目的：比较基于不同类型角膜屈光力的人工晶状体（IOL）计算公式在角膜屈光术后白内障患者中计算IOL屈光度的准确性。 方法：前瞻性临床研究。收集2022-02/2024-08就诊于济南明水眼科医院，既往有近视激光角膜手术史的白内障手术患者32例（42眼）。使用基于模拟角膜曲率（SimK）的Haigis-L公式、Barrett True K公式，基于全角膜曲率（TK）的Haigis公式、基于角膜净屈光力（TNP）的Potvin-Hill Pentacam（PVP）公式及基于净角膜屈光力（NCP）的OCT公式计算IOL度数及预测屈光度数。术后1个月进行主觉验光，计算预测误差（PE）、绝对预测误差（APE）、中位数绝对预测误差（MedAE）及PE在±0.25、±0.50、±0.75、±1.0D范围内的百分比。 结果：4种类型角膜屈光力组内相关系数为0.986（P＜0.001），两两比较TNP与NCP差异无统计学意义（P=0.491），其余两者间差异均有统计学意义（P均＜0.001）。Haigis-L(K)、Haigis(TK)的PE与0比较，差异有统计学意义（P均＜0.001），PVP、OCT、Barrett True K公式的PE与0比较，差异无统计学意义（P＞0.05）。5种公式计算的APE差异无统计学意义（P=0.975）。5种公式中Barrett True K的MedAE值最小（0.32D），5种公式的MedAE总体比较，差异无统计学意义（P=0.870）。Barrett True K在±0.25D、±1.0D内所占百分比较高，PVP在±0.50D内所占百分比较高，Haigis（TK）在±0.75D内所占百分比较高，差异均无统计学意义（P＞0.05）。 结论：角膜屈光术后，不同类型角膜屈光力间存在差异。进行IOL计算时，TK联合Haigis公式的准确性优于Haigis-L公式，Barrett True K公式表现出良好的准确性。

Objective:To compare the accuracy of intraocular lens (IOL) calculation formulas using different types of corneal refractive power measurements in cataract patients with a history of corneal refractive surgery.Methods:A prospective clinical study was conducted involving 32cataract patients (42 eyes) who had previously undergone myopic laser corneal surgery at Jinan Mingshui Eye Hospital between February 2022 and August 2024.The Haigis-L formula, Barrett True K formula based on standard keratometry(K),Haigis formula based on total keratometry(TK),Potvin-Hill Pentacam (PVP)formula based on corneal true net power(TNP),and OCT formula based on net corneal power(NCP)were used to calculate IOL power and predict diopter.Subjective optometry was performed 1 month after surgery,the prediction error (PE),Absolute prediction error (APE),Median absolute prediction error (MedAE),and percentage of prediction error within the ranges of ±0.25D,±0.50D,±0.75D,and ±1.0D were calculated.Results:The intraclass correlation coefficient for the four types of corneal refractive power was 0.986(P<0.001).No significant difference was observed between TNP and NCP(P=0.491),while significant differences were found between the other pairs(P<0.001).Statistically significant differences were observed between PE and 0 for the Haigis-L(K)and Haigis(TK)formulas (P<0.001).In contrast,no statistically significant differences were noted between PE and 0 for the PVP,OCT,and Barrett True K formulas (P>0.05).There was no significant difference in absolute prediction error(APE)among the five formulas (P=0.975).The Barrett True K formula had the lowest median absolute prediction error(MedAE)value among the five formulas (0.32D).However,when comparing the MedAE values overall,the difference was not statistically significant (P=0.870).The Barrett True K formula showed a higher percentage within ±0.25Dand±1.0D ,while the PVP formula had a higher percentage within ±0.50D,and the Haigis(TK)formula had a higher percentage within ±0.75D.Nevertheless,none of these differences were statistically significant (P>0.05).Conclusions:Refractive power varies significantly among different types of corneas following corneal refractive surgery.In IOL calculations,the accuracy of the TK component combined with the Haigis formula is superior to that of the Haigis-L formula.Additionally,the Barrett True K formula demonstrates excellent accuracy and reliability in predicting postoperative refractive outcomes.

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