四种仪器测量中央角膜厚度的比较  

Comparison of central corneal thickness measurements by Ultrasound,Orbscan Ⅱ ,AS-OCT and Pentacam pachymetry

作　　者：江先明[1] 杨斌[1] 王铮[1] 黄国富[1] 罗晓阳[2] 张晓晓[1] 周胜[1] 

机构地区：[1]中山大学中山眼科中心,广州510060 [2]广东省人民医院眼科

出　　处：《中国实用眼科杂志》2009年第5期467-471,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的分析OrbscanⅡ、AS—OCT和Pentacam测量术前检查患者中央角膜厚度（CCT）同超声测厚仪的差异和一致性。方法连续选取行术前检查的屈光不正患者90例（180只眼），对每位患者分别用超声测厚仪、OrbscanⅡ、AS—OCT和Pentacam四种仪器测量其CCT，数据统计分析采用了配对t检验、简单线性相关和Bland—Altman分析。结果超声测厚仪、OrbscanⅡ、AS—OCT和Pentacam测量CCT平均值分别为（542．1±30．4）μm、（541．1±37．1）μm、（530．3±29．3）μm和（544．9±28．7）μm。超声测厚仪和OrbscanⅡ之间的比较没有统计学意义（P〉0．05）。超声测厚仪和AS—OCT、Pentacam之间的差别分别为（11．7±8．9）μm（P〈0．01）、（-2．8±11．0）μm（P〈0．01）。线性相关显示超声测厚仪和OrbscanⅡ、AS—OCT、Pentacam三者间分别存在正相关（P〈0．01）。Bland—Altman分析显示超声测厚仪与OrbscanⅡ、AS—OCT、Pentacam三者间有较好的一致性，95％一致性界限分别为-37．4-＋39．3μm、-5．6-＋29．1μm、-24．4～＋18．8μm。结论对于准分子激光术前患者角膜厚度的测量，三种方法同超声的一致性好，都可用来测量角膜厚度，其中OrbscanⅡ的测量值大小受其声速系数的影响、AS—OCT同超声的一致性最好、Pentacam的测量值同超声最接近。但完全替代使用还须慎重。Objective To analyze the difference and the agreement in central corneal thickness（CCT） measurements between the gold standard method of ultrasound pachymetry and 3 noncontact systems （Orbscan II, AS-OCT, Pentacam）in ametropia eyes before laser refractive surgery.Methods Ninety consecutive patients （180 eyes）who had preoperative examination in Laser Refractive Surgery Center had Orbscan Ⅱ,AS-OCT, Pentacam, and ultrasound pachymetry.Data were analyzed using the paired sample t test, linear regression, and Bland-Altman plots.Results The mean CCT measured by ultrasound,OrbscanlI,Pentacam, and AS-OCT pachymetry were,respectively, （542.1 ± 30.4）μm, （541.1± 37.1）μ m, （530.3_± 29.3）[1 m and （544.9± 28.7）μm.There was no statistically significant difference between ultrasound and OrbscanlI measurements （P〉0.05）.Compared with the ultrasound measurement,AS-OCT and Pentacam measurements significantly misestimate corneal thickness by a mean of （ 11.7± 8.9）μ m（P 〈0.01 ）and （-2.8± 11.0）μm（P 〈0.01 ）,respectively.OrbscanlI, AS-OCT, Pentacam pachymetry showed a high correlation with ultrasound pachymetry. The 95% limits ofagreement （LoA）withultrasoundwere-37.4.-＋39.3μm for the Orbscan Ⅱ devieeand-5.6-＋29.1 μm for the AS-OCT device and -24.4-＋18.8 1.1 μm for the Pentacam device.Conclusions OrbscanlI,AS-OCT and Pentacam pachymetry can be used to measure central corneal thickness.Compared with the ultrasound pachymetry, OrbscanlI pachymetry was effectd by it＇s AF, AS-OCT pachymetry had the best agreement, Pent,acam pachymetry had the nearest CCT.However it is cautious to use the 4 devices interchangeably.

关 键 词：超声测厚仪 ORBSCAN Ⅱ AS—OCT PENTACAM 一致性 

分 类 号：R778.11[医药卫生—眼科] R446.1[医药卫生—临床医学]