非接触式光学相干生物测量仪在高度近视白内障眼人工晶状体度数测量中的应用

目的通过比较非接触式光学相干生物测量仪（IOL-Master）与传统A超联合角膜曲率计测量法对高度近视白内障人工晶状体度数测量的准确性及特点,评价IOL-Master的临床应用价值。方法对78例（共90眼）高度近视且患有白内障的患者术前分别用IOL-Master、接触式A超联合角膜曲率计测量眼轴长度和角膜曲率,使用SRK/T公式计算人工晶状体度数。对患者施行白内障超声乳化吸除术,按A超联合角膜曲率计检查法得出的人工晶状体度数植入注入式人工晶状体。术后1个月随诊检查视力及眼屈光度。结果术前IOL-Master测得的眼轴长度与接触式A超相比差异有统计学意义（P=0.001）,而测得的角膜曲率与角膜曲率计相比差异无统计学意义（P=0.067）。术后1个月IOL-Master测得的平均绝对屈光误差值（MAFE）与A超联合角膜曲率计相比差异有统计学意义（P=0.001）,且IOL-Master测得的MAFE≤±0.50 D者及≤±1.00 D者均显著高于A超联合角膜曲率计（P〈0.05）。结论 IOL-Master是一种操作简单、安全可靠的人工晶状体度数测量工具。与A超相比,IOL-Master对高度近视眼眼轴长度测量精确性较高,对高度近视白内障手术人工晶状体度数的选择有重要意义。

Application of IOL-Master in Intraocular Lens Power Calculation in Patients with High Myopia and Cataract

Objective To compare the accuracies and characteristics of non-contact optical biometry（IOL-Master） and contact biometry（A-scan） in the intraocular lens power calculation in patients with high myopia and cataract, and to evaluate the clinical value of IOL-Master. Methods Ocular axial length and corneal curvature were measured by IOL-Master and A-scan in 78 patients with high myopia and cataract（90 eyes）.Intraocular lens power was calculated by SRK/T formula. The phacoemul-sification and foldable intraocular lens implantation were performed in all patients. The visual acuity and diopter were determined 1 month after operation. Results Before operation, the ocular axial length measured by IOL-Master was significantly different from that measured by A-scan（P=0.001）. However,the corneal curvature measured by IOL-Master was not significantly different from that measured by Ascan before operation（P=0.067）.The mean absolute refractive error（MAFE） measured by IOL-Master was significantly different from that measured by A-scan 1 month after operation（P=0.001）. Furthermore, the number of patients with MAFE ≤±0.50 or MAFE ≤±1.00 measured by IOL-Master was significantly higher than that measured by A-scan（P〈0.05）. Conclusion IOL-Master is a simple, safe and reliable device for measurement of the intraocular lens power. It has higher accuracy than A-scan for measurement of the ocular axial length in patients with high myopia. Therefore, IOL-Master is of great significance for the choice of intraocular lens power in patients with high myopia and cataract.