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9가지 인공수정체 도수 계산 공식의 정확성 비교

Accuracy of Intraocular Lens Power Prediction Using 9 Formula

이가영|신영주|김경욱
대한안과학회 (The Korean Ophthalmological Society)|2024.01|대한안과학회지 (Journal of The Korean Ophthalmological Society)|제65권 제1호|pp. 16-26|DOI https://doi.org/10.3341/jkos.2024.65.1.16

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키워드

Cataract surgeryIOL formula comparisonIOL power calculation
주제분류안과학

초록

목적: 현재까지 나와있는 최신 9가지 인공수정체 도수 계산 공식의 정확성을 비교하였다. 대상과 방법: 2015년 10월부터 2021년 3월까지 백내장수술만 시행한 환자 228명의 228안을 분석하였다. 수술 전 LENSTAR로 9가지공식의 예측 굴절값을 구하였다. 수술 후 2달째 실제 굴절값을 2가지 intraocular lens의 종류, 안축장, Keratometry (K)값에 따라나누어 굴절값의 오차(mean prediction error, ME)와 절대오차(mean absolute error, MAE), 절대오차의 중간값(median absolute error, MedAE), MAE가 ± 0.50 diopters (D), ± 0.75 D, ± 1.00 D 이내 비율을 구하였다. 결과: 두 인공수정체 모두 MAE는 Haigis가 가장 높은 정확도를 보였으며 그 다음 Barrett Universal II (Barrett II)와 Olsen이었다. MAE가 0.50 D 이내 비율 가장 높은 공식은 Haigis였다. AXL≥25 mm 20안에서 MAE는 Hoffer Q가 가장 정확하였고 그 다음은 Olsen 과 Barrett II였다. MAE가 0.50 D 이내 비율이 높은 공식은 Hoffer Q였다. K≥46 D 24안에서 MAE와 MedAE는 Haigis가 정확하였으며그 다음은 Barrett II였다. MAE가 0.50 D 이내 비율이 높은 공식은 Holladay, Barrett II, Haigis 순이었다. 결론: 인공수정체 도수를 계산하는 공식들 중 Haigis와 Barrett II가 정확도가 높았다. 긴 안축장에서는 Hoffer Q와 Olsen 그리고Barrett II가 높은 정확도를 보였고 각막곡률이 큰 환자에서는 Haigis와 Barrett II가 높은 정확도를 보였다.

Abstract

Purpose: To compare the accuracy of nine intraocular lens (IOL) power calculation formulas. Methods: This study is retrospective consecutive case series. A total of 228 eyes of 228 patients who underwent uncomplicated cataract surgery between October 2015 and March 2021 were included. The accuracy of nine IOL calculation formulas (Kane, Emmetropia verifying optical version, Hill-radial basis function, Olsen, Barrett Universal II [Barrett II], Haigis, Holladay, Hoffer, and SRK/T) was compared and analyzed using differences between the predicted refractive power and actual refractive power at 2 months after cataract surgery. Mean prediction error (ME), mean absolute error (MAE), median absolute error (MedAE), and the percentage of eyes that were within ± 0.50 diopters (D), ± 0.75 D, and ± 1.00 D of the target refraction were calculated for each formula. Results: For all eyes, Haigis formula was the most accurate in MAE, followed by Barrett II formula. Comparing the probability of MAE within 0.50 D, Haigis formula showed the highest accuracy. A total of 20 eyes of 20 patients had more than 25 mm axial length. Regarding MAE, Hoffer Q was the most accurate, followed by the Olsen formula. Comparing the probability of MAE within 0.50 D, the Hoffer Q formula was the most accurate. A total of 24 eyes of 24 patients had more than 46 D keratometry. Regarding MAE and MedAE, Haigis was the most accurate, followed by the Barrett II formula. Comparing the probability of MAE within 0.5 D, Holladay formula was the most accurate. Conclusions: Barrett II and Haigis formulas showed greater accuracy for all patients when we determined IOL power before cataract surgery. Hoffer Q, Olsen, and Barrett II formulas showed higher accuracy for long axial length. And Haigis and Barrett II were the most accurate for steep keratometry.

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