摘要
目的分析高密度白内障眼的生物测量和人工晶状体度数计算的准确性。方法老年性白内障患者128例137眼(Ⅲ级和Ⅲ级以上核性白内障116眼,致密皮质性混浊21眼)行上方角膜缘切口的超声乳化摘出术并植入硬质人工晶状体,术前和术后3个月用A超、IOLMaster分别独立测量眼轴长度,测量手术前后角膜曲率,并记录术后屈光度,比较各参数测量结果的差异和不同测量结果下不同公式计算的角膜屈光度的预测误差。结果IOLMaster术前测得眼轴长度有22眼,平均为(23.74±0.92)mm,术后为(23.68±0.90)mm,2者呈高度相关(r=0.997,P<0.001)。137眼的A超术前测量为(23.61±1.62)mm,IOLMaster术后测量为(23.64±1.76)mm,2者呈高度相关(r=0.971,P<0.001),且差异无统计学意义(P>0.05);在长眼轴眼(>24.50mm),A超和IOLMaster的测量值分别为(26.52±1.63)mm、(26.81±2.02)mm,A超偏短达(0.29±0.70)mm,差异有统计学意义(P<0.05)。总的角膜平均曲率在术后3个月增加了(0.22±0.75)D。公式SRKⅡ、SRK/T、HofferQ、HolladayⅠ中代入术前A超和角膜曲率值计算,正常眼轴眼(22.00～24.50mm)的预测误差在(-0.10±0.11)D至(0.11±0.11)D,短眼轴眼(<22.00mm)在(0.33±0.24)D至(0.54±0.24)D,公式之间差异无统计学意义;长眼轴眼在(0.51±0.23)D至(1.58±0.23)D,其中SRKⅡ的误差最大,与其他公式的差异有统计学意义。用IOLMaster术后眼轴值代入公式计算则长眼轴眼的预测误差明显减小,在(-0.07±0.19)D至(0.60±0.20)D;同时用术后角膜曲率值和IOLMaster测量值代入公式计算,短眼轴眼的预测误差明显减小,在(-0.04±0.16)D至(0.29±0.17)D。结论对于高密度白内障眼的眼轴测量,术前A超与术后IOLMaster的测量结果基本一致,可以认为在0.10mm的水平上A超测量是准确的,但在长眼轴有偏短的趋势导致预测过矫;人工晶状体度数计算公式在高密度白内障眼同样适用,但随机性误差不应忽视。
Objective To evaluate the accuracy of ocular biometry and intraocular lens（IOL） power calculation in patients with dense cataract.Methods One hundred and twenty-eight patients（137 eyes） with age-related cataract,which included 116 eyes with nuclear cataract of grade Ⅲ or over and 21 eyes with dense cortical cataract,underwent phacoemulsification with superior incision and polymethylmethacrylate IOL implantation.The axial lengths were measured with A-scan and IOLMaster respectively before operation and 3 months after operation.The corneal curvature before and after operation were measured,the diopter after operation was recorded,the measured results of each parameter were compared,and the prediction error of different IOL formula under different measured results were also compared.Results The mean axial lengths in 22 eyes measured by IOLMaster before operation was （23.74±0.92）mm,and that after operation was （23.68±0.90）mm,there was significant correlation（r=0.997,P〈0.001）.The mean axial lengths measured by A-scan in 137 eyes before operation was （23.61±1.62）mm,and that measured by IOLMaster after operation was （23.64±1.76）mm,there was significant correlation（r=0.971,P〈0.001） and no statistical difference（P〉0.05）;the mean values measured by A-scan and IOLMaster in long axis eyes （〉24.5 mm） were （26.52±1.63）mm,（26.81±2.02）mm respectively,and the former with （0.29±0.70）mm shorting,there was statistical differences（P〈0.05）.The general average corneal curvature increased （0.21±0.71）D at 3 months after operation.Taking the values of axis length measured by A-scan and corneal curvature into the formulas such as SRKⅡ,SRK/T,Hoffer Q and HolladayⅠ,the prediction errors in normal axis eyes （from 22.0 mm to 24.5 mm） were from （-0.10±0.11）D to （0.11±0.11）D,which in short axes eyes were from （0.33±0.24）D to （0.54±0.24）D,there was no statistical differences from the formulas.However,the prediction errors in long axes eyes
出处
《眼科新进展》
CAS
北大核心
2010年第3期254-258,共5页
Recent Advances in Ophthalmology
