Early postoperative refractive outcomes of pediatric intraocular lens implantation
Early postoperative refractive outcomes of pediatric intraocular lens implantation
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DOI：
10.1016/j.jcrs.2003.07.002
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发表时间：
2004-03-01
影响因子：
2.8
通讯作者：
Levin, AV
中科院分区：
文献类型：
--
作者：
Mezer, E;Rootman, DS;Levin, AV
目的：使用5个人工透镜（IOL）计算公式评估屈光结果，以确定哪一个最能预测儿科白内障手术后的屈光。地点：加拿大安大略省多伦多患病儿童医院。方法：这项研究回顾了158名年龄在2至17岁之间的连续患者的病历，这些患者在1992年5月至4月期间由2名外科医生中的1名进行了手术2000.外科医生共进行了206例白内障摘除术和一期或二期人工晶状体植入术。测量结果为术后2 - 6个月的实际屈光度与目标屈光度。两个回归公式（SRK，SRK II）和3个理论公式（Holladay 1，Hoffer Q，SRK/T）被用来预测屈光结果的基础上，术前眼轴长度，角膜曲率，人工晶状体屈光度，和人工晶状体A-常数由制造商提供。还分析了31例患者（34例IOL植入）的数据，这些患者在术后2 - 3个月有可用数据。使用SRK公式（组内相关系数[ICC] = 0.50/0.04 [2- 3个月随访/2- 6个月随访]）预测的术后屈光度与实际屈光度之间的一致性较差至中度，使用其他公式（SRK II的ICC为0.60/0.24，Hoffer Q为0.67/0.37）的一致性良好或一般。所有公式的预测和实际术后屈光度之间的平均差异范围为1.06至1.22屈光度（D）/1.35至1.79 D（中位数0.81至0.99 D/0.94至1.40 D;范围3.03至5.57 D/6.75至9.21 D）。Holladay 1和SRK的结果屈光度偏离目标值+/-2.00D者分别为9%~ 18%和23%~ 39%。这一发现可能对预测长期结果，解释以前的屈光结果报告，并在临床环境中获得术前知情同意书有意义。
Purpose: To evaluate the refractive outcome using 5 intraocular lens (IOL) calculation formulas to determine which best predicts refraction after pediatric cataract surgery.Setting: The Hospital for Sick Children, Toronto, Ontario, Canada.Methods: This study comprised a review of the charts of 158 consecutive patients aged 2 to 17 years old who were operated on by 1 of 2 staff surgeons between May 1992 and April 2000. The surgeons performed a total of 206 cataract extractions with primary or secondary IOL implantation. The measured outcome was the actual refraction 2 to 6 months postoperatively versus the target refraction. Two regression formulas (SRK, SRK II) and 3 theoretical formulas (Holladay 1, Hoffer Q, SRK/T) were used to predict refractive outcome based on preoperative axial length, corneal curvature, IOL power, and the IOL A-constant provided by the manufacturer.Results: Forty-nine patients (59 IOL implantations) with available data 2 to 6 months after surgery were studied. Also analyzed were data from a subset of 31 patients (34 IOL implantations) with available data 2 to 3 months after surgery. There was poor to moderate agreement between the predicted and actual postoperative refractions using the SRK formula (intraclass correlation coefficient [ICC] = 0.50/0.04 [2- to 3-month follow-up/2- to 6-month follow-up]) and good or fair agreement using the other formulas (ICC from 0.60/0.24 for SRK II to 0.67/0.37 for Hoffer Q). The mean difference between the predicted and actual postoperative refractions with all formulas ranged from 1.06 to 1.22 diopters (D)/1.35 to 1.79 D (median 0.81 to 0.99 D/0.94 to 1.40 D; range 3.03 to 5.57 D/6.75 to 9.21 D). Using Holladay 1 and SRK, 9% to 18%/23% to 39% eyes were more than +/-2.00 D off the target outcome refraction.Conclusions: All 5 IOL power calculation formulas were unsatisfactory in achieving the target refraction. This finding may have implications for predicting long-term outcomes, interpreting previous reports of refractive outcomes, and obtaining preoperative informed consent in a clinical setting.