IOLMaster生物测量精确性和可重复性研究  

The accuracy and reproducibility of IOLMaster biometry with intraocular lens used for cataract surgery

作　　者：柏全豪[1] 刘珣[1] 李雪[1] 阎启昌[1] 张劲松[1] 

机构地区：[1]中国医科大学附属第四医院中国医科大学眼科医院辽宁省晶状体学重点实验室辽宁省高校晶状体学重点实验室,沈阳110005

出　　处：《中国实用眼科杂志》2009年第8期848-852,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的比较IOLMaster与接触式A超对眼前节参数的生物学测量结果，以评价IOLMaster在眼内人工晶状体屈光度计算的精确性和可重复性。方法施行白内障超声乳化摘除联合后房型人工晶状体植入手术的患者121例（137只眼），分别用IOLMaster与接触式A超于术前测量眼前节相关参数，电脑验光仪测量术前角膜屈光度，术后随诊，测量最佳矫正视力（BSCVA）和实际屈光度。结果两者测量前房深度（ACD）值分别为（2．94±0．49）mm、（2．69±0．51）mm，两者的差值为（0．25±0．22）mm，配对t检验，差异具有统计学意义（P〈0．001），相关系数r=0．823（P〈0．001）；眼轴长度（AL）分别为（24．17±1．64）mm、（23．81±1．83）mm，两者差值为（0．36±0．24）mm，配对t检验，差异具有统计学意义（P〈0．001），相关系数r=0．996（P〈0．001）。同一测量者应用IOLMaster进行AL、ACD、角膜曲率半径的连续测量获得的标准差分别为±25．6μm、±33．4μm和±12．9μm，变异系数分别为0．11％、0．52％和0．17％；两位不同测量者间测量标准差分别为±21．5μm、±29．8μm和±15．9μm，变异系数分别为0．09％、0．62％和0．21％；三者的可信度分别为99．9％、97．8％、99．8％／99．5％（r1／r2）。两者测量ACD和AL的95％一致限（LoA）分别为-0．08-＋0．48mm、-0．09～＋0．69mm。IOLMaster生物测量平均绝对屈光误差（MARE）为（0．29±0．27）D；而接触式A超生物测量与IOLMaster相比，MARE明显增大，为（0．41±0．38）D。结论IOLMaster与接触式A超均可用于眼前节参数的生物测量，两者的相关性好。但基于光学原理的IOLMaster具有良好的精确性和可重复性，具有较好的临床应用前景。Objective To compare the measurement of anterior segment parameters by IOLMaster and contact ultrasonic （US） axial scan （A-scan）. The accuracy in predicting postoperative refraction and the reproducibility of each biometry measurement were also estimated in a prospective study of eyes that underwent phacoemulsification with intraocular lens implantation. Methods Preoperative measurement of anterior segment parameters were prospectively obtained in 137 eyes of 121 subjects with the IOLMaster compared with the US. Postoperative refractive outcomes were obtained and spherical equivalent calculated and compared to the predicted refractive error with each biometric method. Results There was an excellent correlation between IOLMaster and US measurements for the ACD （r =0.823 ; P 〈 0.001 ） and AL （r =0.996; P 〈0. 001 ）. The mean values of the parameters measured by IOLMaster and US were, respectively, as follows：ACD, 2.94± 0.49 mm,2.69±0.51 mm;AL,24.17± 1.64 mm,23.81± 1.83 mm. The mean differences of ACD and AL values between IOLMaster and US measurements were 0.25 ± 0.22 mm,0.36± 0.24 mm respectively, proved to be statistically significant （P 〈0.001 ）. With the 95% limits of agreement （LoA） from -0.08 mm to ＋ 0.48 mm for ACD and from -0.09 mm to ＋ 0.69 mm for AL. For IOLMaster, the mean absolute prediction error was 0.29＋ 0.27 D with 96% of the eyes within 1 D from the predicted refraction. Applanation ultrasonography after optimisation yielded a greater absolute prediction error than the IOLMaster biometry, 0.41 ± 0.38 D with 88% of the eyes within 1 D from the predicted refraction. For IOLMaster biometry, the intraobserver variability （SD） was ± 25.6 μm for AL, ± 33.4 μm for ACD and ± 12.9 μm for corneal radius. The coefficients of variation （COV） were 0.11%, 0.52%, and 0.17%, respectively. The interobserver variability （ SD ） was ± 21.5 μm for AL, ± 29.8 μm for ACD and ± 15.9 μm for corneal radius. The COV were 0.09% ,0.62% ,and 0.21% ,respectively

关 键 词：前房深度 眼轴长度 角膜曲率 IOLMASTER 白内障 

分 类 号：R322.91[医药卫生—人体解剖和组织胚胎学] R776.1[医药卫生—基础医学]