无病史资料的角膜屈光术后IOL度数测算方法的比较

doi:DOI:10.3760/cma.j.issn.1674-845X.2017.01.010

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摘要

目的比较不同方法测量无病史资料的角膜屈光术后人工晶状体（IOL）度数的准确性。方法回顾性系列病例研究。收集33例准分子激光角膜屈光术后白内障患者，分别采用Haigis-L公式法、Shammas公式法、Olsen 2公式法、Pentacam mTNP法、基于OCT公式法测量IOL度数，综合5种测算结果选择IOL度数。白内障术后实际屈光状态与预测屈光状态之间的差异为预测误差（PE），预测误差的绝对值为绝对误差（AE），计算PE＜±0.5 D、＜±1.0 D和＜±1.50 D的百分比。采用t检验、随机区组设计方差分析、χ²检验对数据进行分析。结果基于OCT公式法、Shammas公式、Haigis-L公式这3种方法的PE与0差异有统计学意义（t=-4.96、-4.61、-6.61，P＜0.05）。对于PE，Olsen 2公式与Pentacam mTNP法差异无统计学意义，基于OCT公式法、Shammas公式、Haigis-L公式3种方法差异无统计学意义，但前2种方法与后3种方法比较差异均有统计学意义（P＜0.05）。对于AE，Olsen 2公式与Pentacam mTNP法差异无统计学意义，基于OCT公式法与Shammas公式差异无统计学意义，前2种方法与后2种方法比较差异均有统计学意义（P＜0.05），而Haigis-L公式与以上4种方法比较差异均无统计学意义。预测误差＜±1.0 D的百分比分别为48%（基于OCT公式法）、50%（Shammas公式）、62%（Haigis-L公式）、81%（Olsen 2公式）、85%（Pentacam mTNP法），前2种方法与后2种方法比较差异均有统计学意义（P＜0.05），而Haigis-L公式与其余4种方法比较差异均无统计学意义。结论准分子角膜屈光术后使用Olsen 2公式、Pentacam mTNP法测算IOL度数的结果优于基于OCT公式、Shammas公式、Haigis-L公式这3种方法，但仍需大样本研究进一步证实。

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	刘晓敏
	黄钰森

关键词 ：角膜屈光手术, 白内障, 人工晶状体度数计算

Abstract：

Objective To evaluate the accuracy of different methods of calculating intraocular lens (IOL) power after corneal refractive surgery without medical histories. Methods In this retrospective case series study, 33 patients were chosen after corneal refractive surgery with cataract extraction. Five methods were used to calculate IOL power: Haigis-L formula, Shammas formula, Olsen 2 formula, Pentacam mTNP, and optical coherence tomography (OCT)-based IOL formula. The prediction error (PE) was determined as the difference between the actual postoperative refraction and the predicted refraction, and the absolute value of the PE was the absolute error (AE). The percentages of PE within ±0.50, ±1.00, and ±1.50 diopters (D) were calculated. The results were analyzed with t-tests, randomized block design of variance, and chi-square test. Results The PEs calculated by the OCT-based, Shammas, and Haigis-L formulas were significantly different from zero (t=-4.96, -4.61, -6.61, P＜0.05). The PEs for the Olsen 2 formula and the Pentacam mTNP were similar, and the PEs for the OCT-based IOL, Shammas and Haigis-L formulas were similar to each other. However, the PEs for the Olsen 2 formula and the Pentacam mTNP were larger than those for the Shammas and Haigis-L formulas (P＜0.05). For the AE, there was no difference between Olsen 2 formula and Pentacam mTNP formula, and there was no difference between the OCT-based IOL formula and Shammas formula for AE too. The AEs for the Olsen 2 formula and the Pentacam mTNP method were less than the AEs for OCT-based IOL and the Shammas formulas (P＜0.05). The AE for the Haigis-L formula was not significantly different from the other four methods. The percentage of correct refraction prediction within ±1.00 D was 48% for OCT-based IOL formula, 50% for Shammas, 62% for Haigis-L, 81% for Olsen, and 85% for the Pentacam method. There were no differences between the OCT-based IOL and Shammas formulas or between the Olsen 2 formula and the Pentacam mTNP method. However the percentage of correct refraction predictions within ±1.00 D for the OCT-based IOL and Shammas formulas was less than for the Olsen 2 formula and the Pentacam mTNP method (P<0.05). The prediction for the Haigis-L formula was not significantly different from the other four formulas. Conclusion After corneal refractive surgery, the Olsen 2 formula and Pentacam mTNP method gave better results than did the Haigis-L, Shammas, and OCT-based IOL formulas. These conclusions need to be confirmed with a larger study population.

Key words： Corneal refractive surgery Cataract Intraoculor lens power calculation

收稿日期: 2016-08-26

通讯作者: 黄钰森，Email：huang_yusen@126.com

引用本文:

刘晓敏,黄钰森. 无病史资料的角膜屈光术后IOL度数测算方法的比较[J]. 中华眼视光学与视觉科学杂志, 2017, 19(1): 53-57. LIU Xiaomin,HUANG Yusen. Comparison of methods to calculate IOL power after corneal refractive surgery without history data. Chinese Journal of Optometry Ophthalmology and Visual science, 2017, 19(1): 53-57. DOI: DOI:10.3760/cma.j.issn.1674-845X.2017.01.010

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