新型三维眼前节分析仪Sirius和Pentacam测量准分子激光角膜原位磨镶术后眼前节参数的对比研究  

Comparison of anterior segment measuring parameters in myopia after laser in situ keratomileusis between Sirius and Pentacam

作　　者：徐真[1] 黄锦海[1] 成拾明[2] 冯一帆[1] 王勤美[1] 

机构地区：[1]温州医学院眼视光学院温州医学院附属眼视光医院浙江省眼科医院,325027 [2]湖北医药学院附属太和医院眼科,十堰442000

出　　处：《中华实验眼科杂志》2013年第6期572-577,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：卫生行业科研专项项目（200802114）

摘　　要：背景新型眼前节分析系统Sirius是结合单Scheimpflug成像与Placido盘的原理用于观察眼前节结构的设备，已用于眼科临床，但目前尚缺乏其与Pentacam系统重复性和一致性的对比研究。目的分析新型三维眼前节分析仪Sirius与Pentacam系统测量准分子激光角膜原位磨镶术（LASIK）术后角膜曲率、角膜厚度、前房深度（ACD）及前房容积（ACV）的重复性、差异性、相关性及一致性，为临床使用提供依据。方法选取2010年5—7月在温州医学院眼视光医院屈光手术中心行LASIK术后的患者35例35眼，分别应用Sirius和Pentacam系统对受试眼的平坦子午线角膜曲率（Kf）值、陡峭子午线角膜曲率（Ks）值，平均SimK（Km）值，角膜最薄点厚度（TCT）及位置，中央ACD及ACV进行测量，并对结果进行统计学分析。结果Sirius和Pentacam测量LASIK术后患者眼前节参数具有高度的重复性，除角膜最薄点的位置坐标（X，Y）外，其他参数的组内相关系数（ICC）和克隆巴赫系数（CoA）均大于0．90。测量角膜曲率Kf、Ks时，两种方法测量的结果差异均无统计学意义（t=-1．533、-1．750，P〉0．05）。Sirius测量的Km值为（39．14±1．95）D，高于Pentacam测量的（39．05±1．91）D，二者间差异有统计学意义（t=3．572，P=0．001）。Sirius测量的TCT为（457．6±40．9）txm，明显低于Pentacam测量的（465．4±37．5）μm，差异有统计学意义（t=-6．689，P〈0．001），二者的测量值呈明显正相关（r=0．988，P〈0．001），Bland—Ahman分析的TCT95％可信区间（c，）为-21～6μm。两种测量系统测得的角膜最薄点定位X、Y的值差异均有统计学意义（t=-4．132、-5．696，P〈0．001），但二者的相关性均一般（r=0．75l、0．775，P〈0．001），95％CI亦较宽（-0．36～0．17mm，-0．35～0．12mm）。两种测量方法测量ACD和ACV值的差异均有统计学意义（￡=9．103�Background Sirius system, a new Scheimpflug camera combined with Placido topography, improved the capability of imaging the anterior eye segment significantly. However, the study of assessing the repeatability and agreement between Sirius and Pentacam is still lack up to now. Objective This study was to evaluate the repeatability and agreement of the anterior ocular segment measuring parameters by Sirius and Pentacam in myopia received laser in situ keratomileusis （ LASIK）. Methods Thirty-five myopic eyes of 35 patients received LASIK were included in School of Optometry and Ophthahnology Eye Hospital from 2010 May through 2010 July. Corneal power flat keratometry （Kf） , step keratometry （Ks） , mean keratometry （ Km ） , thinnest corneal thickness（TCT） ,the location of TCT, anterior chamber depth （ACD） and anterior chamber volume （ACV） were measured by Sirius and Pentacam in all the eyes, respectively. The repeatability of the measuring results were evaluated using intraclass correlation coefficients （ICC） and Cronbaeh＇s coefficient alpha （CoA） ,and the agreement of measuring parameters between Sirius and Pentacam was analyzed using Bland-Ahman plot. Results Both Sirius and Pentaeam demonstrated high intraobserver repeatability, with all ICC and CoA more than 0.90. No significant differences were found in Kf values and Ks values between the two methods （t =- 1. 533,-1. 750,P〉0. 05 ）. Km value was （39. 14 ± 1.95） D by Sirius measurement, which was significantly higher than （39.05 ± 1.91 ） D by Pentaeam measurement （ t = 3. 572, P = 0. 001 ）. The TCT was （457.6± 40.9） μm by Sirius method, showing a significant reduce in comparison with （465.4 ± 37.5 ） μm of Pentacam method （ t = - 6. 689, P 〈 0. 001 ）. A positive correlation was seen in the TCT between the two methods （r = 0. 988, P〈0. 001 ）. The Bland-Ahman plots showed the 95% CI -21μm to 6μm in the TCT value between the two devices. Pairwise comparison of the location of TCT measu

关 键 词：Sirius PENTACAM 眼前节 重复性 一致性分析 Bland—Altman图 

分 类 号：R779.63[医药卫生—眼科]