目的：比较不同人工晶状体(IOL)计算公式计算眼轴大于28mm的既往接受过放射状角膜切开术(RK)的白内障患者的准确性。方法：回顾性研究。分析2011-01/2020-07在首都医科大学附属北京同仁医院接受白内障手术的眼轴长度大于28mm的RK术后患者19例29眼的病历资料。分别使用Barrett True-K、Haigis、Holladay 1(D-K)公式计算白内障术后实际等效球镜和IOL公式预测的等效球镜之间差值的绝对值(AE)。比较三种IOL公式的AE值及AE值≤0.5、0.75、1.0和2.0D的患眼百分比。结果：三种公式的AE值有显著差异(χ2=8.759，P=0.013)，Barrett True-K公式的AE中位数最小，仅为0.62(0.20，1.15)D，Haigis公式次之，为0.76(0.34，1.26)D， Holladay 1(D-K)公式最大，为1.01(0.49，1.62)D。使用Barrett True-K公式，AE值≤0.5、0.75、1.0和2.0D的患眼百分比分别为48%、59%、69%和93%，均等于或高于另外两种公式。结论：对于眼轴长度大于28mm的RK术后白内障患者，在Barrett True-K、Holladay 1(D-K)和Haigis三种公式中，我们更推荐使用Barrett True-K公式。

AIM: To compare the accuracy of different intraocular lens(IOL)calculation formulas in cataract patients with axial length longer than 28mm and a history of radial keratotomy(RK).METHODS: Retrospective study. The medical records of 19 cataract patients(29 eyes)after RK and with axial length longer than 28mm who underwent cataract surgery from January 2011 to July 2020 in Beijing Tongren Hospital were analyzed. The absolute error(AE)of the difference among three different formulas was calculated. AE refers to the absolute value between the actual spherical equivalent after cataract surgery and the spherical equivalent predicted by the IOL formula. The AE values of the three formulas and the percentages of eyes with AE≤0.5, 0.75, 1.0, and 2.0D were calculated and compared.RESULTS: The AE values of the three formulas were significantly different(χ2=8.759, P=0.013). The Barrett True-K formula had the smallest median AE, which was only 0.62(0.20, 1.15)D, followed by the Haigis formula 0.76(0.34, 1.26)D, and the Holladay 1(D-K)formula had the largest 1.01(0.49, 1.62)D. The percentages of affected eyes with AE ≤0.5, 0.75, 1.0, and 2.0D for the Barrett True-K formula were 48%, 59%, 69%, and 93%, which were equal to or higher than the other two formulas.CONCLUSION: The Barrett True-K formula is more recommended among the three formulas for cataract patients after RK and with axial length longer than 28 mm.

国家自然科学基金资助项目(No.82171037)