Optimization of crystalline lens refractive index to improve the accuracy of intraocular lens power calculation in patients with dense cataract.

IF 3.7 3区医学 Q2 OPHTHALMOLOGY

Journal of cataract and refractive surgery Pub Date : 2026-09-01 DOI:10.1097/j.jcrs.0000000000001941

Tsuyoshi Nogami, Takashi Kojima, Akeno Tamaoki, Ayako Sawaki, Asato Hasegawa, Tatsushi Kaga

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引用次数: 0

Abstract

Purpose: To evaluate effects of crystalline lens refractive index (LRI) on prediction error (PE) and suggest the optimal LRI in cases of dense cataract.

Setting: Chukyo Hospital, Aichi, Japan.

Design: Retrospective consecutive case series study.

Methods: Patients who underwent cataract surgery were enrolled and allocated into Group A (nuclear hardness ≤III) and B (nuclear hardness ≥IV) based on the Emery-Little classification. The swept-source optical biometer was used for biometric measurements. Assuming the postoperative axial length (AL) to be the valid value, a corrected LRI (CLRI) was calculated to make the preoperative AL equivalent to the postoperative one. In the validation group, the PE of the SRK/T formula and Barrett Universal II (BUII) were evaluated using the precorrection and postcorrection refractive indices.

Results: Of the 5196 enrolled eyes, 1084 were evaluated. In Group A, there was no significant difference between the preoperative and postoperative ALs ( P = .07). In Group B, the mean postoperative AL (24.09 ± 2.05 mm) was significantly shorter than the mean preoperative AL (24.12 ± 2.06 mm) ( P < .001). The average CLRI in Group A and B were 1.41 and 1.42, respectively. In the validation group, the PEs using CLRI (SRK/T, 0.10 ± 0.48 diopters [D]; BUII, 0.03 ± 0.35 D) were significantly smaller than those using LRI (SRK/T, 0.18 ± 0.49 D; BUII, 0.12 ± 0.36 D) ( P < .001).

Conclusions: In cases of high lens nucleus hardness, the use of proposed CLRI demonstrated potentials for reducing PE.

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优化晶状体折射率以提高密闭性白内障患者人工晶状体度数计算的准确性。

目的：探讨晶状体折射率（LRI）对致密性白内障预测误差（PE）的影响，提出最佳的LRI。地点：日本爱知县中京医院。设计：回顾性连续病例系列研究。方法：选取行白内障手术的患者，根据emeri - little分级分为核硬度≤III组和核硬度≥IV组。扫描源光学生物计用于生物特征测量。假设术后轴向长度（AL）为有效值，计算校正后的LRI (CLRI)，使术前AL与术后AL相等。在验证组中，使用校正前和校正后的折射率评估SRK/T公式和Barrett UniversalⅡ（BUⅡ）的PE。结果：5196只入组眼睛中，1084只被评估。在A组，术前和术后ALs无显著差异（P = .07）。B组术后平均AL（24.09±2.05 mm）明显短于术前平均AL(24.12±2.06 mm) （P < 0.001）。A、B组平均CLRI分别为1.41、1.42。在验证组，使用CLRI的pe （SRK/T, 0.10±0.48 D; BUⅡ，0.03±0.35 D）显著小于使用LRI的pe (SRK/T, 0.18±0.49 D; BUⅡ，0.12±0.36 D) （P < 0.001）。结论：在高晶状体核硬度的病例中，使用CLRI显示出降低PE的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

$Journal of cataract and refractive surgery$

Journal of cataract and refractive surgery 医学-外科

CiteScore

5.60

自引率

14.30%

发文量

259

审稿时长

8.5 weeks

期刊介绍： The Journal of Cataract & Refractive Surgery (JCRS), a preeminent peer-reviewed monthly ophthalmology publication, is the official journal of the American Society of Cataract and Refractive Surgery (ASCRS) and the European Society of Cataract and Refractive Surgeons (ESCRS). JCRS publishes high quality articles on all aspects of anterior segment surgery. In addition to original clinical studies, the journal features a consultation section, practical techniques, important cases, and reviews as well as basic science articles.