LASIK术后<span>Sirius光线追踪法与IOLMaster法测量人工晶状体度数比较</span>

doi:DOI:10.3760/cma.j.issn.1674-845X.2016.06.009

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摘要

目的对比Sirius光线追踪法和IOLMaster法测量准分子激光原位角膜磨镶术（LASIK）后人工晶状体（IOL）度数的一致性。方法前瞻性临床研究。收集近视和近视散光患者89例（89眼），根据术前等效球镜度（SE）分为轻中度近视组（≤-6.0 D，59眼）和高度近视组（＞-6.0 D，30眼），对LASIK术前和术后1个月患者分别行Sirius角膜地形图和IOLMaster检查。术前使用IOLMaster自带的Haigis公式，术后使用Haigis和Haigis-L公式计算IOL度数，分别与Sirius光线追踪法计算所得IOL度数进行比较（IOL型号分别为Alcon SN60WF和AMO Tecnis ZA9003）。采用Bland-Altman对测量结果进行一致性分析。结果 Bland-Altman分析显示术前Sirius光线追踪法与Haigis公式测量IOL度数在轻中度近视组2种型号IOL 95％一致性界限（LoA）分别为（-0.78～+0.84）D、（-0.57～+1.21）D，均有3％的点在各自的95%LoA外，组内相关系数（ICC）分别为0.976、0.945；高度近视组95％LoA分别为（-0.83～+0.69）D、（-0.57～+0.93）D，均有3％的点在各自的95%LoA外，ICC分别为0.981、0.979。术后Sirius法与Haigis公式对比：轻中度近视组95％LoA分别为（-0.27～+2.59）D、（-0.50～+3.30）D，均有5％的点在各自的95％LoA外，ICC分别为0.641、0.584；高度近视组95％LoA分别为（-0.48～+2.78）D、（-0.17～+3.17）D，分别有10％、7％的点在各自的95％LoA外，ICC分别为0.622、0.651。术后Sirius光线追踪法与Haigis-L公式对比：轻中度近视组95％LoA分别为（-1.02～+0.58）D、（-1.10～+0.77）D，分别有0、2％的点在各自的95％LoA外，ICC分别为0.986、0.955；高度近视组95％LoA分别为（-2.36～+0.80）D、（-1.98～+1.22）D，分别有7％、10％的点在各自的95％LoA外，ICC分别为0.667、0.638。结论 Sirius光线追踪法与Haigis公式计算未手术眼IOL度数有较好的一致性，与Haigis-L公式计算轻中度近视LASIK术后IOL度数有较好的一致性，与Haigis-L公式计算高度近视LASIK术后IOL度数的一致性较差。

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关键词 ：角膜磨镶术, 激光原位, Sirius光线追踪, 光学相干生物测量仪, , 晶体, 人工

Abstract：

Objective Compare the consistency in calculating the IOL power after LASIK surgery between the Sirius Ray-Tracing method and IOLMaster． Methods In the prospective clinical study, 89 eyes of 89 patients who underwent myopic and myopic astigmatism LASIK surgery were selected according to preoperative SE and divided into two groups, 59 eyes for mild and moderate myopia(≤-6.0 D), 30 eyes for high myopia(＞-6.0 D). Haigis formula was used to measure the IOL(The types of IOL are Alcon SN60WF and AMO Tecnis ZA9003) power before LASIK, and Haigis-L formula, Haigis formula were used after LASIK 1 month by IOLMaster, and compare the results with Sirius Ray-Tracing method. The Bland-Altman was used to analyze the results. Results The comparison of Sirius method and Haigis formula preoperative: Bland-Altman analysis showed the 95％LoA of mild and moderate myopia group of two type IOL were(-0.78～+0.84)D, (-0.57～+1.21)D, respectively. There were 3％, 3％ of the points beyond their respective 95%LoA. The intraclass correlation coefficient (ICC) were 0.976 and 0.945, respectively. The 95％LoA of high myopia group were (-0.83～+0.69)D, (-0.57～+0.93)D. There were 3％, 3％ of the points beyond their respective 95%LoA. The ICC were 0.981 and 0.979, respectively. The comparison of Sirius method and Haigis formula postoperative: the 95％LoA of mild and moderate myopia group of two type IOL were (-0.27～+2.59)D, (-0.50～+3.30)D. There were 5％, 5％ of the points beyond their respective 95%LoA. The ICC were 0.641, 0.584, respectively. The 95％LoA of high myopia group were (-0.48～+2.78)D, (-0.17～+3.17)D. There were 10％, 7％ of the points beyond their respective 95%LoA. The ICC were 0.622, 0.651, respectively. The comparison of Sirius method and Haigis-L formula postoperative: the 95％LoA of mild and moderate myopia group were (-1.02～+0.58)D, (-1.10～+0.77)D. There were 0, 2％ of the points beyond their respective 95%LoA. The ICC were 0.986 and 0.955, respectively. The 95％LoA of high myopia group were (-2.36～+0.80)D, (-1.98～+1.22)D. There were 7％, 10％ of the points beyond their respective 95%LoA. The ICC were 0.667 and 0.638, respectively. Conclusion There was better consistency of Sirius Ray-Tracing method and Haigis formula in unoperative eyes, and better consistency with Haigis-L formula in mild and moderate myopia after LASIK, but poor consistency with Haigis-L formula in high myopia after LASIK to calculate the IOL power.

Key words： Keratomileusis, laser in situ Sirius Ray-Tracing IOLMaster Lenses, intraocular

收稿日期: 2016-01-10

通讯作者: 王卫群，Email：xiwang389@126.com

引用本文:

杨应琴,王卫群,田英,刘欢,马艳丽. LASIK术后Sirius光线追踪法与IOLMaster法测量人工晶状体度数比较[J]. 中华眼视光学与视觉科学杂志, 2016, 18(6): 363-372. Yang Yingqin,Wang Weiqun,Tian Ying,Liu Huan,Ma Yanli. Comparison of Sirius ray-tracing method and IOLMaster in calculating the intraocular lens power after LASIK . Chinese Journal of Optometry Ophthalmology and Visual science, 2016, 18(6): 363-372.

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