比较Barrett Universal II、Kane人工晶体屈光度计算公式在白内障合并高度近视患者中的准确性

Comparison of the Accuracy of Barrett Universal II and Kane Formulas for Intra Ocular Lens (IOL) Power Calculation in Cataract Patients with High Myopia

摘要: 目的：评估Barrett Universal II与Kane公式对眼轴长度 ≥ 26 mm的高度近视白内障患者人工晶体度数计算的预测准确性。方法：本研究连续纳入2022年9月至2024年12月接受白内障超声乳化摘除联合单焦点人工晶状体植入术的高度近视白内障患者84例(84眼)，所有病例按术前眼轴测量结果(AL ≥ 26 mm)分为短、中、长三个亚组：A组(眼轴长度26.00~27.99 mm)、B组(眼轴长度28.00~29.99 mm)、C组(眼轴长度 ≥ 30 mm)，将患者数据带入Barrett Universal II、Kane两种公式计算拟植入人工晶状体的屈光度，术后根据术眼实际屈光状态分别计算两种公式的误差并进行比较。统计学分析采用SPSS 26.0软件进行统计处理。结果：三组在年龄、性别分布、角膜曲率(K1、K2)等基线数据方面均无显著差异(P > 0.05)；A、B两组Kane公式与Barrett Universal II公式绝对值误差中位数(median absolute error, MedAE)差异无统计学意义(均P>0.05)，C组Kane公式与Barrett Universal II公式MedAE差异有统计学意义(Z = −4.072, P < 0.05)；A组两公式预测误差平均值(mean errors, ME)在±0.50D范围内的比率及在±1.00D范围内的比率差异均无统计学意义(均P>0.05)；B组两公式预测ME在±0.50D范围内的比率差异有统计学意义(Z = −3.404, P < 0.05)，在±1.00D的比率差异有统计学意义(Z = −3.509, P < 0.05)。C组两公式预测ME在±0.50D范围内的比率差异有统计学意义(Z = −2.453, P < 0.05)，在±1.00D的比率差异有统计学意义(Z = −3.463, P < 0.05)。结论：与Barrett Universal II相比，Kane公式在超长眼轴白内障患者的人工晶体计算中准确性更优。

Abstract: Objective: To evaluate the predictive accuracy of Barrett Universal II and Kane formulas for intraocular lens (IOL) power calculation in cataract patients with high myopia (axial length ≥ 26 mm). Methods: The study included clinical data from 84 patients (84 eyes) who underwent phacoemulsification combined with intraocular lens implantation for cataract with high myopia from September 2022 to December 2024. Patients were divided into three groups based on axial length: Group A (axial length 26.00~27.99 mm), Group B (axial length 28.00~29.99 mm), and Group C (axial length ≥ 30 mm). The Barrett Universal II and Kane formulas were used to calculate the IOL power for each patient. Postoperative refractive errors were calculated for both formulas and compared. Statistical analysis was performed using SPSS 26.0 software. Results: There were no statistically significant differences in age, gender, K1, and K2 among patients in groups A, B, and C (P > 0.05). The median absolute error (MedAE) of the Kane formula and the Barrett Universal II formula showed no statistically significant difference in groups A and B (all P > 0.05), while a statistically significant difference was observed in group C (Z = −4.072, P < 0.05). In group A, there were no statistically significant differences in the proportions of mean errors (ME) within ±0.50D and ±1.00D ranges for both formulas (all P > 0.05). In group B, the proportions of ME within ±0.50D and ±1.00D ranges showed statistically significant differences (Z = −3.404, P < 0.05; Z = −3.509, P < 0.05, respectively). Similarly, in group C, the proportions of ME within ±0.50D and ±1.00D ranges demonstrated statistically significant differences (Z = −2.453, P < 0.05; Z = −3.463, P < 0.05, respectively). Conclusion: The Kane formula demonstrates superior accuracy in predicting refractive outcomes for cataract patients with high myopia and extremely long axial lengths, outperforming the Barrett Universal II formula.