IOLMaster与接触性A超测量的精确度和可重复性比较  

Accuracy and reproducibility of IOLMaster versus contact ultrasound biometry

作　　者：柏全豪[1] 苗雨晴[2] 王翠丽[1] 张戈非[1] 

机构地区：[1]中国辽宁省大连市友谊医院眼科,116001 [2]中国辽宁省大连市友谊医院综合科,116001

出　　处：《国际眼科杂志》2015年第6期1057-1060,共4页International Eye Science

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,以评价两者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人工晶状体植入手术的患者121例137眼,分别用IOLMaster与接触式A超于术前测量眼前节相关参数,术后测量最佳矫正视力(BCVA)和实际屈光度。结果:IOLMaster与接触式A超测量前房深度(ACD)值分别为2.94±0.49,2.69±0.51mm,配对t检验,两者的差值为0.25±0.22mm(P<0.01),差异有显著性,相关系数r=0.823(P<0.01)。测量眼轴长度(AL)值分别为24.17±1.64,23.81±1.83mm,配对t检验,两者差值为0.36±0.24mm(P<0.01),差异有显著性,相关系数r=0.996(P<0.01)。同一测量者应用IOLMaster进行AL、ACD、角膜曲率的连续测量获得的标准差分别为±25.6,±33.4,±12.9μm,变异系数分别为0.11%,0.52%,0.17%;两位不同测量者间测量标准差分别为±21.5,±29.8,±15.9μm,变异系数分别为0.09%,0.62%,0.21%。两者测量ACD和AL的95%一致率(LoA)分别为-0.08^+0.48mm,-0.09^+0.69mm。IOLMaster生物测量平均预期屈光误差(MPFE)为-0.15±0.38D,平均绝对屈光误差(MAFE)为0.29±0.27D,而优化后的接触式A超测量与IOLMaster相比,MAFE明显增大为0.41±0.38D。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与接触式A超相比,具有良好的精确性和可重复性,并可同时测量出其他相关参数,具有较好的临床应用前景。AIM： To compare biometry results of IOLMaster and contact ultrasound （US） anterior segment parameters, and to evaluate the calculation accuracy and repeatability of intraocular lens power in both. METHODS： Preoperative measurement of anterior segment parameters were prospectively obtained in 137 eyes of 121 subjects with the IOLMaster compared with the US. Postoperative best corrected visual acuity （BCVA） and the actual diopter were measured. RESULTS： There was an excellent correlation between IOLMaster and US measurements for the ACD （ r= 0. 823, P〈0.01 ） and AL （ r= 0.996, P〈0.01 ）. The mean values of the parameters measured by IOLMaster and US were, respectively, as follows： ACD, 2.94 ± 0.49mm, 2.69 ± 0.51mm; AL, 24.17±1.64mm, 23.81±1.83mm. The mean differences of ACD and AL values between IOLMaster and US measurements were 0. 25 ± 0. 22mm, 0. 36 ± 0.24mm respectively, proved to be statistically significant （ P〈0.01 ）. With the 95% limits of agreement （LoA） from -0.08 ～ ＋0.48mm for ACD and from -0.09 - ＋0.69mm for AL. For IOLMaster, the mean prediction error （MPFE） - 0. 15 ＋ 0. 38D, the mean absolute prediction error （MAFE） was 0.29±0.27D 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±0.38D with 88% of the eyes within 1D from the predicted refraction. For IOLMaster biometry, the intraobserver variability （SD） was ± 25.6μm for AL, ±33.4μm for ACD and ±12.9μm for corneal radius. The coefficients of variation （COV） were 0.11%, 0.52%, and 0.17%, respectively. The interobserver variability （SD） was ±21.5μm for AL, ±29.8μm for ACD and ±15.9μm for corneal radius. The COV were 0. 09%, 0. 62%, and 0.21%, respectively. CONCLUSION： Partial coherence biometry using the IOLMaster provides the more accurate and reliable anterior segment parameters measurement values. A high degree of agreement be

关 键 词：前房深度 眼轴长度 角膜曲率 IOLMASTER 接触式A超 白内障 

分 类 号：R779.6[医药卫生—眼科]