使用模拟角膜测量与光学生物计角膜测量的屈光结果。

IF 4.2 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-09-06 DOI:10.1016/j.ajo.2025.08.055

David L. Cooke , Karanpreet S. Multani , Jascha A. Wendelstein , Kamran M. Riaz

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引用次数: 0

摘要

目的比较Scheimpflug层析仪（Pentacam AXL, Oculus）使用模拟角膜测量法（SimK）测量的屈光预测精度与使用远心角膜测量法（IOLMaster 700 (IOLM700)，卡尔蔡司Meditec AG）使用现代IOL度数计算公式的光学生物计获得的角膜测量法(K)测量的屈光预测精度。设计回顾性准确性和有效性分析方法：设置：私人诊所中心研究人群：589只术前测量了SimK和K的眼睛，接受超声乳化和单焦点人工晶体植入术（Clareon SY60WF IOL，爱尔康实验室，Inc.）。使用IOLCon常数和优化的晶状体常数，使用9个IOL公式(Barrett Universal 2.0 （BU2), Cooke K6 (K6), EVO 2.0, Haigis, Hoffer Q, Holladay I, Pearl DGS， SRK/T和T2）计算三种方法的屈光预测误差：(1)IOLM700生物测量（轴长（AL），前房深度（ACD）和K）， (2) Pentacam AXL生物测量（AL， ACD和Sim K）， (3) IOLM700 AL/ACD与Pentacam AXL Sim K联合使用。使用平均绝对误差（MAE）和均方根误差（RMSE）来评估屈光结果。结果在非优化（IOLCon）和优化后的晶状体常数下，所有9个配方均以IOLMaster 700方法的MAE和RMSE最低，其次是组合方法，最后是Pentacam AXL方法。三种技术的公式排名各不相同，IOLM700技术的K6公式排名最高，Pentacam和组合技术的EVO 2.0公式排名最高。应用异方差检验比较9个配方内各3种方法的差异，IOLM700版本显著优于联合版本（均p < 0.05），联合版本优于PC版本（均p < 0.05）。结论：IOLM700的生物特征值（包括标准K）在所有配方中提供了最准确的屈光预测，即使经过晶状体常数优化，也优于Pentacam AXL的生物特征值（包括Sim K）。Sim K值与SS-OCT生物计衍生的K值不能直接互换。配方的性能根据生物计量和优化的来源而变化。

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Refractive Outcomes Using Simulated Keratometry Versus Keratometry From an Optical Biometer

Purpose

To compare refractive prediction accuracy using simulated keratometry (SimK) measurements obtained from a Scheimpflug tomographer (Pentacam AXL, Oculus) versus keratometry (K) measurements obtained from an optical biometer utilizing telecentric keratometry (IOLMaster 700 (IOLM700), Carl Zeiss Meditec AG) applied to modern IOL power calculation formulas.

Design

Retrospective accuracy and validity analysis

Methods and Setting

Private practice center

Study Population

Five hundred eighty-nine eyes with preoperative SimK and K measurements undergoing phacoemulsification and implantation of monofocal IOL (Clareon SY60WF IOL, Alcon Laboratories, Inc.). Using IOLCon constants and optimized lens constants, nine IOL formulas (Barrett Universal 2.0 (BU2), Cooke K6 (K6), EVO 2.0, Haigis, Hoffer Q, Holladay I, Pearl DGS, SRK/T, and T2) were used to calculate refractive prediction errors across 3 methods: (1) IOLM700 biometry (axial length (AL), anterior chamber depth (ACD), and K), (2) Pentacam AXL biometry (AL, ACD, and Sim K), and (3) combined IOLM700 AL/ACD with Pentacam AXL Sim K

Main Outcome Measures

Mean absolute error (MAE) and root mean squared error (RMSE) were used to assess refractive outcomes.

Results

Using both nonoptimized (IOLCon) and optimized lens constants, all nine formulas demonstrated the lowest MAE and RMSE with the IOLMaster 700 approach, followed by the combination approach, and then the Pentacam AXL approach. Formula rankings varied among the 3 techniques: the K6 formula had the highest ranking for the IOLM700 technique, while EVO 2.0 had the top ranking for the Pentacam and combination techniques. When applying heteroscedastic testing to compare the 3 methods within each of the nine formulas, the IOLM700 version was significantly better than the combination version (all P < .05), and the combination version was superior to the PC version (all P < .05). Among the top-performing Pentacam formulas, the BU2 and Haigis formulas were statistically similar to the EVO 2.0

Conclusions

Biometric values (including standard K) from the IOLM700 provided the most accurate refractive predictions across formulas, outperforming biometric values (including Sim K) from the Pentacam AXL, even after lens constant optimization. Sim K values are not directly interchangeable with SS-OCT biometer-derived K values. The performance of formulas varies based on the source of biometry and optimization.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.