Impact of Posterior Staphyloma and Peripheral Refraction on Intraocular Lens Power Calculation in Highly Myopic Eyes.

IF 2.9 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery Pub Date : 2025-05-01 DOI:10.3928/1081597X-20250403-01

Zhiwen Yao, Yingyan Qin, Lu Qin, Yan Ni, Liangping Liu, Mingxing Wu

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引用次数: 0

Abstract

Purpose: To assess the impact of posterior staphyloma and peripheral refraction on the calculation of intraocular lens (IOL) power in eyes with highly myopic cataracts.

Methods: Multispectral refraction topography (MRT) was used to categorize posterior staphyloma types and detect the refraction difference value (RDV) across different fundus regions. The Barrett Universal II formula was employed for IOL power calculation. Refractive outcomes were assessed through the calculation of standard deviation (SD), mean absolute error (MAE), median absolute error (MedAE), and the proportion of eyes with prediction error (PE) within ±0.25, ±0.50, ±0.75, and ±1.00 diopters (D). The associations between PE and peripheral refraction were analyzed using Pearson correlation analysis.

Results: A total of 65 patients (84 eyes) were included in the study and were categorized into groups based on staphyloma types (non-posterior staphyloma, wide macular staphyloma, narrow macular staphyloma, peripapillary staphyloma) using MRT. The patients with wide macular staphyloma exhibited significantly higher SD (0.465) in comparison to those without staphyloma (0.23). Among patients with posterior staphyloma, peripapillary staphyloma had the least effect on IOL power calculation with the lowest SD (0.325), MAE (0.25), and MedAE (0.25), and highest percentage of cases with a PE within ±0.50 D (90%). According to multivariate analysis, RDV-Superior was significantly correlated with PE (B = -0.471, P = .001).

Conclusions: Patients with wide macular staphyloma present challenges for accurate IOL power calculation. In addition, superior retinal peripheral myopic defocus in patients with posterior staphyloma may lead to greater hyperopic shifts after cataract surgery. Consideration of staphyloma types and RDV-Superior is recommended for more precise IOL power calculation. [J Refract Surg. 2025;41(5):e472-e480.].

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高度近视眼后葡萄肿和周围屈光对人工晶体度数计算的影响。

目的：探讨高度近视白内障后葡萄肿和周围屈光对人工晶状体度数计算的影响。方法：采用多光谱折射地形图（MRT）对后巩膜葡萄肿进行分型，检测眼底不同区域的折射差值（RDV）。采用Barrett Universal II公式计算人工晶状体度数。通过计算标准差（SD）、平均绝对误差（MAE）、中位绝对误差（MedAE）和预测误差在±0.25、±0.50、±0.75和±1.00屈光度(D)范围内的眼的比例（PE）来评估屈光结果。采用Pearson相关分析分析PE与外周屈光之间的关系。结果：共纳入65例患者（84只眼），根据葡萄肿类型（非后斑葡萄肿、宽斑葡萄肿、窄斑葡萄肿、乳头周围葡萄肿）进行MRT分类。广角葡萄肿患者的SD值（0.465）明显高于无葡萄肿患者（0.23）。在后端葡萄肿患者中，乳突周围葡萄肿对人工晶状体度数计算的影响最小，SD最低（0.325），MAE最低（0.25），MedAE最低（0.25），PE在±0.50 D内的比例最高（90%）。多因素分析显示，RDV-Superior与PE显著相关（B = -0.471, P = .001）。结论：广角黄斑葡萄肿患者对人工晶状体度数的准确计算提出了挑战。此外，后葡萄肿患者的上视网膜周围性近视离焦可能导致白内障手术后更大的远视移位。考虑葡萄肿的类型和RDV-Superior推荐更精确的人工晶状体度数计算。[J].中华眼科杂志，2015;41(5):572 - 578。

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来源期刊

$Journal of refractive surgery$

Journal of refractive surgery 医学-外科

CiteScore

5.10

自引率

12.50%

发文量

160

审稿时长

4-8 weeks

期刊介绍： The Journal of Refractive Surgery, the official journal of the International Society of Refractive Surgery, a partner of the American Academy of Ophthalmology, has been a monthly peer-reviewed forum for original research, review, and evaluation of refractive and lens-based surgical procedures for more than 30 years. Practical, clinically valuable articles provide readers with the most up-to-date information regarding advances in the field of refractive surgery. Begin to explore the Journal and all of its great benefits such as: • Columns including “Translational Science,” “Surgical Techniques,” and “Biomechanics” • Supplemental videos and materials available for many articles • Access to current articles, as well as several years of archived content • Articles posted online just 2 months after acceptance.