Sirius光迹追踪法计算人工晶状体度数的准确性

doi:10.3969/j.issn.2095-9400.2019.02.007

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摘要目的：与IOL-Master法比较，分析应用Sirius光迹追踪法计算人工晶状体（IOL）度数的白内障手术后屈光误差的准确性及影响因素，探讨Sirius光迹追踪法的适用范围。方法：选取2016年7月至2017年8月在温州医科大学附属眼视光医院杭州院区行白内障超声乳化吸除并IOL植入术治疗的白内障患者64例（80眼）。术前用IOL-Master检查眼轴（AL）、角膜屈光力（K）、前房深度（ACD），同时行Sirius检查，获得房角度数，短AL（AL＜22 mm）患者应用SRK/T公式、Haigis公式及Hoffer Q公式，正常AL（22 mm≤AL＜26 mm）及长AL（AL≥26 mm）患者应用SRK/T公式及Haigis公式，所有患眼同时用Sirius光迹追踪法计算IOL度数。术中植入单焦点可折叠IOL，术后3个月进行主觉验光。根据预留屈光度数与实际屈光度数计算屈光误差值及误差绝对值（AE）。结果：在各AL组中，仅在长AL组及短AL组Sirius光迹追踪法屈光误差值与SRK/T公式、Haigis公式、Hoffer Q公式差异有统计学意义（P＜0.05），各AL组内Sirius光迹追踪法的AE与SRK/T公式、Haigis公式、Hoffer Q公式差异均有统计学意义（P＜0.05）。各AL组间比较，Sirius光迹追踪法屈光误差值两两比较差异均有统计学意义（P＜0.01）；正常AL组与短AL组的AE差异无统计学意义（P>0.05），但在正常AL组与长AL组及短AL组与长AL组的差异有统计学意义（P＜0.05）。Sirius光迹追踪法的屈光误差值与AL呈正相关（r=0.68，P＜0.01），与K呈负相关（r=-0.38，P＜0.01），与ACD呈正相关（r=0.44，P＜0.01），与房角度数呈正相关（r=0.34，P＜0.01）。结论：与IOL-Master法比较，短AL术眼中Sirius光迹追踪法近视漂移更多，长AL术眼远视漂移更多，屈光预测的准确性较IOL-Master公式差，在非正常AL术眼中屈光误差更明显，且随AL增长、ACD加深、K减小及房角增大，远视漂移量增加（或近视漂移量减少）。

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	傅映晖

关键词 ： Sirius, 光迹追踪, IOL-Master, 白内障, 屈光误差

Abstract：Objective: To detect the factors that influence postoperative refractive error by ray-tracing using sirius internal software in comparison with IOL-Master method and to explore the scope of the application. Methods: Sixty-four patients (80 eyes) with cataract who underwent phacoemulsification and intraocular lens (IOL) implantation in the Eye Hospital of Wenzhou Medical University from July 2016 to August 2018 were included. Axial length (AL), corneal refractive power (K) and preoperative anterior chamber depth (ACD) were measured by IOL-Master preoperatively. At the same time, the eyes were checked by sirius and the anterior chamber angle was obtained. The SRK/T, Haigis and Hoffer Q formulas were used in patients with short AL (<22 mm). The SRK/T and Haigis formulas were used in patients with normal AL between 22 mm to 26 mm and long AL (≥26 mm). The IOL calculation of all eyes was carried out by ray-tracing using sirius internal software simultaneously. Monofocal foldable IOLs were then implanted during surgery. Refractions were measured with a phoropter three months postoperatively. Refractive errors and absolute errors (AE) of the four calculation approaches were calculated based on the results of postoperative and predictive refraction. Results: Refractive errors of ray-tracing were different from SRK/T, Haigis and Hoffer Q formulas only in short AL group and long AL group (P<0.05), and AEs were different from IOL calculation formulas in all groups (P<0.05). Significant statistics difference of the refractive error of ray-tracing in multiple comparison with IOL-Master formulas was found in each AL groups (P<0.01). AE by ray-tracing was statistically different between normal AL group and long AL group, between short AL group and long AL group. Refractive error of ray-tracing was positively correlated with AL (r=0.68, P<0.01), ACD (r=0.44, P<0.01) and anterior chamber angle (r=0.34, P<0.01), but negatively correlated with K (r=-0.38, P<0.01). Conclusion: Compared with IOL-Master method, postoperative refractive error exhibits a more obvious myopic shift for eyes with a short AL while a more obvious hyperopic shift for eyes with a long AL by ray-tracing using sirius internal software. A more accurate prediction of postoperative refractive error is considered in IOL calculation formulas, especially in eyes with abnormal ALs. As AL is increased, the acd, the K is decreased the angle of anterior chamber widens and hyperopic shift increases (myopic shift decreases).

Key words： sirius ray-tracing IOL-Master cataract refractive error

基金资助:温州市公益性科技计划项目（Y20160444）。

通讯作者: 映晖，主任医师，Email：fuyinghui@foxmail.com

作者简介: 魏丽清（1986-），女，浙江平阳人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/10.3969/j.issn.2095-9400.2019.02.007 或 https://xb.wmu.edu.cn/CN/Y2019/V49/I2/108

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