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中华眼科医学杂志(电子版) ›› 2021, Vol. 11 ›› Issue (04) : 211 -216. doi: 10.3877/cma.j.issn.2095-2007.2021.04.004

论著

六种人工晶状体计算公式计算先天性白内障患者人工晶状体度数准确性的临床研究
李猛1, 王进达1, 张景尚1, 王开杰1, 毛迎燕1, 陈淑莹1, 姚沁楠1, 万修华1,†()   
  1. 1. 100730　首都医科大学附属北京同仁医院　北京同仁眼科中心　北京市眼科研究所　北京市眼科学与视觉科学重点实验室
  • 收稿日期:2021-01-07 出版日期:2021-08-28
  • 通信作者: 万修华
  • 基金资助:
    北京市医院管理中心临床医学发展专项经费(XMLX202133); 北京市眼科研究所重点研究计划(2019009)

The accuracy of six intraocular lens formulas in patients with congenital cataract

Meng Li1, Jinda Wang1, Jingshang Zhang1, Kaijie Wang1, Yingyan Mao1, Shuying Chen1, Qinnan Yao1, Xiuhua Wan1,†()   

  1. 1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab., Beijing 100730, China
  • Received:2021-01-07 Published:2021-08-28
  • Corresponding author: Xiuhua Wan
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李猛, 王进达, 张景尚, 王开杰, 毛迎燕, 陈淑莹, 姚沁楠, 万修华. 六种人工晶状体计算公式计算先天性白内障患者人工晶状体度数准确性的临床研究[J]. 中华眼科医学杂志(电子版), 2021, 11(04): 211-216.

Meng Li, Jinda Wang, Jingshang Zhang, Kaijie Wang, Yingyan Mao, Shuying Chen, Qinnan Yao, Xiuhua Wan. The accuracy of six intraocular lens formulas in patients with congenital cataract[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2021, 11(04): 211-216.

目的

比较六种人工晶状体(IOL)计算公式计算先天性白内障患者IOL度数的准确性。

方法

收集2014年1月至2018年12月在首都医科大学附属北京同仁医院眼科中心接受白内障吸除联合IOL植入的先天性白内障患者27例(38只眼)。其中，男性11例(17只眼)，女性16例(21只眼)。年龄为43~162个月，平均年龄为(98.5±37.4)个月。计算SRK Ⅱ、SRK/T、Holladay 1、Hoffer Q、Barrett及Haigis等六种IOL计算公式的预测误差(PE)和绝对预测误差(APE)。PE采用±s表示，APE分别使用±s、中位数(上下四分位数)表示。计算每种IOL计算公式APE≤0.50 D、APE≤1.00 D和APE≤2.00 D患眼的百分比。使用Friedman检验比较不同IOL计算公式APE的差异。使用Cochran′s Q检验比较不同IOL计算公式APE≤0.50 D、APE≤1.00 D和APE≤2.00 D百分比的差异。

结果

全部六种IOL计算公式的PE平均值均为负值，其计算结果均偏近视。SRK Ⅱ、SRK/T 、Holladay 1、Hoffer Q、Barrett及Haigis公式APE的中位数，自小到大依次为0.71 D、1.04 D、1.10 D、1.19 D、1.20 D及1.60 D；SRK Ⅱ、SRK/T 、Holladay 1、Hoffer Q、Barrett及Haigis公式APE的平均值，自小到大依次为1.03 D、1.03 D、1.11 D、1.20 D、1.32 D及1.60 D。这六种公式APE值的差异具有统计学意义(χ2＝28.33，P<0.05)。不同公式APE值的两两比较，SRK/T公式优于Haigis和Barrett公式，差异具有统计学意义(χ2＝1.80，1.43；P<0.05)；SRK Ⅱ公式优于Haigis和Barrett公式，差异具有统计学意义(χ2＝1.65，1.28；P<0.05)；Holladay 1公式优于Haigis公式，差异具有统计学意义(χ2＝1.38，P<0.05)。六种IOL计算公式APE≤0.50 D、APE≤1.00 D和APE≤2.00 D的眼数及百分比不同。按照APE≤0.50 D进行统计，六种公式计算的APE值所占百分比的差异具有统计学意义(χ2＝15.08，P<0.05)；SRK Ⅱ公式最准确，有34.21%患者的APE≤0.50 D，而Haigis公式最差，仅有10.53%患者的APE≤0.50 D；不同公式两两比较结果显示SRK Ⅱ公式优于Haigis公式，差异具有统计学意义(χ2＝-0.24，P<0.05)。按照APE值≤1.00 D进行统计，六种公式APE值所占百分比的差异具有统计学意义(χ2＝16.59，P<0.05)；SRK Ⅱ公式最准确，有63.16%患者的APE值≤1.00 D，而Haigis公式最差，仅有28.95%患者的APE≤1.00 D；不同公式的两两比较显示SRK Ⅱ公式优于Haigis公式，差异具有统计学意义(χ2＝-0.34，P<0.05)。按照APE值≤2.00 D进行统计，六种公式计算的APE值所占百分比的差异具有统计学意义(χ2＝18.75，P<0.05)；Holladay 1公式最准确，有94.74%患者的APE值≤2.00 D，而Haigis公式最差，仅有65.79%患者的APE值≤2.00 D；不同公式两两比较的结果显示Hollday 1和SRK/T公式均优于Haigis公式，差异具有统计学意义(χ2＝-0.29，-0.24；P<0.05)。

结论

六种IOL计算公式计算先天性白内障患者IOL度数的准确性均不理想，亟待开发针对先天性白内障患儿的新型IOL计算公式。

关键词: 先天性白内障, 人工晶状体计算公式, 预测误差, 绝对预测误差
Objective

The aim of this study was to compare the accuracy of six intraocular lens (IOL) power calculation formulas in patients with congenital cataract.

Methods

Twenty-seven (38 eyes) subjects with congenital cataract who underwent cataract extraction and primary IOL implantation in Beijing Tongren Eye Center, Beijing Tongren Hospital affiliated with Capital Medical University from January 2014 to December 2018 were retrospectively analyzed. Among them, there were 11 male (17 eyes), and 16 female (21 eyes) with the average age of (98.5±37.4) months (ranged from 43 to 162 months). The prediction error (PE) and absolute prediction error (APE) of 6 formulas (SRK Ⅱ, SRK/T, Holladay 1, Hoffer Q, Barrett, Haigis) were calculated. PE of different formulas were described as ±s, APE as ±s or median (upper and lower quartile). The percentage of APE value less than or equal to 0.50 D, 1.00 D, 2.00 D for per formulas, respectively were calculated. The analysis of APE for 6 formulas was performed by Friedman test; the percentage for 6 formulas performed by Cochran′s Q test.

Results

The mean PE of all formulas was negative, suggesting myopia. The median of APE for SRK Ⅱ, SRK/T, Holladay 1, Hoffer Q, Barrett and Haigis formulas from small to large were 0.71 D, 1.04 D, 1.10 D, 1.19 D, 1.20 D, 1.60 D, respectively; the mean APE from small to large were 1.03 D, 1.03 D, 1.11 D, 1.20 D, 1.32 D, 1.60 D. There were significant difference among 6 IOL calculation formulas (χ2=28.33, P<0.05). After comparing using post hoc multiple comparisons for APE of 6 formulas, SRK/T was better than Barrett and Haigis with significant difference (χ2=1.80, 1.43; P<0.05); SRK Ⅱ better than Barrett and Haigis with significant difference (χ2=1.65, 1.28; P<0.05); Holladay 1 better than Haigis with significant difference (χ2=1.38, P<0.05). The eyes and percentage of APE value≤0.50 D, 1.00 D, 2.00 D were different from formulas to formulas. According to the calculation of APE value≤0.50 D, there were significant difference on the percentage for 6 formulas (χ2=15.08, P<0.05); SRK Ⅱ was the most accurate, and 34.21% of patients′ APE value were less than or equal to 0.50 D, while Haigis was the worst accurate, and 10.53% of patients′ APE value were less than or equal to 0.50 D. After comparing using post hoc multiple comparisons for APE of 6 formulas, SRK Ⅱ was better than Haigis with significant difference (χ2=-0.24, P<0.05). According to the calculation of APE value≤1.00 D, there were significant difference on the percentage for 6 formulas (χ2=16.59, P<0.05). SRK Ⅱ was the most accurate, while Haigis was the worst accurate. After comparing using post hoc multiple comparisons for APE of 6 formulas, SRK Ⅱ was better than Haigis with significant difference (χ2=-0.34, P<0.05). According to the calculation of APE value≤2.00 D, there were significant difference on the percentage for 6 formulas (χ2=18.75, P<0.05). Holladay 1 was the most accurate, while Haigis was the worst accurate. After comparing using post hoc multiple comparisons for APE of 6 formulas, Hollday 1and SRK/T were better than Haigis with significant difference (χ2=-0.29, -0.24; P<0.05).

Conclusions

The accuracy of six formulas is not good in subjects with congenital cataract. It is necessary to develop a new IOL calculation formula for children with congenital cataract.

Key words: Congenital cataract, Intraocular lens power calculation formula, Prediction error, Absolute prediction error
表1 六种人工晶状体计算公式的预测误差和绝对预测误差的比较
公式 眼数(只眼) 预测误差(±s)D 绝对预测误差
(±s)D M(Q1，Q3)D
Barrett 38 -1.11±1.02 1.32±0.71 1.20(0.87，1.85)
Haigis 38 -1.45±1.12 1.60±0.87 1.60(0.85，2.35)
Hoffer Q 38 -0.95±1.00 1.20±0.68 1.19(0.75，1.62)
Holladay 1 38 -0.84±1.00 1.11±0.68 1.10(0.54，1.63)#
SRK Ⅱ 38 -0.58±1.25 1.03±0.91 0.71(0.36，1.81)#*
SRK/T 38 -0.76±1.02 1.03±0.74 1.04(0.36，1.43)#*
χ2值     28.33
P值     <0.05
表2 六种人工晶状体计算公式绝对预测误差≤0.50 D、1.00 D和2.00 D的眼数和百分比[只眼(%)]
公式 眼数(只眼) 绝对预测误差≤0.50 D 绝对预测误差≤1.00 D 绝对预测误差≤2.00 D
Barrett 38 6(15.79%) 14(36.84%) 32(84.21%)
Haigis 38 4(10.53%) 11(28.95%) 25(65.79%)
Hoffer Q 38 7(18.42%) 15(39.47%) 33(86.84%)
Holladay 1 38 7(18.42%) 16(42.11%) 36(94.74%)#
SRK Ⅱ 38 13(34.21%)# 24(63.16%)# 32(84.21%)
SRK/T 38 12(31.57%) 18(47.37%) 34(89.47%)#
χ2值   15.08 16.59 18.75
P值   <0.05 <0.05 <0.05
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