| Objective: To investigate whether there is a difference in the measurement results of intraocular lens power between A-scan and IOL-Master for patients with idiopathic macular epiretinal membrane and cataract,and to evaluate the accuracy of measurement instruments for such patients.Methods: This subject adopts a prospective analysis and collects 60 patients,which are divided into an experimental group and a control group,with 30 people in each group.The experimental group selected patients diagnosed as age-related cataract with idiopathic macular epiretinal membrane.The control group was a simple age-related cataract patient.In the experimental group,patients adapt A-scan and IOL-Master measurements of their axis length,in which the anterior chamber depth and corneal curvature were measured using IOL-Master data.The obtained data were calculated using the Barrett UniversalⅡ,Kane,SRK-T,Haigis,Hoffer Q,Holladay2 formulas to calculate the intraocular lens power;The central foveal thickness(CFT),maximum retinal thickness(MRT),and degree of structural disorder in the inner retina(DRIL)were measured using OCT.Andidiopathic macular epiretinal membranes were staged by Govetto A staging.The control group also collected the same data.Compare groups of data.Statistical measurements were performed using SPSS statistical software,with a statistical significance of P<0.05.Results: 1.Analyze the collected data of 60 patients,and compare the axial lengths measured by A-scan and IOL-Master within and between the two groups: the axial lengths measured by A-scan and IOL-Master within the experimental group were(22.98 ± 0.2)mm and(23.13 ± 0.18)mm,respectively.Compared with A-scan measurement,the average axial length of IOL-Master was 0.15 mm longer than that measured by A-scan.(t=6.48,p<0.01);The axial length measured by A-scan and IOL-Master in the control group was(23.28 ± 0.47)mm and(23.41 ± 0.42)mm,respectively.Compared with A-scan measurement,the average axial length of IOL-Master was 0.13 mm longer(t=7.37,p<0.01).The axis length measured by A-scan and IOL-Master were compared between the two groups.The results of the two groups were p>0.05.There were significant differences between the experimental group and the control group in the measurement of axis length by A-scan and IOL-Master in the two groups,with statistical significance.There was no significant difference between the experimental group and the control group in terms of A-scan and IOL-Master measurements of the axis length between the two groups,with no statistical significance.2.Comparison of the results obtained by using six intraocular lens power calculation formulas(BUⅡ,Kane,SRK-T,Haigis,Hoffer Q,Holladay 2)to measure the axis length measured by A-scan and IOL-Master in the two groups: In the experimental group,the results obtained by using six intraocular lens power calculation formulas(BU Ⅱ,Kane,SRK-T,Haigis,Hoffer Q,Holladay 2)to measure the axis length measured by A-scan were(21.98 ± 0.65,22.22 ± 0.67,22.06 ± 0.6,21.98 ± 0.7,22.62 ± 0.73,21.98 ±0.65),respectively(f=0.14,p>0.05);The measurement results of the axis length measured by IOL-Master and the degrees of the six intraocular lenses BUⅡ,Kane,SRK-T,Haigis,Hoffer Q,and Holladay2 were(21.44 ± 0.65,21.66 ± 0.67,21.50 ± 0.62,21.38 ±0.71,21.98 ± 0.72,and 21.48 ± 0.67),respectively(f=0.1,p>0.05).In the control group,the measurement results of the axis length measured by A-scan and the degrees of six intraocular lenses(BU Ⅱ,Kane,SRK-T,Haigis,Hoffer Q,Holladay 2)were(21.66 ±0.43,22.02 ± 0.48,21.73 ± 0.42,21.63 ± 0.52,22.61 ± 0.55,21.63 ± 0.48),respectively(f=0.81,p>0.05);The measurement results of the axis length measured by IOL-Master and the degrees of the six intraocular lenses BU Ⅱ,Kane,SRK-T,Haigis,Hoffer Q,and Holladay2 were(21.26 ± 0.42,21.45 ± 0.48,21.26 ± 0.40,21.18 ± 0.52,21.18 ± 0.52,and 22.02 ± 0.53),respectively(f=0.46,p>0.05).There was no significant difference between the experimental group and the control group in the measurement results of six intraocular lens powers measured by A-scan and IOL-Master through BUⅡ,Kane,SRK-T,Haigis,Hoffer Q,and Holladay2,and neither group had statistical significance.3.To compare the correlation between the axis length measured by two instruments and the stages of CFT,MRT,DRIL,and idiopathic macular epiretinal membrane measured by OCT in the experimental group: The correlation between the axis length measured by A-scan and the stages of CFT,MRT,DRIL,and idiopathic macular epiretinal membrane measured by OCT in the experimental group was(1.0,0.89,0.78,0.76,p<0.01),respectively;The correlation between the axis length measured by IOL-Master and the stages of CFT,MRT,DRIL,and idiopathic macular epiretinal membrane measured by OCT was(1.0,0.89,0.78,0.76,p<0.01),respectively.In the experimental group,there was a positive correlation between the axis length measured by A-scan and IOL-Master and the CFT,MRT,DRIL measured by OCT,as well as the stage of idiopathic macular epiretinal membrane,which was statistically significant.4.To compare the correlation between the intraocular lens power results obtained by two instruments and six calculation formulas in the experimental group and the stages of CFT,MRT,DRIL,and idiopathic macular epiretinal membrane measured by OCT: The experimental group calculated the correlation between the intraocular lens power and the stages of CFT,MRT,and DRIL of OCT by substituting the axis length measured by A-scan into six formulas,in which CFT was correlated with BUⅡ,Kane,SRK-T,Haigis,Hoffer Q The correlation of Holladay2 was(1.0,0.998,0.996,0.995,0.992,0.994,p<0.01);The correlation between MRT and BUⅡ,Kane,SRK-T,Haigis,Hoffer Q,Holladay2 was(1.0,0.998,0.997,0.995,0.991,0.994,p<0.01);The correlation between DRIL and BUⅡ,Kane,SRK-T,Haigis,Hoffer Q,Holladay2 was(1.0,0.998,0.996,0.995,0.992,0.994,p<0.01);The correlation between idiopathic macular epiretinal membrane stage and BUⅡ,Kane,SRK-T,Haigis,Hoffer Q,and Holladay2 was(1.0,0.998,0.996,0.995,0.991,0.994,p<0.01);The correlation between intraocular lens power and the CFT,MRT,and DRIL stages of OCT was calculated by substituting six formulas for the axis length measured by IOL-Master.The correlation between CFT and BUⅡ,Kane,SRK-T,Haigis,Hoffer Q,and Holiday 2 was(1.0,0.998,0.996,0.991,0.991,0.995,p<0.01),respectively;The correlation between MRT and BUⅡ,Kane,SRK-T,Haigis,Hoffer Q,Holladay2 was(1.0,0.998,0.996,0.990,0.991,0.995,p<0.01);The correlation between DRIL and BU Ⅱ,Kane,SRK-T,Haigis,Hoffer Q,Holladay2 was(1.0,0.998,0.996,0.990,0.992,0.995,p<0.01);The correlation between idiopathic macular epiretinal membrane staging and BU Ⅱ,Kane,SRK-T,Haigis,Hoffer Q,and Holladay2 was(1.0,0.998,0.996,0.990,0.992,and 0.995,respectively,p<0.01).Two sets of data within the experimental group showed a statistically significant positive correlation between the degree of intraocular lens calculated using six formulas and the correlation between the CFT,MRT,DRIL,and idiopathic macular epiretinal membrane stages of OCT.5.In the experimental group,for patients with idiopathic macular epiretinal membrane in stages Ⅰ andⅡand accompanied by cataract,the maximum retinal thickness is ≤ 350μ m.When the degree of structural disorder in the inner layer of the retina is ≤ 1(mild);For patients with idiopathic macular epiretinal membrane in stagesⅢand Ⅳwith cataract,and the maximum retinal thickness is greater than 350μm.When the degree of structural disorder in the inner layer of the retina is ≥ 2(severe),the phenomenon of intraocular lens power exceeding 1D measured by A-scan and IOL-Master combined with six formulas is statistically significant.Severe patients have significantly more occurrences of this phenomenon than mild patients(p<0.05).Conclusion:1.There were significant differences in the axis length measured by A-scan and IOL-Master in both the idiopathic macular epiretinal membrane group and the age-related cataract group,but there was no significant difference between the groups.In the idiopathic macular epiretinal membrane group,the axis length length measured by IOL-Master was 0.15 mm longer than that measured by A-scan;In the simple age-related cataract group,the axis length measured by IOL-Master was 0.13 mm longer than that measured by A-scan.2.The intraocular lens power calculated by the six formulas BUⅡ,Kane,SRK-T,Haigis,Hoffer Q,and Holladay2 has no significant difference between the idiopathic macular epiretinal membrane group and the simple age-related cataract group.3.The axis length of the idiopathic macular epiretinal membrane group was positivel correlated with CFT,MRT,DRIL,and the stage of idiopathic macular epiretinal membrane measured by OCT,with CFT having the greatest correlation.CFT,MRT,DRIL of idiopathic macular epiretinal membrane and the stage of idiopathic macular epiretinal membrane affect the measurement of axis length.4.The CFT,MRT,DRIL,and idiopathic macular epiretinal membrane stages measured by OCT in the idiopathic macular epiretinal membrane group were positively correlated with the intraocular lens power predicted by the six formulas BU Ⅱ,Kane,SRK-T,Haigis,Hoffer Q,and Holladay2.CFT,MRT,DRIL,and idiopathic macular epiretinal membrane stages were the most correlated with the BUⅡ formula.CFT,MRT,DRIL of idiopathic macular epiretinal membrane,and the influence of stages of idiopathic macular epiretinal membrane on the measurement of intraocular lens power.5.In the idiopathic macular epiretinal membrane group,both mild and severe patients have a case where there is a 1D difference in the diopter of the intraocular lens obtained by combining two measurement instruments with six measurement formulas,but severe patients have more occurrences.Patients with severe idiopathic macular epiretinal membrane have a greater impact on the outcome of intraocular lens power measurement. |
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