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ENGLISH ABSTRACT
IOLMaster 700与IOLMaster 500不同计算公式对白内障眼人工晶状体屈光力计算的准确性比较
邓小慧
常平骏
黄锦海
王丹丹
赵银莹
丁锡霞
赵云娥
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20200226-00110
A comparative study on calculation of intraocular lens power using different formulas between IOLMaster 700 and IOLMaster 500 in cataract eyes
Deng Xiaohui
Chang Pingjun
Huang Jinhai
Wang Dandan
Zhao Yinying
Ding Xixia
Zhao Yun'e
Authors Info & Affiliations
Deng Xiaohui
The Eye Hospital of Wenzhou Medical University, Hangzhou 310020, China
Deng Xiaohui is now working at Ningbo No.2 Hospital, Ningbo 315010, China
Chang Pingjun
The Eye Hospital of Wenzhou Medical University, Hangzhou 310020, China
Huang Jinhai
The Eye Hospital of Wenzhou Medical University, Hangzhou 310020, China
Huang Jinhai is now working at Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China
Wang Dandan
The Eye Hospital of Wenzhou Medical University, Hangzhou 310020, China
Zhao Yinying
The Eye Hospital of Wenzhou Medical University, Hangzhou 310020, China
Ding Xixia
The Eye Hospital of Wenzhou Medical University, Hangzhou 310020, China
Zhao Yun'e
The Eye Hospital of Wenzhou Medical University, Hangzhou 310020, China
·
DOI： 10.3760/cma.j.cn115989-20200226-00110
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摘要

目的比较IOLMaster 700与IOLMaster 500不同计算公式对白内障眼人工晶状体(IOL)屈光力计算的准确性。

方法采用横断面研究方法，纳入2018年11月至2019年11月在温州医科大学附属眼视光医院接受白内障超声乳化摘出联合IOL植入术治疗的年龄相关性白内障患者262例262眼。分别采用IOLMaster 700和IOLMaster 500进行术前生物测量，采用IOLMaster 700和IOLMaster 500仪器内置公式Haigis、Holladay Ⅰ、Hoffer Q和SRK/T计算IOL屈光力。本研究以屈光预测误差为指标，比较不同眼轴长度(AL)下受检眼用2种仪器不同计算公式的屈光结果。

结果在所有眼轴范围内，IOLMaster 700与IOLMaster 500 Haigis、Hoffer Q、SRK/T公式计算的绝对预测误差平均值(MAE)差异均无统计学意义(均 P>0.05)，IOLMaster 500 Holladay Ⅰ计算的MAE为0.47(0.24，0.90)D，小于IOLMaster 700的0.50(0.28，0.99)D，差异有统计学意义( Z＝－3.120， P＝0.002)。AL<22.0 mm、24.5 mm≤AL<26.0 mm时，4种公式计算的MAE差异均无统计学意义(均 P>0.05)；22.0 mm≤AL<24.5 mm时，Haigis、Hoffer Q、SRK/T公式计算的MAE差异均无统计学意义(均 P>0.05)，IOLMaster 500 Holladay Ⅰ计算的MAE为0.42(0.18，0.75)D，小于IOLMaster 700的0.45(0.25，0.79)D，差异有统计学意义( Z＝－3.487， P<0.001)，但差异数值很小，无临床意义；AL≥26.0 mm时，Haigis、Holladay Ⅰ、SRK/T公式计算的MAE差异均无统计学意义(均 P>0.05)；IOLMaster 500 Hoffer Q计算的MAE为0.66(0.38，1.00)D，小于IOLMaster 700的0.98(0.62，1.32)D，差异有统计学意义( Z＝－3.046， P＝0.002)。

结论所有眼轴范围内，2种仪器Haigis、Hoffer Q和SRK/T公式屈光预测准确性接近。对于长眼轴患者，IOLMaster 700 Hoffer Q公式计算的MAE明显大于IOLMaster 500，临床使用中需谨慎。IOLMaster 700与IOLMaster 500的屈光预测准确性基本接近。

白内障;人工晶状体;光学生物测量;屈光力;IOLMaster;人工晶状体计算公式
ABSTRACT

ObjectiveTo compare the accuracy of IOLMaster 700 and IOLMaster 500 in intraocular lens (IOL) power calculation.

MethodsA cross-sectional study was conducted.Two hundred and sixty-two eyes of 262 patients who underwent phacoemulsification combined with IOL implantation at the Eye Hospital of Wenzhou Medical University from November 2018 to November 2019 were enrolled.Preoperative biometry for cataract surgery was performed using IOLMaster 700 and IOLMaster 500.IOL power was calculated through the built-in formulas, Haigis, Holladay Ⅰ, Hoffer Q and SRK/T of the two devices.The difference in IOL power calculation between the two devices was analyzed through the prediction error of IOL power calculation using different formulas across different axial length (AL) ranges.This study complied with the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Eye Hospital of Wenzhou Medical University (No.2020-038-K-33). Written informed consent was obtained from each patient before the surgery.

ResultsThere was no significant difference in mean absolute error (MAE) between IOLMaster 700 and IOLMaster 500 using Haigis, Hoffer Q and SRK/T over the entire AL range (all at P >0.05). The MAE of IOLMaster 500 was 0.47 (0.24, 0.90) D, which was significantly lower than 0.50 (0.28, 0.99) D of IOLMaster 700 using Holladay Ⅰ formula ( Z=-3.120, P=0.002). When AL was <22.0 mm and ≥24.5 mm-<26.0 mm, there was no significant difference in MAE between the two devices using the four formulas (all at P >0.05). When AL was ≥22.0 mm-24.5 mm, there was no significant difference in the MAE between the two devices using Haigis, Hoffer Q and SRK/T (all at P >0.05), but 0.42 (0.18, 0.75) D from IOLMaster 500 was smaller than 0.45 (0.25, 0.79) D from IOLMaster 700 using Holladay Ⅰ, showing a statistically significant difference ( Z=-3.487, P <0.001). But the difference was negligible and therefore was of no clinical significance.When AL was ≥26.0 mm, there was no statistically significant difference in the MAE between the two devices using Haigis, Holladay Ⅰ and SRK/T, but 0.66 (0.38, 1.00) D from IOLMaster 500 was significantly smaller than 0.98 (0.62, 1.32) D from IOLMaster 700 using Hoffer Q ( Z=-3.046, P=0.002).

ConclusionsThe refractive prediction accuracy of IOLMaster 700 and IOLMaster 500 using Haigis, Hoffer Q and SRK/T is similar over the entire AL range.For patient with long AL, the IOL calculation from IOLMaster 700 using Hoffer Q is significantly larger than that from IOLMaster 500, which requires extra caution in clinical practice.The accuracy of IOLMaster 700 and IOLMaster 500 for IOL prediction is very similar.

Cataract;Lenses, intraocular;Optical biometry;Refractive power;IOLMaster;IOL calculation formula
Zhao Yun'e, Email: nc.defcaab.eye.liameyz
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引用本文

邓小慧,常平骏,黄锦海,等. IOLMaster 700与IOLMaster 500不同计算公式对白内障眼人工晶状体屈光力计算的准确性比较[J]. 中华实验眼科杂志,2022,40(12)：1170-1175.

DOI:10.3760/cma.j.cn115989-20200226-00110

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人工晶状体(intraocular lens，IOL)屈光力的计算直接影响白内障手术效果，而术前精确的生物测量是提高IOL计算准确性的关键步骤。既往研究表明，屈光预测误差中来源于眼轴长度(axial length，AL)、角膜曲率(keratometry，K)和术后有效IOL位置(effective lens position，ELP)的预估不准确因素分别占36%、22%和42% [ 1 ]。IOLMaster 500采用光学部分相干干涉(partial coherence interferometry，PCI)技术测量眼球参数，被认为是白内障术前生物测量的金标准 [ 2 ]。IOLMaster 500在常规和复杂白内障眼中计算IOL屈光力的准确性已得到证实 [ 3 ]，然而当存在角膜混浊、后囊膜下混浊等出现在视轴区的混浊以及严重白内障、黄斑疾病、固视不佳时，其无法得到准确的AL测量值 [ 4 ]。IOLMaster 700是一种基于扫频光相干断层扫描(swept-source optical coherence tomography，SS-OCT)技术的新型生物测量仪，其测量AL的成功率高于IOLMaster 500，且可重复性和再现性好，与IOLMaster 500及其他仪器一致性好 [ 5 , 6 ]。实现精准的IOL屈光力计算的另一个重要因素为IOL计算公式的选择。目前一些IOL计算公式在临床上广泛使用，第3代公式SRK/T、Hoffer Q和Holladay Ⅰ基于AL和K值来预测ELP [ 7 , 8 , 9 ]；第4代公式Haigis将前房深度考虑在内来进行计算 [ 10 ]。目前关于IOLMaster 700与IOLMaster 500的生物参数测量一致性研究较多 [ 11 , 12 , 13 ]，但基于这2种仪器测量数据的IOL屈光力计算准确性鲜有报道。本研究拟评价IOLMaster 700和IOLMaster 500不同IOL计算公式得到的屈光结果之间的差异，比较2种仪器测量和计算的准确性。
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备注信息
A
赵云娥，Email： nc.defcaab.eye.liameyz
B

邓小慧：参与眼部参数测量、数据收集及分析、实施研究、论文撰写及修改；常平骏、黄锦海：参与选题、酝酿和设计试验、受试者招募；王丹丹、赵银莹、丁锡霞：分析/解释数据、对文章知识性内容的审阅和智力性内容的修改；赵云娥：指导选题、研究设计、论文修改及最终定稿

C
所有作者均声明不存在利益冲突
D
浙江省重点研发计划项目 (2018C03012)
温州市科技局资助项目 (Y2020037)
浙江省医药卫生科技计划项目 (2019KY111)
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