傅立叶域光学相干断层扫描仪测量LASIK术后角膜参数的重复性和准确性  

Repeatability and accuracy of corneal parameters in post-LASIK eyes measured by Fourier-domain optical coherence topography

作　　者：华焱军[1] 黄锦海[1] 许琛琛[1] 潘超[1] 王勤美[1] 

机构地区：[1]温州医学院附属眼视光医院,325027

出　　处：《中华眼视光学与视觉科学杂志》2013年第3期150-155,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：卫生部科技教育司卫生行业科研专项资金资助项目（200802114）;温州市科技局项目（Y20110045,Y20120176）;浙江省卫生厅项目（2012KYBl35）;浙江省教育厅项目（Y201223147）

摘　　要：目的研究RTVue傅立叶域光学相干断层扫描仪（FD．OCT）测量准分子激光原位角膜磨镶术（LASIK）后角膜参数的重复性与准确性。方法前瞻性研究。接受LASIK手术者58例（58眼），均选择右眼进行研究，术前及术后3个月行主觉验光。术前IOLMaster测量角膜屈光力，术后3个月使用RTVueFD．OCT测量角膜中央3mm直径范围内前表面曲率半径（Ranterior）、后表面曲率半径（Rposterior）、角膜后前表面曲率半径之比（Ranterior/Rposterior）、角膜中央厚度（CCT）、角膜总屈光力（Knet）、模拟角膜屈光力（SimK）、角膜前表面屈光力（Kanterior）、角膜后表面屈光力（Kposterior），IOL Master获得的角膜屈光力（Km），临床病史法计算LASIK术后角膜总屈光力（Kchu）。连续测量3次。采用变异系数（CV）、Cronbaeh’s Alpha系数及组内相关系数（ICC）评估重复性；Bonfferroni校正的多重比较分析SimK、Knet、Km与Kchm之间的差异；Pearson相关分析SimK、Knet、Km与Kchm之间的相关性；Bland—Altman分析SimK与Kchm，Knet与Kchm，Km与Kchm，SimK与Knet，SimK与Km一致性并计算95％一致性界限范围（LoA）。结果Ranterior、Rposterior、Rposterior/Rarterior、Kanterior、Kposterior、SimK、Knet和CCT分别为（8．560±0．292）mm、（6．525±0．159）mm、0．763±0．024、（43．98±1．48）D、（-6．13±0．15）D、（39．47±1．33）D、（37．93±1．42）D和（451．81±33．91）μm，各参数CV均小于l％，各参数Cronbach’s Alpha系数和ICC均大于0．9。SimK比Kchm大（0．434±0．433）D，Knet比Kchm小（1．112±0．471）D，K。比Km大（0．334±0．379）D，SimK比Knet大（1．546±0．162）D，差异均有统计学意义（P〈0．01）；SimK比Km大（0．100±0．287）D，差异无统计学意义。Pearson相关分析，SimK、Knet Km、Kchm相互间均具有密切的相关性（r均≥0．944，P〈0．01）。Bland—Ahman图分析SimK与Kchm,KnObjective To evaluate the repeatability and accuracy of corneal parameters in post-laser in situ keratomileusis （LASIK） eyes obtained by RTVue Fourier-domain optical coherence topography （FD-OCT）. Methods In this prospective study, 58 right eyes of 58 persons who agreed to undergo LASIK were included. Subjective refractions were performed before LASIK and 3 months after LASIK. IOL Master was used to evaluate corneal power before LASIK. Three months after LASIK, RTVue FD-OCT was used to evaluate the anterior corneal curvature in a 3 mm central zone （Ranterior）, posterior corneal curvature in a 3 mm zone （Rposterior）, the ratio of posterior and anterior curvature （Rposterior/Ranterior）, central corneal thickness （CCT）, total corneal power （Knet）, simulated corneal power （SlinK）, anterior corneal power （Kanterior）, and posterior corneal power （Kposterior）. Km was obtained with IOL Master 3 months after the surgery. Kchm, was calculated from the patient＇s clinical history. Repeatability of corneal parameters was assessed using the coefficient of variation （CV）, Cronbach＇s alpha, and intra-class correlation coefficient （ICC）. Bonferroni corrected multiple comparisons analyzed the differences between SimK, Knet, Km and Kchm. A Pearson correlation analyzed the correlations between SimK, Knet, Km and Kchm,. Bland-Altman plots analyzed the agreements between SimK and Kchm, Knet and Kchm, Km and Kchm, SimK and Knet, and SimK and Km. Results The Ranterior, Rposterior, Rposterior/Ranterior, Kanterior, Kposterior, SimK, Knet and CCT were （8.560±0.292）mm, （6.525±0.159）mm, 0.763±0.024, （43.98±1.48）D, （-6.13±0.15）D, （39.47±1.33）D, （37.93±1.42）D and （451.81±33.91）μm, respectively. The CVs of all parameters were lower than 1%. Cronbach＇s alpha and ICC were both higher than 0.9. SimK was （0.434±0.433）D higher than Kchm, Knet was （1.112±0.471）D lower than Kchm, Km was （0.334±0.379）D higher than Kchm, and SimK was （1.546±0.162

关 键 词：体层摄影术 光学相干 角膜磨镶术 激光原位 角膜曲率 角膜厚度 重复性 一致性 

分 类 号：R77[医药卫生—眼科]