CN117976205A - Method and software for calculating intraocular lens power of malformed eye of Marfan syndrome - Google Patents
Method and software for calculating intraocular lens power of malformed eye of Marfan syndrome Download PDFInfo
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- 206010057362 Underdose Diseases 0.000 claims description 4
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Abstract
The invention relates to an artificial lens degree calculation method and software of a mare syndrome lens insufficiency dislocation eye based on genotype-phenotype association, wherein the calculation method is based on an eye axis growth rate prediction model based on genotype-phenotype association and a Haigis formula, and calculates and obtains the postoperative eye axis length, the recommended artificial lens degree, the postoperative immediate diopter, the target age diopter and other data results which can be used for guiding the surgical selection of a patient; the calculation software is based on the calculation method and comprises an input module, a prediction model, a calculation module, an additional module and an output module, wherein preoperative information of the Marfan syndrome patient is taken as input, and the data which can be used for guiding the operation selection of the patient are obtained. The invention has the advantages that the correlation between the eye axis growth rate and the FBN1 genotype of the equine syndrome patient is based on the full consideration of diopter change caused by the long-term eye axis growth, and the individuation accurate calculation of the intraocular lens degree is realized, so that the postoperative and long-term refractive states of the patient are predicted to the greatest extent, and the satisfaction degree of the patient is improved.
Description
Technical Field
The invention belongs to the technical field of medical treatment, and particularly relates to an artificial lens degree calculation method and software for a mare syndrome lens insufficiency dislocation eye based on genotype-phenotype association.
Background
Marfan syndrome is the most common hereditary connective tissue disease with a incidence of about six parts per million. About 60% of patients with equine syndrome experience dislocation of the lens, and thus manifest as varying degrees of ametropia, low vision and even blindness. Lens removal and intraocular lens implantation are currently the only effective radical solutions. With the continued advancement of surgical techniques, there has been a significant improvement in post-operative vision in Marfan syndrome patients. However, since equine syndrome patients often undergo lens surgery during childhood, as the ocular axis develops, the postoperative refractive power is still changing and the far-reaching refractive power of the infant is often difficult to predict. At present, the degree reservation scheme of cataract doctors on congenital crystalline lens insufficiency dislocation infants with equine syndrome often refers to the scheme of congenital cataract infants, and is selected by combining with own experience, so that errors of postoperative long-term diopter and design values are often larger. Excessive myopia degree often causes the equine syndrome patient to feel spelt, and serious patients even have reduced corrected vision; too high a distance vision level is detrimental to the patient's close range work and makes amblyopia training more difficult.
Most equine syndrome patients undergo lens surgery after 3-4 years of age, at which point the anterior segment structure of the eye has approached adult level, together with the relative fixation of the refractive power of the intraocular lens (IOL), and post-operative changes in the axis of the eye are critical factors in determining the extent of myopia shift in the patient. Therefore, constructing a predictive model for post-operative ocular axis changes, and optimizing intraocular lens power based on post-operative ocular axis is critical for improving the long-term refractive status of the infant.
In view of the foregoing, there is a need for a calculation tool that can predict the refractive power change of a patient with Marfan syndrome after an intraocular lens implantation surgery, and based on the refractive power of a preset target age, help cataract surgeons to select the refractive power of the intraocular lens when the patient accepts the surgery, thereby achieving an ideal long-term refractive state and increasing the satisfaction of the patient and parents.
Disclosure of Invention
Aiming at the current situation of calculating the intraocular lens degree of the congenital subluxation patient with equine syndrome, the invention aims at providing the intraocular lens degree calculating method and software which are convenient to use and have good prediction accuracy, so as to help cataract doctors to realize individual diagnosis and treatment of the congenital subluxation patient with equine syndrome, effectively reduce postoperative refractive errors and achieve more ideal long-term refractive state.
According to the invention, through analyzing the eye axis development rule of the Marfan syndrome patient in the real world after receiving the intraocular lens implantation operation, an eye axis prediction model is constructed, and the eye axis growth rate of the Marfan syndrome infant is found to be closely related to the genotype of the pathogenic gene FBN 1. Patients carrying dominant negative mutations affecting cystine residues [ DN (-Cys) ] and calcium binding motif [ DN (CaB) ] have a higher rate of ocular axis growth than patients carrying haploid underdose mutations (HI) than patients carrying other mutation types [ DN (other) ]. Patients who are operated at the same age can have about 300 degrees of refractive error due to the difference of the FBN1 genotypes, and have remarkable clinical significance.
Based on the above findings, the present invention provides an intraocular lens number calculation method and software for a marfan syndrome lens insufficiency dislocation eye based on genotype-phenotype association.
Accordingly, a first object of the present invention is to provide a method for calculating the intraocular lens power of an subluxated eye of equine syndrome, comprising the steps of:
step one, constructing a postoperative eye axis prediction model:
The post-operation eye axis prediction model is constructed by taking a Marfan syndrome lens dislocation database as a sample, analyzing the relevance of the eye axis logarithmic growth rate and the FBN1 genotype, and generating by applying a multiple linear regression model, wherein:
the eye axis logarithmic growth rate of the prediction model is expressed as follows:
RALG＝-10.231+0.563×preAL+2.603×c
Wherein RALG is the log rate of eye axis growth in mm/log 10 y; preAL is the preoperative ocular axis length in mm; preAL corresponds to preoperative age preAge, the preoperative age preAge units being y; c is the genotype factor of FBN1, c takes 1 when the mutation type is dominant negative mutation affecting cystine or calcium binding motif [ DN (-Cys+CaB) ] or haploid underdose mutation (HI); c takes 0 when the mutation type is other mutation types;
the post-operation eye axis length formula of the prediction model is as follows:
Wherein postAL is the post-operative eye axis length in mm; postAL corresponds to a target age postAge, the target age postAge units being y;
Step two, acquiring patient data:
Obtaining patient data, substituting the patient data into the postoperative eye axis prediction model formula in the step one, and calculating to obtain a predicted postoperative eye axis length postAL;
Step three, calculating recommended intraocular lens degrees:
The calculation formula of the recommended intraocular lens power applies Haigis formula, and calculates the recommended intraocular lens power according to the postoperative eye axis length postAL obtained in the second step and the set target diopter R;
Based on the obtained recommended intraocular lens powers, +1.50d, +1.00d, +0.50d, -0.50d, -1.00D, -1.50D, respectively, obtaining simulated intraocular lens powers;
step four, calculating the diopter immediately after arithmetic and the diopter of the target age:
Calculating an immediate post-arithmetic diopter R and a diopter R of a target age based on the recommended or simulated intraocular lens number, and the pre-operative or post-operative axial length preAL or postAL;
Step five, obtaining a calculation result:
The calculation results include the length of the eye axis at the target age of the patient, the recommended intraocular lens power, and the corresponding post-operative diopter and diopter of the target age, the simulated intraocular lens power, and the corresponding post-operative diopter and diopter of the target age.
According to the present invention, the patient data in step two includes: patient name, birth date, date of examination, eye axis (mm), mean corneal curvature (D), anterior chamber depth (mm), target age, and diopter at target age, eye class (right or left), and FBN1 gene mutation type (including DN (-Cys), DN (CaB), DN (other) or HI).
According to the present invention, the Haigis formula in the third step is specifically as follows:
Wherein,
ELP＝a0+a1×ACD+a2×postAL
Wherein Km is the average corneal curvature in D; ELP is the effective post-operative intraocular lens position in mm; ACD is anterior chamber depth in mm; a0, a1, a2 are parameters of the model of the intraocular lens to be built in; IOLpower is the intraocular lens power in D, the intraocular lens power in 0.5D, the recommended intraocular lens power taking the IOLpower closest value.
According to the invention, the formula for the diopter R immediately after the calculation in step four and the diopter R of the target age is as follows:
Wherein,
ELP＝a0+a1×ACD+a2×AL
Wherein AL is a pre-operation eye axis length preAL or a post-operation eye axis length postAL, the post-operation immediate diopter R is calculated by substituting the pre-operation eye axis length preAL, and the diopter R of the target age is calculated by substituting the post-operation eye axis length postAL.
In a second aspect of the present invention, there is provided intraocular lens number calculation software for a subluxated eye of equine syndrome, the calculation software comprising an input module, a predictive model, a calculation module, an additional module, and an output module, based on the calculation method as described above, wherein:
The input module is used for inputting patient data, and the patient data comprises: patient name, birth date, date of examination, eye axis (mm), mean corneal curvature (D), anterior chamber depth (mm), target age, and diopter at target age, eye class (right or left), and FBN1 gene mutation type (including DN (-Cys), DN (CaB), DN (other) or HI);
The prediction model predicts the post-operation eye axis length postAL of the target age based on the post-operation eye axis prediction model in the first calculation method step;
The calculation module calculates and obtains recommended intraocular lens power, and corresponding diopter immediately after operation and diopter of target age based on the calculation methods of the third and fourth calculation methods;
the additional module obtains simulated intraocular lens degrees based on the recommended intraocular lens degrees obtained by the calculation module, namely +1.50D, +1.00D, +0.50D, -0.50D, -1.00D and-1.50D respectively, and then substitutes the simulated intraocular lens degrees into the calculation module to obtain the diopter of the simulated intraocular lens corresponding to the postoperative immediate diopter and the diopter of the target age;
the output module is used for outputting the calculation result of the step five of the calculation method, wherein the calculation result comprises the length of the eye axis of the patient at the target age, the recommended intraocular lens number, the diopter of the corresponding postoperative immediate diopter and the target age, the simulated intraocular lens number, and the diopter of the corresponding postoperative immediate diopter and the diopter of the target age.
According to a preferred embodiment of the invention, the calculation module is written based on the Python language and in Haigis formula blue book and performs Wang-Koch correction on patient data with an eye axis length exceeding 25 mm.
According to a preferred embodiment of the present invention, the parameters of the commonly used IOL model include a0, a1, a2, which have been built into the calculation module, and the IOL model includes Rayner C-flex Aspheric 920H or 970C, TECNIS PCB00 or ZCB00, and AcrySof IQ SN60AT or SN60WF.
In a third aspect of the present invention, there is provided a method of using the calculation software for the intraocular lens power of a malsquare syndrome phakic subluxated eye as described above, comprising the steps of:
Step one, inputting a patient name, a birth date, an examination date, an eye axis, an average cornea curvature, an anterior chamber depth, a target age and diopter under the target age, and selecting an eye class and an FBN1 gene mutation type;
Step two, clicking calculation;
selecting the model of the artificial lens to be implanted;
and step four, obtaining the recommended intraocular lens degree and the diopter of the corresponding postoperative and target ages.
The invention has the following beneficial effects:
1. According to the method and software for calculating the intraocular lens degree of the malformed eye of the equine syndrome based on genotype-phenotype association, haigis-WK formula is used as a blue book, and the accuracy of calculating the intraocular lens degree of the equine syndrome patient can be improved.
2. Based on the eye axis prediction model of the Marfan syndrome patient, the invention combines the eye parameters of the patient and the FBN1 genotype, and can realize the calculation of the individual intraocular lens degree of the Marfan syndrome patient.
3. The invention can calculate not only the diopter of the patient after operation of the given intraocular lens, but also the corresponding distance diopter, thereby optimizing the selection of the intraocular lens before operation so as to achieve a more ideal distance diopter state.
4. According to the invention, an Internet platform is relied on, online computing service is provided for users, an intraocular lens number computing method suitable for equine syndrome patients is provided for worldwide surgeons, and differences of diagnosis and treatment levels of different medical institutions among areas are made up, so that more equine syndrome patients are benefited.
5. The invention can continuously optimize model parameters along with clinical use and long-term follow-up observation, and further improves the prediction accuracy.
Drawings
FIG. 1 is a schematic diagram of a process for constructing the computing software of the present invention.
FIG. 2 is a schematic flow chart of the operation of the computing software of the present invention.
Detailed Description
The invention will be further illustrated with reference to specific examples. It should be understood that the following examples are illustrative of the present invention and are not intended to limit the scope of the present invention. The procedures not specifically identified in the examples below are generally performed under conventional conditions, or as required by clinical guidelines. The examples should not be construed as limiting the invention, but any modifications based on the spirit of the invention should be within the scope of the invention.
Example 1, design idea and calculation method
Step 1, constructing a postoperative eye axis prediction model
The post-operation eye axis prediction model is constructed by taking a Marfan syndrome lens dislocation database as a sample and applying a multiple linear regression model. The specific method is as follows.
1) Database creation
The equine syndrome patient database includes: patient identity information (name, identification number, contact, etc.), demographic characteristics (date of birth, sex, etc.), ocular biological parameters (eye category, eye axis, corneal curvature, anterior chamber depth, etc.), genetic test information (whether FBN1 gene mutation, mutation type, etc.), surgical information (eye category, surgical mode, intraocular lens model and degree), post-operative follow-up information (vision, optometry, ocular biometric, fundus examination, etc.), the same patient is included at random only at a glance, and the same family is included only in the first person.
2) Data correction
Because the eye axis and the age of the equine syndrome patient are in logarithmic relation, the invention carries out logarithmic conversion on the age and appropriately increases the age to correct the problem that the logarithmic model approaches minus infinity when the age is 0 years, and the logarithmic growth rate of the eye axis is calculated by taking 0.6 of correction by referring to the research on the eye development in embryo period in the prior literature.
3) Calculation of eye axis logarithmic growth Rate RALG
The logarithmic growth rate of the eye axis is calculated according to the corrected data, and the specific formula is as follows:
Wherein RALG is the log rate of eye axis growth in mm/log 10 y. RALG does not change with age before age 15 and the median drops to 0 after age 15, which is understood to mean that equine syndrome patients reach adult level at age 15. preAL is the preoperative ocular axis length in mm; preAL corresponds to preoperative age preAge, the preoperative age preAge units being y; postAL is the post-operative ocular axis length in mm; postAL corresponds to a target age postAge, which is postAge units y.
4) Data analysis and processing
The data obtained according to the method described above were divided into training and testing sets at a ratio of 4:1, and after single factor analysis and multiple linear regression analysis, RALG was found to be significantly related to the preoperative baseline eye axis and FBN1 genotype, and the predictive formula for RALG was found as follows:
RALG＝-10.231+0.563×preAL+2.603×c
DN(Others)，c＝0；DN(-Cys+CaB)or HI，c＝1
Wherein c is the genotype factor of FBN1, c taking 1 when the mutation type is a dominant negative mutation affecting cystine or calcium binding motif [ DN (-cys+cab) ] or a haploid underdose mutation (HI); when the mutation type is other mutation type, c takes 0.
5) Establishment of predictive model
Accordingly, a predictive formula of the postoperative eye axis is obtained by applying a multiple linear regression equation, and the formula is as follows:
Wherein postAge is the target age, the target age is recommended to be 15 years old, and the target diopter is set to be-3.00D.
Step 2, acquiring patient data
Acquiring patient data, comprising: name, date of birth, date of examination, eye axis (mm), mean corneal curvature (D), anterior chamber depth (mm), target age, and diopter at target age, eye class (right or left eye) and FBN1 gene mutation type (including DN (-Cys), DN (CaB), DN (other) or HI) are selected. Substituting the data into the postoperative eye axis prediction model formula in the step 1, and calculating to obtain the predicted postoperative eye axis length postAL.
Step3, calculating a recommended intraocular lens (IOL) power
The Haigis equation has been shown to be the equation for minimizing errors in IOL power calculation in Marfan syndrome combined lens dislocation patients, and the present invention uses Wang-Koch correction on patient data with an eye axis length exceeding 25 mm. The specific formula is as follows:
IOL power (0.50D accuracy) was calculated from post-operative eye axis length postAL and set target diopter R:
Wherein,
ELP＝a0+a1×ACD+a2×postAL
Wherein Km is the average corneal curvature in D; ELP is the effective post-operative intraocular lens position in mm; ACD is anterior chamber depth in mm; a0, a1, a2 are parameters of the built-in intraocular lens model, provided by the manufacturer; IOLpower is the IOL power in D, and since IOL power is in 0.5D, the recommended IOL power takes IOLpower the closest value.
Based on the calculated recommended IOL power, +1.50D, +1.00D, +0.50D, -0.50D, -1.00D, -1.50D, respectively, simulated IOL powers were obtained.
Step 4, calculating the diopter immediately after arithmetic and the diopter of the target age
The target age diopter recommendation was set to-3.0D at 15 years old, but since IOLpower had an accuracy of only 0.50D, the actual target age diopter was often slightly different from-3.0D, requiring recalculation with IOL power IOLpower obtained in step 3.
From the recommended or simulated IOL power, and the pre-operative or post-operative axial length preAL or postAL, the immediate post-operative diopter R and the target age diopter R are calculated:
Wherein,
ELP＝a0+a1×ACD+a2×AL
Wherein AL is the pre-operative or post-operative eye axis length preAL or postAL; the post-operative diopter R is related to the pre-operative ocular axis length preAL, so the post-operative diopter R is calculated by substituting the value of the pre-operative ocular axis length preAL; the diopter R of the target age is related to the post-operation eye axis length postAL, so that the diopter R of the target age is calculated and substituted into the value of the post-operation eye axis length postAL.
Step 5, obtaining a result
Based on the above calculation method, the length of the eye axis at the target age of the patient, the recommended IOL power, the corresponding post-operative diopter and diopter of the target age, the simulated IOL power, and the corresponding post-operative diopter and diopter of the target age are obtained.
Example 2 construction flow of calculation software
Based on the design thought and the calculation method described in embodiment 1, corresponding calculation software was developed and designed. As shown in fig. 1, the computing software of the present invention includes an input module, a prediction model, a computing module, an additional module, and an output module.
1. An input module: patient name, date of birth (date of birth), date of examination (date of day), eye axis (mm), mean corneal curvature (D), anterior chamber depth (mm), target age (adjustable, default of 15 years), and diopter at target age (adjustable, default of-3.0D), eye group (right or left eye) and FBN1 gene mutation type (including DN (-Cys), DN (CaB), DN (other) or HI) are selected.
2. Prediction model: using the post-operative eye axis prediction model described in step 1 of example 1, a post-operative eye axis length postAL of the target age was obtained from the prediction model.
3. The calculation module: the module is written based on Python language and formulated as a Haigis's blue book and performs Wang-Koch correction on patient data with an eye axis length AL exceeding 25 mm.
Based on the calculation methods described in step 3 and step 4 of example 1, the recommended IOL power, and the corresponding post-operative diopter and diopter of the target age are calculated.
Parameters (a 0, a1, a 2) of the common IOL model are provided by the manufacturer and are built into the computing software, and the common IOL model comprises Rayner C-flex Aspheric 920H or 970C, TECNIS PCB or ZCB00 and AcrySof IQ SN60AT or SN60WF.
4. And (3) an additional module: based on the recommended IOL power obtained by the calculation module, respectively +1.50D, +1.00D, +0.50D, -0.50D, -1.00D and-1.50D to obtain simulated IOL power, and substituting the simulated IOL power into the calculation module to obtain the diopter of the simulated IOL corresponding to the postoperative immediate diopter and the diopter of the target age.
5. And an output module: the length of the eye axis of the target age of the patient, the recommended IOL power and the corresponding post-operative diopter and diopter of the target age, the simulated IOL power and the corresponding post-operative diopter and diopter of the target age are output.
Example 3 method of Using computing software and operational flow
The invention can be used for calculating the intraocular lens degree of patients with the malformation of the equine syndrome lens under 15 years old and below 15 years old, is applicable to intraocular lenses of different models, and is convenient for clinical use. As shown in fig. 2, the method and the operation flow of the software of the present invention are as follows:
S1, inputting information: patient name, date of birth (accurate to day), date of examination (accurate to day), eye axis (mm), mean corneal curvature (D), anterior chamber depth (mm), target age (adjustable, default of 15 years) and diopter at target age (adjustable, default of-3.0D), selection of eye class (right or left eye) and FBN1 gene mutation type (including DN (-Cys), DN (CaB), DN (other) and HI) are entered on the entry page.
S2, click calculation: clicking the calculate button below the input page.
S3, selecting a model: the model of the intraocular lens to be implanted is selected on the left side of the output interface, including Rayner C-flex Aspheric 920H or 970C,TECNIS PCB00 or ZCB00, and AcrySof IQ SN60AT or SN60WF.
S4, outputting data: the output page gives the length of the eye axis at the target age of the patient, presents the recommended IOL power and the corresponding post-operative diopter and diopter of the target age in tabular form, and simulates the IOL power and the corresponding post-operative diopter and diopter of the target age.
Compared with the existing intraocular lens degree calculation formula or software, the intraocular lens degree calculation software has the following advantages:
1. The calculation software of the invention is suitable for intraocular lens calculation, postoperative and distant diopter prediction of patients with below 15 years old equine syndrome. The best published international accuracy is the Barrett Universal II formula, which is however less accurate in equine syndrome patients, as dislocation of the lens affects the measurement of lens thickness. The invention adopts Haigis formula with optimal calculation accuracy in Martensitic syndrome patients in the past study, automatically carries out Wang-Koch correction on patients with eye axes larger than 25mm, improves the accuracy of calculation of the intraocular lens degree after operation, and has simple operation and convenient clinical use.
2. The invention is based on the change of the long-term eye axis of the Marfan syndrome patient, and introduces the FBN1 genotype as a variable, and can calculate the diopter of the long-term of the patient, thereby guiding cataract doctors to select the individual intraocular lens power before the intraocular lens is implanted.
3. According to the invention, the lens parameters of the common intraocular lens model for lens dislocation are automatically incorporated, and the ophthalmologist can call out the calculation results corresponding to the intraocular lenses of different models only by selecting on the left side of the output interface, so that the invention is convenient for clinical use.
4. The computing software provided by the invention has an independent formula and independent codes, is not limited by other limitations, and can be independently used and independently updated.
Application example 1
The patient male, carrying a DN (-Cys) mutation, received lens removal and phase I IOL implantation surgery at age 5. The ocular biological parameters of the surgical eye are as follows: AL,21.48mm; ACD,3.06mm; km,41.78D. According to the calculation software of the present invention, postAL at 15 years old was expected to be 23.46mm, and if Rayner (C-flex Aspheric 970H) intraocular lens was selected for implantation, the recommended implantation power was 27.00D, his expected diopter after surgery was +2.69D, and his diopter at 15 years old was expected to be-3.08D.
Application example 2
The patient male, carrying DN (other) mutations, received lens removal and phase I IOL implantation surgery at 5 years old. The ocular biological parameters of the surgical eye are as follows: AL,21.48mm; ACD,3.06mm; km,41.78D. According to the calculation software of the present invention, postAL at 15 years old was expected to be 22.31mm, if Rayner (C-flex Aspheric 970H) intraocular lens was selected for implantation, the recommended implantation power was 31.00D, his expected diopter after surgery was-0.19D, and his diopter at 15 years old was expected to be-2.85D.
It can be seen that the patients of example 1 and example 2 were operated on at the same age, eye parameters and implanted intraocular lens type number, but were of different FBN1 genotypes, and the implanted intraocular lens degrees were 4.00D different. If the same intraocular lens number as in example 1 is implanted in example 2, the expected refractive power after surgery of the patient is +2.69D according to the calculation software of the present invention, but the refractive power at the age of 15 years is predicted to be +0.25D, which is different from the distance refractive power in the recommended result by approximately 3.00D, that is, a refractive error of around 300 degrees. Therefore, the introduction of the FBN1 genotype as a key variable ensures that the calculation method and the software of the invention have higher accuracy about the postoperative eye axis than the traditional calculation software, so that the calculated recommended intraocular lens degree has higher practical application value, can be used for guiding the preoperative intraocular lens degree selection, and further ensures that the patient long-term diopter is closer to an ideal value and has higher clinical application value.
Application example 3
To verify the predictive model of example 1, we randomly selected 27 Marfan syndrome patients based on the accuracy of the genotype-phenotype correlation based calculation method for intraocular lens power of Marfan syndrome lens insufficiency dislocation eyes, and obtained the eye axis length at the target age of the patient, the recommended IOL power and the corresponding postoperative diopter and target age diopter, the simulated IOL power and the corresponding postoperative diopter and target age diopter using the calculation method of example 1. The Prediction Error (PE) is calculated as the average of the differences between the actual values and the predicted values in the validation set.
The results show that with the predictive model of the invention, the average PE of the postoperative eye axis is-0.191 (95% CI, -0.433,0.051) mm calculated from the 1mm eye axis corresponding to a refractive power of about-3.0D, and that the average refractive error for the group of patients is verified to be about 0.573D, corresponding to a refractive error of 57.3 degrees. Such a small amount of error is acceptable to the patient.
Once the computing software is put into application, the following technical effects can be achieved:
1. The artificial lens degree calculation software for the marfan syndrome lens incomplete dislocation eye based on genotype-phenotype association is simple in interface, simple in operation and convenient for a clinician to use.
2. The error between the predicted postoperative diopter and the target diopter is smaller than that of the existing formula, wang-Koch correction is automatically carried out on the patient with the long eye axis, and the calculation accuracy of the patient with the long eye axis of the Marfan syndrome is further improved.
3. The gene mutation type of the Marfan syndrome patient is used for predicting the long-term eye axis growth of the patient and calculating the long-term diopter, and the method can be used for guiding the preoperative artificial lens degree selection, so that the long-term diopter is closer to an ideal value, the visual quality of the patient is improved, and the method has higher clinical application value.
In conclusion, the eye axis prediction model constructed by analyzing the postoperative eye axis development rule of the Marfan syndrome patient in the real world has remarkable clinical significance, and based on the discovery, the invention establishes a calculation method and software capable of predicting diopter change of the Marfan syndrome patient after intraocular lens implantation. The calculation software is simple to operate and convenient for clinical use, and the error between the predicted postoperative diopter and the target diopter is small, so that the calculation accuracy is improved; therefore, the calculation software can be used for guiding the selection of the preoperative intraocular lens power of the patient, so that the long-term diopter is closer to an ideal value, the vision quality of the patient is improved, and the method has higher clinical application value.
The foregoing has shown and described the basic principles, principal features and advantages of the invention. It will be understood by those skilled in the art that the present invention is not limited to the embodiments described above, and that the above embodiments and descriptions are merely illustrative of the principles of the present invention, and various changes and modifications may be made without departing from the spirit and scope of the invention, which is defined in the appended claims. The scope of the invention is defined by the appended claims and equivalents thereof.
Claims (8)
1. A method for calculating the intraocular lens power of an eye with a malsquare syndrome lens insufficiency dislocation, the method comprising the steps of:
step one, constructing a postoperative eye axis prediction model:
The post-operation eye axis prediction model is constructed by taking a Marfan syndrome lens dislocation database as a sample, analyzing the relevance of the eye axis logarithmic growth rate and the FBN1 genotype, and generating by applying a multiple linear regression model, wherein:
the eye axis logarithmic growth rate of the prediction model is expressed as follows:
RALG＝-10.231+0.563×preAL+2.603×c
Wherein RALG is the log rate of eye axis growth in mm/log 10 y; preAL is the preoperative ocular axis length in mm; preAL corresponds to preoperative age preAge, the preoperative age preAge units being y; c is the genotype factor of FBN1, c takes 1 when the mutation type is dominant negative mutation affecting cystine or calcium binding motif [ DN (-Cys+CaB) ] or haploid underdose mutation (HI); c takes 0 when the mutation type is other mutation types;
the post-operation eye axis length formula of the prediction model is as follows:
Wherein postAL is the post-operative eye axis length in mm; postAL corresponds to a target age postAge, the target age postAge units being y;
Step two, acquiring patient data:
Obtaining patient data, substituting the patient data into the postoperative eye axis prediction model formula in the step one, and calculating to obtain a predicted postoperative eye axis length postAL;
Step three, calculating recommended intraocular lens degrees:
The calculation formula of the recommended intraocular lens power applies Haigis formula, and calculates the recommended intraocular lens power according to the postoperative eye axis length postAL obtained in the second step and the set target diopter R;
Based on the obtained recommended intraocular lens powers, +1.50d, +1.00d, +0.50d, -0.50d, -1.00D, -1.50D, respectively, obtaining simulated intraocular lens powers;
step four, calculating the diopter immediately after arithmetic and the diopter of the target age:
Calculating an immediate post-arithmetic diopter R and a diopter R of a target age based on the recommended or simulated intraocular lens number, and the pre-operative or post-operative axial length preAL or postAL;
Step five, obtaining a calculation result:
The calculation results include the length of the eye axis at the target age of the patient, the recommended intraocular lens power, and the corresponding post-operative diopter and diopter of the target age, the simulated intraocular lens power, and the corresponding post-operative diopter and diopter of the target age.
2. The method of claim 1, wherein the patient data in step two comprises: patient name, birth date, date of examination, eye axis (mm), mean corneal curvature (D), anterior chamber depth (mm), target age, and diopter at target age, eye class (right or left), and FBN1 gene mutation type (including DN (-Cys), DN (CaB), DN (other) or HI).
3. The method of claim 1, wherein the Haigis formula in step three is specifically as follows:
Wherein,
ELP＝a0+a1×ACD+a2×postAL
Wherein Km is the average corneal curvature in D; ELP is the effective post-operative intraocular lens position in mm; ACD is anterior chamber depth in mm; a0, a1, a2 are parameters of the model of the intraocular lens to be built in; IOLpower is the intraocular lens power in D, the intraocular lens power in 0.5D, the recommended intraocular lens power taking the IOLpower closest value.
4. The intraocular lens power calculation method according to claim 1, wherein the formula of the diopter R immediately after the arithmetic calculation in step four and the diopter R of the target age is as follows:
Wherein,
ELP＝a0+a1×ACD+a2×AL
Wherein AL is a pre-operation eye axis length preAL or a post-operation eye axis length postAL, the post-operation immediate diopter R is calculated by substituting the pre-operation eye axis length preAL, and the diopter R of the target age is calculated by substituting the post-operation eye axis length postAL.
5. The intraocular lens power calculation software for an equine syndrome subluxated eye based on the calculation method of claim 1, wherein the calculation software comprises an input module, a predictive model, a calculation module, an additional module, and an output module, wherein:
The input module is used for inputting patient data, and the patient data comprises: patient name, birth date, date of examination, eye axis (mm), mean corneal curvature (D), anterior chamber depth (mm), target age, and diopter at target age, eye class (right or left), and FBN1 gene mutation type (including DN (-Cys), DN (CaB), DN (other) or HI);
The prediction model predicts the post-operation eye axis length postAL of the target age based on the post-operation eye axis prediction model in the first calculation method step;
The calculation module calculates and obtains recommended intraocular lens power, and corresponding diopter immediately after operation and diopter of target age based on the calculation methods of the third and fourth calculation methods;
the additional module obtains simulated intraocular lens degrees based on the recommended intraocular lens degrees obtained by the calculation module, namely +1.50D, +1.00D, +0.50D, -0.50D, -1.00D and-1.50D respectively, and then substitutes the simulated intraocular lens degrees into the calculation module to obtain the diopter of the simulated intraocular lens corresponding to the postoperative immediate diopter and the diopter of the target age;
the output module is used for outputting the calculation result of the step five of the calculation method, wherein the calculation result comprises the length of the eye axis of the patient at the target age, the recommended intraocular lens number, the diopter of the corresponding postoperative immediate diopter and the target age, the simulated intraocular lens number, and the diopter of the corresponding postoperative immediate diopter and the diopter of the target age.
6. The computing software of claim 2, wherein the computing module is written based on Python language and formulated as a Haigis's blue book and performs Wang-Koch correction on patient data with eye axis length exceeding 25 mm.
7. The computing software of claim 2, wherein the parameters of the common IOL model include a0, a1, a2, which have been built into the computing module, and wherein the IOL model includes Rayner C-flex Aspheric 920hor 970C, TECNIS PCB or ZCB00, and AcrySof IQ SN60AT or SN60WF.
8. A method of using the calculation software for the intraocular lens power of an equine syndrome subluxated eye of any one of claims 5-7, said method of using comprising the steps of:
Step one, inputting a patient name, a birth date, an examination date, an eye axis, an average cornea curvature, an anterior chamber depth, a target age and diopter under the target age, and selecting an eye class and an FBN1 gene mutation type;
Step two, clicking calculation;
selecting the model of the artificial lens to be implanted;
and step four, obtaining the recommended intraocular lens degree and the diopter of the corresponding postoperative and target ages.
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