新一代人工晶状体计算公式对高度近视行前后段联合手术的准确性分析

陶亮; 陈旭; 万超; 赵赫; 吴龙旺; 陶醉; 吴楠; 刘玺; 刘勇

doi:10.16016/j.2097-0927.202310065

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新一代人工晶状体计算公式对高度近视行前后段联合手术的准确性分析

临床医学 | 更新时间：2026-01-09

- 新一代人工晶状体计算公式对高度近视行前后段联合手术的准确性分析
- Accuracy of new generation intraocular lens formula for patients with high myopia undergoing combined anterior and posterior segment surgery
- 陆军军医大学学报 2024年46卷第13期页码：1545-1552
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院眼科
- 作者简介：
  
  [ 刘勇，E-mail：liuyy99@163.com LIU Yong, E-mail: liuyy99@163.com
- 基金信息：
  
  国家自然科学基金面上项目(82271132)
- DOI：10.16016/j.2097-0927.202310065
  中图分类号： R311;R778.11;R779.6
- 收稿：2023-10-26，
  
  修回：2023-12-20，
  
  纸质出版：2024-07-15
- 稿件说明：
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陶亮, 陈旭, 万超, 等. 新一代人工晶状体计算公式对高度近视行前后段联合手术的准确性分析[J]. 陆军军医大学学报, 2024,46(13):1545-1552.

Liang TAO, Xu CHEN, Chao WAN, et al. Accuracy of new generation intraocular lens formula for patients with high myopia undergoing combined anterior and posterior segment surgery[J]. Journal of Army Medical University, 2024, 46(13): 1545-1552.
陶亮, 陈旭, 万超, 等. 新一代人工晶状体计算公式对高度近视行前后段联合手术的准确性分析[J]. 陆军军医大学学报, 2024,46(13):1545-1552. DOI： 10.16016/j.2097-0927.202310065.

Liang TAO, Xu CHEN, Chao WAN, et al. Accuracy of new generation intraocular lens formula for patients with high myopia undergoing combined anterior and posterior segment surgery[J]. Journal of Army Medical University, 2024, 46(13): 1545-1552. DOI： 10.16016/j.2097-0927.202310065.

摘要

目的

探究新一代人工晶状体(intraocular lens

IOL) 计算公式及Wang-Koch (WK) 眼轴校正公式在接受前后段联合手术的高度近视患者中的准确性。

方法

收集2015年6月至2021年6月于陆军军医大学第一附属医院眼科接受前后段联合手术且眼轴(axial length AL)＞26 mm的患者100例(100眼)。分别采用Barrett Universal Ⅱ (BUⅡ)、Emmetropia Verifying Optical (EVO)、Kane、Haigis、Hoffer Q、Holladay 1、SRK/T、第一代线性WK眼轴优化公式(Haigis-WK1

SRK/T-WK1，Hoffer Q-WK1，Holladay 1-WK1)及第二代线性WK眼轴优化公式(SRK/T-WK2，Holladay 1-WK2)等13种公式计算IOL屈光度。获得各IOL屈光度公式的平均预测误差(mean prediction error，ME)、平均绝对误差(mean absolute error，MAE)、中位绝对误差(median absolute error，MedAE)及预测误差在不同屈光阈的百分比，以评价各公式的准确性。将所有患者根据眼轴长度分组：26.00 mm < AL≤28.00 mm者为A组(38眼)，28.00 mm < AL≤30.00 mm者为B组(28眼)，AL>30.00 mm者为C组(34眼)，以探究眼轴长度对IOL屈光度计算的影响。根据术前眼内填充物，将患者分为硅油眼组(63眼)和非硅油眼组(37眼)，比较术前眼内填充物对IOL屈光度计算的影响。

结果

新一代IOL公式(BUⅡ、EVO及Kane)的MedAE(0.34D、0.31D、0.35D)显著低于传统公式(

＜0.05)，而且预测误差在±0.25 D、±0.50 D、±0.75 D及±1.00 D范围内的百分比显著高于传统公式(

＜0.05)。传统公式均出现远视偏移(0.35~0.65 D)，WK眼轴调整法可以矫正传统公式的远视偏移。WK2可以提高SRK/T和Holladay 1公式的计算准确性，且SRK/T-WK2和Holladay 1-WK2公式的MedAE与新一代IOL公式差异无统计学意义。比较各公式在不同眼轴分组的MedAE，发现新一代IOL公式(BUⅡ、Kane和EVO)及WK校正眼轴公式(Haigis-WK1、SRK/T-WK1、SRK/T-WK2、Hoffer Q-WK1、Holladay 1-WK1和Holladay 1-WK2)在眼轴分组间均差异无统计学意义；传统公式的MedAE在眼轴分组间均存在显著差异(

0.01)，其中C组的MedAE均最大(Haigis: 0.84 D，SRK/T: 1.10 D，Hoffer Q: 1.23 D，Holladay 1: 1.20 D)。比较各公式在不同术前眼内填充物分组的MedAE，结果发现，新一代IOL公式(BUⅡ、Kane和EVO)、Haigis及SRK/T公式在硅油眼组的MedAE均显著高于非硅油眼组(

0.05)。

结论

在接受前后段联合手术的高度近视患者中，新一代IOL公式和第二代线性WK眼轴校正公式的准确性和稳定性显著优于传统公式。

Abstract

Objective

To analyze the accuracy of the new generation intraocular lens (IOL) formula and the Wang-Koch (WK) adjustment in individuals with severe myopia undergoing combined anterior-posterior surgery.

Methods

A total of 100 patients (100 eyes) with axial length (AL) >26 mm undergoing combined anterior and posterior segment surgery in our department from June 2015 to June 2021 were enrolled in this study. Totally 13 IOL calculation formulas

such as Barrett Universal Ⅱ (BUⅡ)

Emmetropia Verifying Optical (EVO)

Kane

Haigis

Hoffer Q

Holladay

and SRK/T as well as the first generation linear WK eye axis optimization formula (Haigis-WK1

SRK/T-WK1

Hoffer Q-WK1

Holladay 1-WK1) and the second generation linear WK eye axis optimization formula (SRK/T-WK2

Holladay 1-WK2)

were utilized to determine IOL diopter. The mean prediction error (ME)

mean absolute error (MAE)

median absolute error (MedAE)

and percentage of prediction error within different refractive thresholds were calculated to assess the accuracy of each formula. In order to investigate the impact of AL on accuracy of IOL calculation

the patients were categorized into group A (38 eyes

26.00 mm < AL≤28.00 mm)

group B (28 eyes

28.00 mm < AL≤30.00 mm)

and group C (34 eyes

AL >30.00 mm). Additionally

the patients were also divided into silicone oil (63 eyes) and non-silicone oil (37 eyes) groups based on preoperative intraocular filling to determine the effect of intraocular filling on IOL calculation.

Results

The MedAE values of the new-generation IOL formulas (BUⅡ

EVO

and Kane) were significantly lower (0.34D

0.31D

0.35D) than those of traditional formulas (

0.05). Additionally

the percentage of prediction errors within ±0.25 D

±0.50 D

±0.75 D

and ±1.00 D were significantly higher with the new formulas when compared to traditional ones (

05). Traditional formulas exhibited a hyperopic deviation (0.35D~0.65 D)

which could be corrected using the WK eye axis adjustment. WK2 was effective in improving the accuracy of calculation in SRK/T and Holladay 1 formulas

and there was no statistical difference in the MedAE values of SRK/T-WK2 and Holladay 1-WK2 formulas with the new-generation IOL formulas. When comparing the formulas across different axial eye length groups in terms of MedAE

the new IOL formulas (BUⅡ

kane and EVO) and WK-corrected formulas (Haigis-WK1

SRK/T-WK1

SRK/T-WK2

Hoffer Q-WK1

Holladay 1-WK1

Holladay 1-WK2) showed no significant differences among the different AL groups. However

there were significant differences in the MedAE values of traditional formulas among the different AL groups (

0.01)

with group C displaying the largest MedAE values (Haigis: 0.84D

SRK/T: 1.10D

Hoffer Q: 1.23D

Holladay 1: 1.20D). Comparing the MedAE values of different formulas in various preoperative intraocular filling groups

it was observed that the MedAE values of the new-generation IOL formulas (BUⅡ

kane and EVO)

Haigis

and SRK/T formulas were significantly higher in the silicone oil-filled eye group than the non-silicone oil-filled eye group (

0.05).

Conclusion

In patients with high myopia undergoing combined anterior and posterior segment surgery

the precision and consistency of the new-generation IOL formulas and the second-generation linear WK axis correction formula exhibit significant improvements when compared to traditional formulas.

关键词

Keywords

references

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