인공수정체 도수공식 정확성 비교: SRK/T, Barrett Universal II, T2
Comparison of Three Formulas for Intraocular Lens Power Formula Accuracy
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목적: 백내장수술환자에서 3가지 인공수정체 도수공식 간(SRK/T, Barrett Universal II, T2) 예측 정확성을 비교해 보고자 하였다. 대상과 방법: 백내장수술을 받은 73명 73안을 대상으로 인공수정체 도수 산출 공식(SRK/T, Barrett Universal II, T2)로 도수를 결정하였고, 수술 후 3개월째에는 구면 대응치와 각 공식의 예측치를 이용해 공식별 예측오차(수술 후 현성 굴절검사를 통해 계산된 구면대응치-수술 전 각 공식들의 목표 굴절력)와 절대오차(예측오차의 절대값)를 비교하였다. 그리고 안축장 길이(AL), 각막곡률(K)의 변화에 따른 수술 후 3개월째 각 공식에서의 예측오차의 변화를 탐색해 보았다. 결과: 백내장수술 후 3개월째에 평균 예측오차와 평균 절대오차는 SRK/T (각 -0.08 ± 0.45D, 0.35 ± 0.40D), Barrett Universal II (각 -0.01 ± 0.44D, 0.33 ± 0.30D), T2 (각 0.04 ± 0.45D, -0.34 ± 0.30D)으로 공식 간의 통계적으로 유의한 차이는 없었다. 다만, AL≥26 mm나 K≥47D인 경우, Barrett Universal II 공식의 평균 예측오차가 다른 공식들에 비해 0에 가까웠고, 표준편차가 가장 작았다. 결론: 세 공식 간 인공수정체 도수 예측의 정확성에 있어서 유의한 차이는 없었지만, 안축장과 각막곡률이 평균 구간에서 벗어나는 경우 Barrett Universal II과 같은 최신 공식을 고려해 볼 수 있겠다.
Abstract
Purpose: To compare the accuracy of three intraocular lens (IOL) power calculation formulas (SRK/T, Barrett Universal II, and T2) in cataract surgery patients. Methods: In total, 73 eyes of 73 patients who underwent uneventful cataract surgery were retrospectively reviewed. IOL power was determined using SRK/T, Barrett Universal II, and T2 preoperatively. The findings were compared with the actual refractive outcome to obtain the prediction error. The mean prediction error (ME) and mean absolute error (MAE) of each formula were compared. The MAE was defined as the difference between the postoperative spherical equivalence (SE) and the preoperatively predicted SE. The ME and MAE of each formula 3 months after surgery were compared with preoperatively predicted SE. Eyes were classified into subgroups based on axial length (AL) and average keratometry (K). Results: The ME and MAE for the three formulas were SRK/T [-0.08 ± 0.45 diopters (D) and 0.35 ± 0.40 D, respectively], Barrett Universal II (-0.01 ± 0.44 D and 0.33 ± 0.30 D, respectively), and T2 (0.04 ± 0.45 D and -0.34 ± 0.30 D, respectively), but no statistically significant differences were detected. Similar results were obtained in groups with a long AL or a large average K. In groups with an AL ≥ 26 mm or with an average K ≥ 47 D, the Barrett Universal II formula yielded the smallest standard deviation and a ME closest to zero, but these differences were not statistically significant. Conclusions: No significant differences were observed between the three formulas regarding ME or MAE. However, recent formulas such as the Barrett Universal II could provide certain benefits in predicting IOL power for patients with a long AL (> 26 mm) or larger average K. Further research with a larger sample size is recommended for more evaluation.
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