论著

角膜横径和晶状体厚度在 Barrett Universal Ⅱ人工晶状体计算公式中的应用价值

Application value of corneal horizontal diameter and lens thickness in Barrett Universal Ⅱ intraocular lens prediction formula

:822-836
 
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.
论著

基于 OA-2000 测量的硅油取出联合白内障手术患者人工晶状体计算公式预测准确性分析

Prediction accuracy analysis of intraocular lens calculation formulas in patients undergoing silicone oil removal combined with cataract surgery based on OA-2000 measurement

:857-866
 
目的:在硅油取出联合白内障手术患者中,使用扫频源光学相干断层扫描生物测量仪OA-2000进行生物测量,比较10种人工晶状体(IOL)屈光力计算公式的准确性。方法:回顾性分析2021年3月—7月于中山大学中山眼科中心接受硅油取出联合白内障手术的患者共62例(62眼),所有患者均使用扫频源光学相干断层扫描生物测量仪OA-2000进行生物学参数测量。计算并比较新公式[Barrett Universal II (BUII)、Emmetropia Verifying Optical(EVO) 2.0、Hill-Radial Basis Function (Hill-RBF) 3.0、Hoffer QST、Kane、Pearl-DGS]及传统公式(Haigis、Hoffer Q、Holladay 1、SRK/T)的预测准确性,主要评价指标为绝对预测误差中位数(MedAE)及平均绝对预测误差(MAE)。按眼轴长度≤23 mm(组1),>23 mm且≤26 mm(组2)与>26 mm(组3)进行亚组分析。结果:6个新公式、Haigis、SRK/T公式均出现近视漂移(-0.47 ~-0.27 D,P<0.05),而HofferQ及Holladay 1公式无系统误差(P>0.05)。Kane公式的MedAE(0.55 D)及MAE(0.81 D)最小,但公式间比较差异无统计学意义(P>0.05)。组1中所有公式均出现近视漂移(-1.46~ -1.25 D,P<0.05),而其他亚组比较差异无统计学意义(-0.32 ~ 0.41 D,P>0.05)。在组1中,Pearl-DGS公式的MedAE(0.97 D)及MAE(1.26 D)最小,且优于Hill-RBF 3.0(P=0.01)及SRK/T公式(P=0.02);组2中,Kane公式具有最小的MedAE(0.44 D)及MAE(0.66 D);组3各个公式屈光预测准确性比较差异无统计学意义(P>0.05)。结论:在使用OA-2000进行术前生物测量时,Kane公式在接受硅油取出联合白内障手术患者中的预测准确性较高;而眼轴长度≤23 mm时,Pearl-DGS公式可能更为准确。
Objective: To compare the accuracy of 10 intraocular lens (IOL) power calculation formulas in patients undergoing combined silicone oil removal and cataract surgery, biometry is performed using the swept-source optical coherence tomography biometer OA-2000. Methods: A retrospective analysis. A total of 62 patients (62 eyes) who underwent combined silicone oil removal and cataract surgery in Zhongshan Ophthalmic Center, Sun Yat-sen University from March to July in 2021 were enrolled. Preoperative biometry was performed by OA-2000 in all patients. New-generation formulas (Barrett Universal II [BUII], Emmetropia Verifying Optical [EVO] 2.0, Hill-Radial Basis Function [Hill-RBF] 3.0, Hoffer QST, Kane and Pearl-DGS) and traditional formulas (Haigis, Hoffer Q, Holladay 1 and SRK/T) were evaluated. The median absolute prediction error (MedAE) and mean absolute prediction error (MAE) were the main parameters used to assess accuracy. Subgroup analyses were performed based on the axial length of 23 mm and 26 mm. Results: Six new-generation formulas, Haigis, and SRK/T showed myopic shift (-0.47 ~ -0.27 D, P<0.05), while no systematic bias was found in Hoffer Q and Holladay 1 displayed (P>0.05). The smallest MedAE (0.55 D) and MAE (0.81 D) were found in Kane formula, but there was no statistically significant difference compared with other formulas (P>0.05). The myopic shift (-1.46 ~ -1.25 D, P<0.05) in eyes shorter than 23 mm were found in all formulas, while there was no significant systematic bias (-0.32 ~ 0.41 D, P>0.05) in other subgroups. In axial length shorter than 23 mm, the Pearl-DGS formula stated the smallest MedAE (0.97 D) and MAE (1.26 D), and was significantly more accurate than Hill-RBF 3.0 (P=0.01) and SRK/T (P=0.02). In eyes with an axial length between 23 mm and 26 mm, the Kane formula had the lowest MedAE (0.44 D) and MAE (0.66 D). No significant difference was found in eyes longer than 26 mm. Conclusion: The Kane formula showed the highest accuracy in patients undergoing combined silicone oil removal and cataract surgery measured by OA-2000, whereas the Pearl-DGS formula could be more accurate in eyes with an axial length shorter than 23 mm.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
推荐阅读
出版者信息