IOL implantation. Keratometry, corneal white-to-white, central corneal thickness, anterior chamber depth, lens thickness, and axial length were measured by the IOL Master 700 before surgery. Predicted refractive errors were calculated by the third-generation formulas (SRK/T, Holladay 1, and Hoffer Q), Barrett UniversalⅡ (BUⅡ), and the newer-generation AI formulas (Kane, Pearl-DGS, Hill-RBF 3.0, Hoffer QST, and Jin-AI), and were compared with the actual postoperative refractive value. After adjusting the prediction error (PE) to zero, the standard deviation (SD), mean absolute error (MAE), median absolute error (MedAE), and the percentage of a PE within the range of ±0.25 diopter (D), ±0.50 D, ±1.00 D, and ±2.00 D were analyzed. Results: The SD, MAE, and MedAE of the AI-based formulas ranged from 0.37 D (Kane and Jin-AI) to 0.39 D (Hoffer QST), 0.28 D (Hill-RBF 3.0 and Jin-AI) to 0.31 D (Hoffer QST), and 0.21 D (Hill-RBF 3.0 and Jin-AI) to 0.24 D (Hoffer QST), respectively. These values were all lower than those of the third-generation formula (SD: 0.43 D to 0.45 D; MAE: 0.34 D; MedAE: 0.25 D to 0.28 D). Among all the formulas, the Jin-AI formula had the highest proportion of a PE within ±0.50 D (84.73%), followed by Kane (84.35%) and BUⅡ (83.97%) formulas. Conclusion: The new AI-based IOL formulas show higher accuracy compared with the traditional third-generation ones in predicting IOL power. thereby enabling more patients to achieve the expected refractive outcomes after surgery

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 Universal Ⅱ(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Hoffer Q(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 Universal Ⅱ [BU Ⅱ ], 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 BU Ⅱ and 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.

目的：探讨人工晶状体(IOL)预先巩膜悬吊在严重晶状体半脱位中的应用效果。方法：选取 2018年12月至2022年7月四川省人民医院收治的>180°的严重晶状体半脱位患者8例(8 眼)。术中避开脱位的晶状体，预先将IOL悬吊于玻璃体腔，再将晶状体托起置于IOL上方，必要时辅助以虹膜拉钩，稳定晶状体，确保超声乳化手术安全完成。结果：严重的晶状体半脱位患者8例，其中晶状体核N1-N3硬度的患者各1例，单独使用IOL预先巩膜悬吊于术中稳定脱位的晶状体，3例超声乳化手术均顺利完成；达N4患者3例、N5患者2例，其中4例在虹膜拉钩的辅助下安全完成超声乳化；有1例N5的患者，由于悬韧带损伤超过270°，在将晶状体托起放置于IOL之上时，坠入玻璃体腔，给予玻璃体腔超声粉碎处理。8例患者术后IOL均居中，视力有不同程度的提高，眼压正常，未见严重并发症。结论：在严重晶状体半脱位的超声乳化手术中，对于N2~N3的软核，IOL预先巩膜悬吊可以良好地稳定晶状体，确保超声乳化手术的顺利进行；对于N4~N5的硬核，IOL预先巩膜悬吊可以作为一种辅助方法，联合虹膜拉钩共同稳定晶状体，确保超声乳化手术的安全进行。

Objective: To investigate the effect of intraocular lens (IOL) pre-suspension in thetreatment of severe lens subluxation. Methods: Retrospective case study. From December 2018 to July 2022, 8 eyes of 8 patients with severe lens subluxation greater than 180 degrees admitted to our hospital were selected. During surgery, the IOL should avoid the subluxated lens and be pre-suspended in the vitreous cavity, and then the lens is lifted and placed above the IOL. If necessary, the iris hook can be used to stabilize the lens to ensure the safe completion of phacoemulsification. Results: There were 8 patients with severe subluxation of lens. Among them, the hardness of 3 patients' lens nucleus ranged from N1 to N3. In these 3 patients, we used the IOL pre-suspension alone to stabilize the subluxated lens, and phacoemulsification in these 3 patients was successfully completed. Three patients had N4 and 2 patients had N5, of which 4 patients underwent phacoemulsification safely with the assistance of iris hook. In another patient with N5, the lens fell into the vitreous cavity during surgery (the suspension ligament rapture greater than 270 degrees) when it was lifted and placed on the IOL which was crushed by the vitreous cavity ultrasound. After surgery, the IOL was centered in all 8 patients, visual acuity was improved to varying degrees, intraocular pressure was normal, and no serious complications were observed. Conclusions: In severe lens subluxation surgery, IOL presuspension in soft nuclei of N2 to N3 can stabilize the lens well and ensure the safety of phacoemulsification. For hard nuclei N4 to N5, IOL presuspension can be used as an auxiliary method in combination with iris hook to stabilize the lens and ensure the safety of phacoemulsification.

目的：探讨运用Barrett Universal Ⅱ公式(BUⅡ公式)计算人工晶状体(intraocular lens,IOL)屈光力时，可选参数角膜横径，又称白到白(white-to-white,W T W)与晶状体厚度(lens thickness,LT)的实际应用价值。方法：采用单中心、前瞻性临床研究，连续纳入同一术者顺利进行白内障超声乳化吸除术联合MX60(IOL植入术患眼279眼，术前使用OA-2000非接触式光学生物测量仪测量眼部数据并计算IOL植入度数，代入B UⅡ公式保留或去掉可选参数WTW、LT计算预测结果，进一步根据患者眼轴长度(axial length,AL)分亚组分析。主要结局指标：随访患者至术后1个月以上，比较使用和未使用WTW和LT两个参数、BUⅡ公式预测误差(prediction error,PE)、绝对预测误差(absolute error,AE)、AE小于0.5 D所占比例。结果：总体1上，忽略W T W + LT，PE为-0.05 D(-0.26, 0.18)(P=0.011)，其他参数组合的PE与0比较差异无统计学意义(P>0.05)。各参数组合的AE比较差异无统计学意义(0.22~0.23 D，P= 0.404)。同时忽略WTW + LT时AE出现最大值(+1.5 D)。应用WTW + LT、忽略WTW + LT、忽略WTW和忽略LT时纳入患者AE ≤ 0.50 D的比例分别为80.65%、79.57%、80.65%和81.36%。在各眼轴亚组中，忽略LT时，AE ≤ 0.50 D的百分比在短眼轴亚组(80.00% vs.66.67%~73.33%)与长眼轴亚组(77.78% vs. 73.33%~75.56%)中较高。在中等眼轴亚组中，AE ≤ 0.50 D百分比代入全部参数时略高(83.11% vs. 80.82%~82.19%)，忽略WTW + LT计算时稍低(80.82%)。结论：使用BU Ⅱ计算IOL屈光力时，可选参数WTW和LT无论是否代入公式中，皆可得到相近的平均预测水平；但是，同时忽略WTW和LT可能出现较大预测误差。对于22 mm ≤ AL<26 mm眼，推荐代入全部参数计算；当AL≤ 22 mm或AL ≥ 26 mm，仅输入WTW的计算方法累积精确度更高，可优先采用。

Objective: To investigate the practical application value of the optional parameters of corneal horizontal diameter or white to white (WTW) and lens thickness (LT) a using Barrett Universal II formula. Methods: Single-center, prospective clinical study. Eligible 279 eyes who underwent uneventful phacoemulsification and enVista MX60 implantation by the same surgeon were consecutively enrolled. OA-2000 (Tomey, Japan) non-contact optical biometry was used to measure the ocular data and calculate the IOL implantation power preoperatively. The BU II network formula was used to retain or remove optional parameters WTW and LT, and the predicted results were calculated. Further subgroup analysis was conducted based on the patient's axial length. Main outcome measures: Follow up patients for more than 1 month after surgery, compare the proportion of using and not using WTW and LT parameters, BU II formula prediction error (PE), absolute prediction error (AE), and AE less than 0.5 D. Results: Overall, ignoring WTW + LT, the median PE was -0.05 D (-0.26, 0.18) (P = 0.011) , and there is no statistically significant difference in PE compared 0 for the other parameter combinations (P > 0.05). There was no significant difference in the median AE of each parameter combination (0.22~0.23 D, P = 0.404). While ignoring both WTW and LT, the maximum AE value (+1.5 D) was found. The proportion of patients with AE ≤ 0.50 D included in the application of WTW+LT, neglect of WTW+LT, neglect of WTW, and neglect of LT were 80.65%, 79.57%, 80.65%, and 81.36%, respectively in each axial subgroup, when LT was ignored, the percentage of AE ≤ 0.50 D was higher in the short axial subgroup (80% vs. 66.67%~73.33%) and the long axial subgroup (77.78% vs. 73.33%~75.56%). In the subgroup of moderate eye axis, the percentage of AE ≤ 0.50 D was slightly higher when all parameters were substituted (83.11% vs. 80.82%~82.19%), and slightly lower when WTW+LT calculation was ignored (80.82%). Conclusions: When applying Barrett Universal II to calculate the refractive power of artificial lenses, the optional parameters WTW and LT can obtain similar average prediction levels regardless of whether they are substituted into the formula; However, ignoring both WTW and LT may result in significant prediction errors. For eyes with a diameter of 22 mm ≤ AL<26 mm, it is recommended to use all parameters for calculation; When AL ≤ 22 mm or AL ≥ 26 mm, the calculation method that only inputs WTW has higher cumulative accuracy, and it is suggested to be prioritized.

YAMANE式后房型人工晶状体巩膜层间固定术是近年出现的一种人工晶状体悬吊术式。该文介绍了笔者结合实际条件对其改良后的手术步骤，手术关键点及使用经验。在缺乏足够囊膜支撑的条件下，此手术方式微创、安全、有效，术后恢复快。在随访期间(最长5年)，视力稳定，未出现人工晶状体脱位、移位、倾斜，人工晶状体夹持及人工晶状体襻暴露等并发症，值得临床推广应用。

The YAMANE intrascleral fixation of posterior chamber intraocular lens (IOL) is a new technique in recent five years for IOL suspension. This article introduces a modified YAMANE technique including surgical procedure, key points and using experience. In the absence of adequate capsular support, this procedure is minimally invasive, safe, effective and has a fast postoperative recovery. During the follow-up period (up to 5 years), the visual acuity was stable, and there were no complications such as luxation of lens, displacement, tilt of intraocular lens, intraocular lens clamping and IOL haptic exposure.

该文报道一例激光原位角膜磨镶(laser-assisted in situ keratectomy,LASIK)术后行白内障超声乳化摘除联合多焦点散光矫正型人工晶状体植入术的病例。该患者为42岁女性患者，20年前外院行双眼LASIK手术，现因右眼视物模糊1年就诊。术前IOLMaster检查患者右眼眼轴长度29.66 mm，前房深度3.18 mm，晶状体厚度4.75 mm，白到白距离11.6 mm，前表面及全角膜散光分别为1.01 D@67 °及0.91 D@56 °。Pentacam角膜地形图15 °范围模拟角膜屈光力得到的角膜散光为1.2 D@58.1 °，为规则领结型。患者眼底检查未见明显异常，因其脱镜意愿强烈，植入双焦点散光矫正型IOL(德国Zeiss公司AT LISA toric 909M)。根据Barrett True-K Toric公式测量的后表面散光计算结果进行手术规划，选择+17 D球镜1.5 D柱镜Zeiss 909M IOL，植入轴位55 °。术后1个月患者裸眼远视力0.8，35 cm裸眼近视力1.0，最佳矫正远视力–0.25 DS/–0.5 DC×120 °至1.0，患者满意。提示经过详细的术前评估及规划，并与患者充分沟通，多焦点散光矫正型人工晶状体可以在部分适合的LASIK术后患者中取得良好效果。

It is reported a case of cataract phacoemulsification combined with toric multifocal intraocular lens (IOL) implantation after LASIK surgery in this article. A 42 year-old female patient who underwent bilateral LASIK surgery in other hospital 20 years ago. She visited our hospital due to blurred vision in her right eye for one year. The preoperative IOL Master examination results showed an axial length of 29.66 mm, anterior chamber depth of 3.18 mm, lens thickness of 4.75 mm, white to white distance of 11.6 mm, and anterior surface and total corneal astigmatism of 1.01 D @ 67 ° and 0.91 D @ 56 °, respectively in right eye. The corneal astigmatism measured by Pentacam using 15°range simulated keratometry is 1.2 D@ 58.1 °, which is a regular bow tie shape.No obvious abnormalities was found in the patient's fundus examination. Due to her strong desire to get rid of the glassesa toric bifocal IOL (AT LISA Toric 909M, Zeiss, Germany) was implanted.Based onthe IOL power calculation results of Barrett True-K Toric formula with measured posterior corneal astigmatism, an IOL with Sph 17.0 D/Cyl1.5 D/A 55°was chosen. One month after surgery, the patient's uncorrected distance visual acuity was 20/25, 35 cm uncorrected near visual acuity was 20/20, and the best corrected distance visual acuity was 20/20 with a prescription of –0.25 DS/–0.5 DC × 120 °. The patient was satisfied with the outcome. After detailed preoperative evaluation and design, and sufficient communication with patients, toric multifocal IOL implantation can achieve good results in some apropriated for the patients after LASIK surgery.

玻璃体视网膜疾病并发白内障患者行玻璃体切割术联合超声乳化白内障摘除术，即前后节联合手术，是高效的手术方式，而后囊膜破裂(posterior capsular rupture,PCR)是超声乳化白内障摘除术的术中并发症之一，能够及时、有效地处理PCR，稳定、安全地植入人工晶状体(intraocular lens,IOL)，对于顺利完成后段手术，减少术后并发症十分重要。本文将对前后段联合手术中后囊膜破裂的术中处理、以及IOL光学部夹持固定法植入IOL的手术技术要点进行总结。

Combined surgery of pars plana vitrectomy (PPV) and phacoemulsification is an effective and safe way for management of retinal diseases complicated with cataract. Posterior capsular rupture (PCR) is one of the common intraoperative complications of phacoemulsification, and it is thus very important to deal with it promptly and efficiently, and ensure the subsequent procedures of intraocular lens (IOL) implantation as well as PPV. We will summarize the key points of the surgical technique for management of PCR and capture of IOL optic during combined surgery.

儿童白内障是全球范围内可治疗儿童盲症的主要原因之一。对于这些患儿而言，手术是恢复或保护视力的主要方法。然而，手术后的并发症，特别是青光眼相关不良事件(glaucoma-related adverse events, GRAEs)，常常成为导致儿童二次致盲的主要原因，这引起了眼科医疗领域的广泛关注。文章综述了儿童Ⅱ期人工晶状体植入术后GRAEs的影响因素，包括手术设计、眼部解剖特征、其他眼部发育异常和全身疾病等。手术设计中是否植入人工晶状体(intraocular lens，IOL)以及植入的时机和位置都对GRAEs的发生有显著影响。此外，眼部解剖特征如角膜直径、眼轴长度、前房深度、中央角膜厚度和术前晶状体厚度等，也是影响GRAEs发生的重要因素。同时，其他眼部发育异常和全身疾病，如先天性无虹膜、先天性风疹综合征等，也会增加儿童白内障术后青光眼的发生率。文章还总结了预测GRAEs的方法，并推荐使用Cox回归模型建立预测模型。这种模型可以有效地预测儿童Ⅱ期IOL植入术后在特定时间段内发展为GRAEs的概率，从而为早期识别GRAEs高危儿童提供了重要的借鉴。通过对GRAEs影响因素的深入分析和预测模型的建立，文章旨在帮助眼科医生更好地理解GRAEs的发生机制，并在手术前对患儿进行风险评估，从而选择最佳的手术方案和预防措施。这对于改善患儿的术后恢复、减少并发症、保护视功能具有重要的临床意义。

Pediatric cataract is one of the leading causes of treatable childhood blindness worldwide. For these children, surgery is the primary method to restore or preserve vision. However, postoperative complications, particularly glaucoma-related adverse events (GRAEs), often become the main reason for secondary blindness in children, attracting widespread concern in the field of ophthalmology. This study reviews the impact factors of glaucoma-related adverse events after secondary intraocular lens (IOL) implantation in children, including surgical design, ocular anatomical characteristics, other ocular developmental abnormalities, and systemic diseases. Whether to implant an IOL in the surgical design and the timing and positioning of the implantation have a significant impact on the occurrence of GRAEs. In addition, ocular anatomical characteristics, such as corneal diameter, axial length, anterior chamber depth, central corneal thickness, and preoperative lens thickness, are also important factors affecting the occurrence of GRAEs. At the same time, other ocular developmental abnormalities and systemic diseases, such as congenital aniridia and congenital rubella syndrome, also increase the incidence of glaucoma after pediatric cataract surgery. The article also summarizes methods for predicting GRAEs and recommends using the Cox regression model to establish a predictive model. This model can effectively predict the probability of children developing GRAEs after secondary IOL implantation within a specific time period, providing an important reference for the early identification of high-risk children for GRAEs. Through in-depth analysis of the impact factors of GRAEs and the establishment of predictive models, the article aims to help ophthalmologists better understand the mechanisms of GRAEs and assess the risks of children before surgery, thereby selecting the best surgical plan and preventive measures. This is of great clinical significance for improving postoperative recovery in children, reducing complications, and protecting visual function.

目的：比较Alcon Acrysof IQ PanOptix TFNT00 (PanOptix)晶状体常数优化前后对人工晶状体(intraocular lens,IOL)度数计算准确性的影响，以及不同眼轴长度晶状体常数优化的效果。方法：回顾性收集2021年6月—2022年3月在上海爱尔眼科医院行白内障超声乳化手术联合植入PanOptix IOL患者的术前眼球生物学测量参数、植入IOL度数和术后1~3个月的显然验光结果。联合SRK/T、Hoffer Q、Holladay 1、Haigis公式，通过回归法计算优化的晶状体常数A、pACD、SF，通过多元线性回归计算优化的晶状体常数a0、a1和a2。观察晶状体常数优化前后平均绝对预测误差值(mean absolute error,MAE)及中位绝对预测误差值(median absolute error,MedAE)，预测误差在±0.25、±0.50、±0.75、±1.00 D以内的百分比的差异，评价晶状体常数优化对IOL计算准确性的影响。随后，按照眼轴长度进行分组(非高度近视组：<26.00 mm; 高度近视组：≥26.00 mm)，比较非高度近视组和高度近视组优化晶状体常数的差异。结果：共92眼(54位患者)纳入研究。优化前的晶状体常数A、pACD、SF、a0、a1和a2分别为119.1、5.63、1.83、1.39、0.40和0.10；优化后分别为119.35、6.14、2.36、?3.42，0.12和0.34。在全部眼轴组，晶状体常数优化前，SRK/T、Hoffer Q、Holladay 1、Haigis公式的MAE值分别为0.44、0.50、0.54、0.46 D；优化后，MAE值分别为0.43、0.54、0.51、0.35 D，其中Haigis公式优化前后比较差异有统计学意义(P=0.001)。在非高度近视组，晶状体常数优化前，4条公式的MAE值分别为0.46、0.40、0.40、0.42 D；优化后，MAE值分别为0.46 D、0.38 D、0.39 D、0.38 D，比较差异均无统计学意义(均P>0.05)。在高度近视组，晶状体常数优化前，4条公式的MAE值分别为0.42、0.59、0.66、0.50 D；优化后，MAE值分别为0.36、0.48、0.47、0.31 D，其中Holladay 1和Haigis公式优化前后比较差异有统计学意义(P 分别为 0.020、0.002)。结论：PanOptix IOL的晶状体常数优化可以提高IOL度数计算的准确性，在高度近视组中比非高度近视组中优化意义更大。

Objective: To assess the benefits of intraocular lens (IOL) constant optimization of Alcon Acrysof IQ PanOptix TFNT00 (PanOptix) on the accuracy of IOL power calculation, and the effects of constant optimization between different axial length (AL) groups were further compared. Methods: Patients who underwent phacoemulsification and implantation with PanOptix IOL between June, 2021 and March, 2022 were included in this retrospective study. The preoperative biological ocular parameters, implanted IOL power, and subjective 1-3 months postoperative refraction were collected. Combined with SRK/T, Hoffer Q, Holladay 1 and Haigis formulas, the optimized IOL constant A, surgeon factor (SF), post-surgery anterior chamber depth (pACD), and a0, a1, a2 were back-calculated. Refractive outcomes using optimized IOL constants were re-calculated combined with the corresponding formulas. Compare the mean absolute error (MAE), medium absolute error (MedAE) and percentage of eyes with IOL prediction errors (PE) within ±0.25, ±0.50, ±0.75 and ±1.00 (diopter)D when using the optimized constants and the manufacture constants. Patients were divided into two groups according to AL (non-high myopia: <26.0 mm; high myopia: ≥26 mm), compare the difference of IOL constant optimization between AL subgroups. Results: A total of 92 eyes of 54 patients were enrolled. The manufacture lens constant of A, pACD, SF, a0, a1 and a2 are respectively 119.1, 5.63, 1.83, 1.39, 0.4 and 0.1; and the optimized values are respectively 119.35, 6.14, 2.36, ?3.42, 0.12 and 0.34. In all patients group, with manufacture lens constant, the MAE values of SRKT, Hoffer Q, Holladay 1 and Haigis formula are 0.44, 0.50, 0.54, 0.46 D; with optimized lens constants, the MAE values are 0.43, 0.54, 0.51, 0.35 D, and there is a statistical difference of Haigis formula after optimization (P=0.001). In non-high myopia group, with manufacture lens constant, the MAE values are 0.46, 0.40, 0.40, 0.42 D; with optimized lens constants, the MAE values are0.46, 0.38, 0.39, 0.38 D, and no statistical difference has been found(P>0.05). In high myopia group, with manufacture lens constant, the MAE values are 0.42, 0.59, 0.66, 0.50 D; with optimized lens constants, the MAE values are 0.36, 0.48, 0.47, 0.31 D, and there are statistical differences of Holladay 1 and Haigis formula after optimization (P = 0.020, 0.002). Conclusion: IOL constant optimization of PanOptix IOL can improve the accuracy of IOL calculation, which is more significant in the high myopia group.

目的：通过对改良“Z”形无线结经巩膜缝线固定人工晶状体手术和传统有线结巩膜缝线固定人工晶状体手术治疗先天性晶状体脱位的比较来评价改良术式的临床疗效。方法：回顾性病例研究。纳入2018年1月—2021年3月期间于中山大学中山眼科中心行手术治疗的先天性晶状体脱位患者73例73眼，按手术方式不同将患者分为无线结组36例36眼和有线结组37例37眼。比较两组患者术前和术后1年的球镜度(DS)、柱镜度(DC)、等效球镜(SE)、最佳矫正视力(BCVA)、眼压(IOP)、眼轴长度(AL)、角膜内皮细胞计数和术后并发症的发生率。结果：两组患者术前各项观察指标组间比较差异无统计学意义(均P>0.05)。两组患者术后1年 BCVA 均较术前提高(均P<0.05)，SE均较术前降低(均P<0.05)。两组患者术后1年 BCVA 、DS、DC、SE、IOP、AL、角膜内皮细胞丢失率组间比较差异均无统计学意义(均P>0.05)。术后1年，有线结组有5例(13.5%)出现缝线暴露，无线结组未出现缝线暴露，组间比较差异有统计学意义(P<0.05)。结论：改良无线结 IOL 巩膜缝线固定手术可改善CEL患者的最佳矫正视力和屈光不正，有效减少缝线暴露及相关并发症。

Objective: To evaluate the clinical efficacy of modified “Z”-shaped knotless transscleral suture fixation intraocular lens (IOL) and traditional knotted transscleral suture fixation IOL in congenital ectopia lentis. Methods: A retrospective case study. A total of 73 eyes of 73 patients with congenital ectopia lentis who underwent surgical treatment in our hospital from January 2018 to March 2021 were included. According to different surgical methods, the patients were divided into the knotless group (36 eyes) and knotted group (37 eyes). Preoperative and postoperative of 1-year diopter sphere (DS), diopter cylinder (DC), spherical equivalent (SE), best corrected visual acuity (BCVA), intraocular pressure (IOP), and axial length (AL), corneal endothelial cell counts and the occurrence of postoperative complications rate were analyzed among two groups. Results: There was no significant difference in preoperative outcome measures between the two groups (P>0.05). BCVA at 1-year postoperative was significantly better (P<0.05), and SE at 1-year postoperative was significantly lower (P<0.05). There was no significant difference in BCVA, DS, DC, SE, IOP, AL, and corneal endothelial cell loss rate between the two groups at 1-year after operation (P>0.05). One year after the operation, there were 5 cases of suture exposure (13.5%) in the knotted group and no suture exposure in the knotless group, and the difference was statistically significant (P<0.05). Conclusions: The modified knotless IOL transscleral suture fixation can improve the best corrected visual acuity and alleviate ametropia of CEL patients, and reduce suture exposure and related complications effectively.