目的：探讨并比较角膜上皮增厚对Barrett Universal Ⅱ、Haigis、Holladay 2、Kane、EVO、Hill-RBF及SRK/T等7种常用人工晶状体(IOL)计算公式预测准确性的影响。

方法：纳入2023年7月-2023年9月接受白内障超声乳化联合人工晶状体植入术的患者。术前采用 IOLMaster 700获取生物测量数据，并使用光学相干断层扫描(OCT)测定角膜上皮厚度。囊袋内植入单焦点人工晶状体(Hoya iSert 250)。术后3 mo测量术后屈光度。以角膜上皮厚度中位数57.0 μm作为分组界值：≥57.0 μm(厚上皮组)，Symbol|@@57.0 μm(薄上皮组)。评估两组预测误差落在±0.25 D、±0.50 D、±0.75 D和±1.00 D范围内的眼数占比、平均绝对误差(MAE)和中位绝对误差(MedAE)。

结果：本研究共纳入59例患者59眼，女性34例，男性25例，平均年龄68.85±8.71岁。其中薄上皮组30眼，厚上皮组29眼。全部59眼中，Barrett Universal Ⅱ公式预测误差在 ±0.50 D内的眼占比最高(83%)，其次为 Hill-RBF(81%)。Kane(71%)与 EVO(73%)占比最低。7种IOL计算公式分析显示：与薄上皮组相比，多数公式在厚上皮组的预测准确性显著下降(U=6.00，PSymbol|@@0.05)。Hill-RBF公式在角膜上皮增厚眼表现出更优的预测效能，其预测误差落在 ±0.25 D、±0.50 D范围内的眼占比分别可达52%、83%。

结论：IOL计算准确性与角膜上皮增厚存在相关性，Hill-RBF公式对于角膜上皮增厚患眼具有更好的适用价值。

METHODS: Patients undergoing phacoemulsification and IOL implantation surgery from July 2023 to September 2023 were included. Before the surgery, biometry data was obtained by IOLMaster 700 and epithelial thickness was determined using optical coherence tomography. A monofocal IOL(Hoya iSert 250)was inserted into the capsular bag. The postoperative refraction was measured 3 mo after the surgery. The median epithelial thickness of 57.0 μm was set as a grouping criterion: ≥57.0 μm(thick group)and Symbol|@@57.0 μm(thin group). The percentage of eyes within prediction errors of ±0.25 D, ±0.50 D, ±0.75 D and ±1.00 D, mean absolute error(MAE), and median absolute error(MedAE)were reviewed.

RESULTS: Fifty-nine eyes of 59 patients(34 females, 25 males, mean age 68.85±8.71 y)were included in the study. The thin group included 30 eyes and the thick group included 29 eyes. Among all 59 eyes, Barrett Universal II showed the highest percentage of prediction error within ±0.50 D(83%), followed by Hill RBF(81%). Kane(71%)and EVO(73%)exhibited the lowest percentages. When calculating the percentage of eyes with absolute error within ±0.25 D using seven IOL calculation formulas, most formulas showed significant declined accuracy in the thick group compared with the thin group(U=6.00, PSymbol|@@0.05). Hill RBF showed better accuracy in eyes with thickened epithelium, with higher percentage of prediction error within ±0.25 D(52%)and ±0.50 D(83%).

CONCLUSION: The accuracy of IOL calculation is associated with corneal epithelium thickening. Hill-RBF has better validity in eyes with thickened corneal epithelium.