인공수정체 도수 산출 공식간 오차에 영향을 미치는 요인 분석
Analysis of Factors that Influence on Accuracy of Intraocular Lens Power Calculation
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목적: 인공수정체 도수산출 공식간 오차에 영향을 미치는 요인을 알아보고자 하였다. 대상과 방법: 백내장 수술을 받은 266안을 대상으로 인공수정체 도수 산출 공식(SRK/T, HofferQ (H/Q), Master SRK/T (M/T), MasterHofferQ (M/Q), Master Holladay (M/Hol), Master Haigis (M/Hai))으로 도수를 결정하였고 수술 후 1개월 구면 대응치와 각 공식의예측치를 이용해 공식별 평균 절대오차를 비교하였고 공식별 예측치의 차이가 어떤 요인에 의해 발생하는지 분석하였다. 각막곡률에따라 세 군으로 나눈 후 군간 오차의 차이가 있는지 분석하였고, 각막 곡률의 변화와 각 공식의 절대오차와의 상관관계를 알아보았다. 결과: 평균 절대오차가 가장 작은 공식은 M/T이며 M/Hol, M/Hai, SRK/T, H/Q, M/Q 순으로 공식간 통계적으로 유의한 차이는 없었다. 공식간 예측값의 차이는 안축장과 각막곡률에 의해 발생했고 다변량 분석에서는 안축장만이 유의하였다. 각막곡률에 따라 나눈 세군사이의 평균 절대오차가 유의한 차이를 보이는 공식은 SRK/T, M/Hol, M/Hai였다. 각막곡률에 감소함에 따라 절대오차가 유의하게증가하는 공식은 SRK/T와 M/Hai였고, 특히 안축장이 22.5 mm 이하인 경우에 더 많은 영향을 받았다. 결론: 평균 절대오차는 공식간의 유의한 차이가 없었고 공식간 도수 예측치의 차이는 주로 안축장에 의해 발생하지만 SRK/T와 M/Hai의 절대 오차는 각막곡률에 의해 영향을 많이 받았다.
Abstract
Purpose: To investigate which factors primarily influence refractory errors between various formulas used to calculate intraocularlens (IOL) power. Methods: Records of 266 eyes of 191 patients who underwent uneventful cataract surgery were reviewed retrospectively. IOL power was determined using SRK/T, HofferQ (H/Q), Master SRK/T (M/T), Master HofferQ (M/Q), Master Holladay(M/Hol), and Master Haigis (M/Hai). The mean absolute error (MAE) of each formula was compared; MAE was defined asthe difference between the postoperative spherical equivalence (SE) determined 1 month after surgery and the predictedSE. Factors that could have influenced interformula refractive errors were analyzed. Patients were divided into 3 groupsbased on average keratometric value (Kavg) and the inter-group differences of the AE of each formula were analyzed. Effects of corneal curvature on changes in AE of each formula were evaluated by linear regression. Results: The MAE was minimized in the M/T formula, followed by the M/Hol, M/Hai, SRK/T, H/Q, and M/Q formulas. Interformula MAE differences were not statistically significant. Kavg and AXL were significantly influenced by the differentpredictive values between formulas in univariate analysis, but only AXL was significant in multivariate analysis. The AE ineach formula among the 3 groups according to keratometry was significantly different in SRK, M/Hol, and M/Hai. Linear regressionanalysis showed a significant negative correlation between Kavg, AE of SRK/T and the MHai formula. In particular,this effect was more pronounced in those with short AXL (<22.5 mm). Conclusions: There were no significant MAE differences between formulas. AXL was a significant factor that influencedthe differences between formulas. SRK/T and M/Hai may be affected by outside the normal range of corneal curvatures.
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