目的:评估使用两种不同技术行巩膜内人工晶状体(IOL)固定术的普通人工晶状体屈光力计算公式的屈光预测误差。
方法:这是一个前瞻性的,随机化,纵向,单站点,单外科医生研究。使用Yamane或Carlevale技术进行巩膜内人工晶体植入术的患者在术后随访六个月。使用4m处的最佳矫正视力测量屈光度(EDTRS图)。透镜偏心,使用眼前节光学相干断层扫描(AS-OCT)评估倾斜和有效晶状体位置(ELP).对SRK/T的预测误差(PE)和绝对误差(AE)进行了评估,Hollayday1和HofferQ公式。随后,PE和轴向长度之间的相关性,角膜曲率测量,评估白色至白色和ELP。
结果:总计,该研究包括53例患者的53只眼。Yamane组(YG)为24例患者的24只眼,Carlevale组(CG)为29例患者的29只眼。在YG中,Holladay1和HofferQ公式导致远视PE(0.02±0.56D,和0.13±0.64D,分别),而在SRK/T公式中,PE略有近视(-0.16±0.56D)。在CG中,SRK/T和Holladay1公式导致近视PE(-0.1±0.80D和-0.04±0.74D,分别),HofferQ为远视PE(0.04±0.75D)。两组相同配方的PE之间没有差异(P>0.05)。在每个评估的公式中,两组的AE均与零存在显着差异。根据所使用的配方和手术方法,45%-71%的眼的AE误差在±0.50D以内,72%-92%的眼的AE误差在±1.00D以内。组间和组间配方差异均无统计学意义(P>0.05)。与YG(7.67±3.70°)相比,CG(6.45±2.03°)的人工晶状体倾斜较低(P<0.001)。YG(0.57±0.37mm)的透镜偏心高于CG(0.38±0.21mm),差异无统计学意义(P=0.9996)。
结论:两组的屈光可预测性相似。在CG中IOL倾斜较好,然而,这并不影响屈光可预测性。虽然不重要,Holladay1公式似乎比SRK/T和HofferQ公式更可能。然而,在所有三个不同的公式中都观察到了显著的异常值,因此在二次固定IOL中仍然是一项具有挑战性的任务.
OBJECTIVE: To evaluate the refractive prediction error of common intraocular lens (IOL) power calculation formulae in patients who underwent intrascleral IOL fixation using two different techniques.
METHODS: This is a prospective, randomized, longitudinal, single-site, single-surgeon study. Patients who underwent intrascleral IOL implantation using the Yamane or the Carlevale technique were followed up for a period of six months postoperatively. Refraction was measured using the best-corrected visual acuity at 4 m (EDTRS chart). Lens decentration, tilt and effective lens position (ELP) were assessed using an anterior segment optical coherence tomography (AS-OCT). The prediction error (PE) and the absolute error (AE) were evaluated for the SRK/T, Hollayday1 and Hoffer Q formula. Subsequently, correlations between the PE and axial length, keratometry, white to white and ELP were assessed.
RESULTS: In total, 53 eyes of 53 patients were included in the study. Twenty-four eyes of 24 patients were in the Yamane group (YG) and 29 eyes of 29 patients were in the Carlevale group (CG). In the YG, the Holladay 1 and Hoffer Q formulae resulted in a hyperopic PE (0.02 ± 0.56 D, and 0.13 ± 0.64 D, respectively) while in the SRK/T formula the PE was slightly myopic (- 0.16 ± 0.56 D). In the CG, SRK/T and Holladay 1 formulae led to a myopic PE (- 0.1 ± 0.80 D and - 0.04 ± 0.74 D, respectively), Hoffer Q to a hyperopic PE (0.04 ± 0.75 D). There was no difference between the PE of the same formulae across both groups (P > 0.05). In both groups the AE differed significantly from zero in each evaluated formula. The AE error was within ± 0.50 D in 45%-71% and was within ± 1.00 D in 72%-92% of eyes depending on the formula and surgical method used. No significant differences were found between formulae within and across groups (P > 0.05). Intraocular lens tilt was lower in the CG (6.45 ± 2.03°) compared to the YG (7.67 ± 3.70°) (P < 0.001). Lens decentration was higher in the YG (0.57 ± 0.37 mm) than in the CG (0.38 ± 0.21 mm), though the difference was not statistically significant (P = 0.9996).
CONCLUSIONS: Refractive predictability was similar in both groups. IOL tilt was better in the CG, however this did not influence the refractive predictability. Though not significant, Holladay 1 formula seemed to be more probable than the SRK/T and Hoffer Q formulae. However, significant outliers were observed in all three different formulae and therefore remain a challenging task in secondary fixated IOLs.