短眼轴患者人工晶体测量公式准确性的分析

发布时间：2018-01-16 01:00

本文关键词：短眼轴患者人工晶体测量公式准确性的分析　出处：《山东大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：分析短眼轴患者白内障术后屈光误差与不同人工晶体屈光力计算公式的关系,寻找影响人工晶体屈光力计算公式准确性的因素,探讨适合此类患者的人工晶体屈光力计算公式。方法：本研究分为两部分。第一部分为理论分析：通过单变量分析的方法,在给定合理数值的情况下,分析不同人工晶体屈光度计算公式的计算结果,比较不同公式的理论一致性,从而找到不同公式在理论计算结果之间的差异。第二部分为自身回顾性研究,筛选2012年4月至2014年11月之间在山大二院眼科施行白内障超声乳化摘除联合后房型人工晶体植入手术的眼轴小于22.0mm的患者,共36人(48眼),术前应用IOL-master测量人工晶体屈光度计算所需相关参数,计算人工晶体屈光度及预期术后屈光度,术后3至8周内复查,散瞳电脑验光测量等效球镜。计算绝对屈光误差。对比分析SRK/T、Hoffer Q、 Haigis-1(仅优化a0)、Haigis-3(优化a0、a1、a2)公式中位绝对误差、平均绝对屈光误差与前房深度、角膜曲率的相关性。所有统计结果使用SPSS17.0软件分析。结果：第一部分,眼轴大于24mm时,各公式结果的一致性较好,随眼轴减小,Haigis-1公式、SRK/T公式和Hoffer Q公式偏离趋势增加；短眼轴情况下,Haigis-1公式的结果与SRK/T公式、Hoffer Q公式的偏差较大,Haigis-3公式的结果偏差较小；不同前房深度时,Haigis-1公式结果明显背离其他公式,Haigis-3公式与Hoffer Q公式最为接近并形成交叉,其平均误差为0.35D,当2.3mmACD3.3mm时,二者的偏差小于平均差,提示根据前房深度进行分组时,可以使用2.3mm和3.3mm为分界点。第二部分,SRK/T、Hoffer Q、Haigis-1、Haigis-3公式的中,Haigis-1的平均绝对屈光误差较大(0.81D),有统计学意义(P0.05),其他公式比较无统计学意义,其中平均绝对屈光误差最小的是Haigis-3公式(0.38D),其次为Hoffer Q公式(0.50D)和SRK/T公式(0.45D)；分析角膜曲率和平均绝对屈光误差的关系,Haigis-3公式的绝对屈光误差与角膜曲率存在线性相关(P0.01),SRK/T、Hoffer Q、Haigis-1公式的绝对屈光误差与角膜曲率无线性相关。分析前房深度和平均绝对屈光误差,随着前房深度变浅,SRK/T、Hoffer Q公式平均绝对屈光误差呈增加趋势,Haigis-3公式绝对平均屈光误差则无明显增加；当前房深度小于等于2.3mm时,Haigis-3公式的平均绝对屈光误差为0.35D,与Hoffer Q公式(0.61D)、SRK/T公式(0.62D)有显著性差异。当前房深度大于2.3mm时,SRK/T.Hoffer Q和Haigis-3公式的之间无显著性差异；SRK/T、HofferQ公式的绝对屈光误差与前房深度成线性相关关系(P0.01)。结论：不同人工晶体屈光力计算公式导致的短眼轴患者白内障术后的屈光误差不同。仅优化a0常数的Haigis公式的误差最大；随着前房深度的减小,SRK/T、 Hoffer Q、Haigis-1公式的屈光误差呈增加趋势,Haigis-3公式无显著性变化,因此对于短眼轴患者选择人工晶体屈光力计算公式,应该考虑前房深度的影响；仅优化a0常数的Haigis公式在短眼轴患者中会有较大误差,不建议使用；优化a0、a1、a2三个常数的Haigis公式,术后屈光误差较小,可以做为推荐公式；对于前房深度大于2.3mm的患者,Hoffer Q及SRK/T公式均能提供较准确的结果,对于没有优化三个常数Haigis公式的条件下,可以作为首选公式。
[Abstract]:Objective: to analysis the formulas for calculating short axial refractive error after cataract surgery and intraocular lens with different refractive power, find the factors that affect the accuracy of intraocular lens refractive power calculation formula, calculation formula for discussion of intraocular lens diopter in such patients. Methods: This study is divided into two parts. The first part is the theory by analysis. The method of single variable analysis, given the reasonable numerical case analysis of different refractive intraocular lens calculation formula, the theoretical consistency comparison of different formula, so as to find out the differences between the different formula in the calculation results. The second part is the retrospective study, between April 2012 to November 2014 in No.2 Affiliated Hospital of Shandong University ophthalmic screening of cataract phacoemulsification combined with posterior chamber intraocular lens implantation in patients with axial length less than 22.0mm, a total of 36 people (48 eyes), preoperative application IOL-master measurement of intraocular lens power calculation of the required parameters, degree of refractive power of IOL and expected postoperative follow-up of 3 to 8 weeks after the operation, with computer optometry in measurement of spherical equivalent. Calculation of absolute refractive error. Comparative analysis of SRK/T, Hoffer Q, Haigis-1 (only A0 Haigis-3 (optimization), optimization A0, A1, A2) the absolute error formula, the mean absolute refractive error and the correlation between anterior chamber depth, corneal curvature. All statistical results were analyzed by SPSS17.0 software. Results: in the first part, the eye axis is greater than 24mm, the consistency of each formula results better, decreases with the axial, Haigis-1 formula, SRK/T formula and Hoffer Q formula from trend increase; short eye axis case, Haigis-1 formula and SRK/T formula results, Hoffer Q formula of large deviations, smaller Haigis-3 formula results deviation; different anterior chamber depth, the formula of Haigis-1 results from the His formula, Haigis-3 formula and Hoffer Q formula is most close to and form a cross, the average error is 0.35D, when 2.3mmACD3.3mm, the deviation of the two less than the average difference, that were grouped according to the anterior chamber depth, can use 2.3mm and 3.3mm as the cut-off point. The second part, SRK/T Hoffer, Q, Haigis-1, Haigis-3 formula in the mean absolute refractive error Haigis-1 (0.81D), the larger was statistically significant (P0.05), other formula was not statistically significant, the mean absolute refractive error is the smallest Haigis-3 formula (0.38D), followed by Hoffer (0.50D) Q formula and SRK/T formula (0.45D); analysis of the relationship between corneal curvature and mean absolute refractive the error of the linear Haigis-3 formula of absolute refractive error and corneal curvature (P0.01), SRK/T Hoffer, Q Haigis-1, no linear correlation formula of absolute refractive error and corneal curvature analysis of anterior chamber depth and the average. Absolute refractive error, with the depth of shallow anterior chamber, SRK/T Hoffer, Q formula of mean absolute refractive error was increased, the Haigis-3 formula of absolute average refractive error is obviously increased; the real depth is less than or equal to 2.3mm, the average absolute refractive error of Haigis-3 formula for 0.35D, Hoffer and Q (0.61D), SRK/T formula (0.62D formula) there was significant difference. The real depth is more than 2.3mm, there was no significant difference between SRK/T.Hoffer Q and Haigis-3 formula; SRK/T, linear correlation between absolute refractive error and anterior chamber depth into the HofferQ formula (P0.01). Conclusion: the refractive error of short eye axis cataract formula leads to different intraocular lens diopter after different. Haigis error formula is only to optimize the A0 constant of the maximum; with the decrease of anterior chamber depth, SRK/T, Hoffer, Q, refractive error formula of Haigis-1 increased, the Haigis-3 formula No significant changes, so for short eye axis patients intraocular lens refractive power calculation formula, should consider the effect of anterior chamber depth; Haigis formula is only optimized A0 constant will have a greater error in the short axial patients, does not recommend the use of the optimization of A0, A1, Haigis; A2 formula three constants, the smaller refractive error after the operation, can be used as the recommended formula; for anterior chamber depth of more than 2.3mm patients, Hoffer Q and SRK/T formula can provide more accurate results, not for optimization of three Haigis constant conditions, can be used as the preferred formula.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R779.66

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