浸润式A型超声法与Lenstar光学生物测量仪在不同类型白内障眼测量的晶状体厚度值的差异及其临床意义  

The difference of lens thickness measured by immersion A-scan ultrasound versus Lenstar optical biometry in various types of cataract eyes and its clinical significance

作　　者：薛文琛 宋慧[2] 汤欣[2] 

机构地区：[1]天津医科大学眼科临床学院天津市眼科医院天津医科大学,300020 [2]天津市眼科医院天津市眼科学与视觉科学重点实验室天津市眼科研究所,300020

出　　处：《中华实验眼科杂志》2016年第12期1121-1125,共5页Chinese Journal Of Experimental Ophthalmology

摘　　要：背景白内障是全球致盲眼病的主要原因，手术是目前治疗白内障的主要手段，因此术前参数的精准测量对提高术后视觉质量有重要意义。目的比较浸润式A型超声与Lenstar光学生物测量仪对不同类型白内障晶状体厚度（LT）进行测量时结果的差异，分析两种检测方法的一致性，探讨超声测量在对不同类型和不同核硬度的白内障患者进行LT测量时是否需要改变声速参数。方法采用诊断试验可靠性评价方法，分别应用浸润式A型超声和Lenstar光学生物测量仪（Lenstar测量仪）于2013年9月至2014年5月在天津市眼科医院对130例143眼单纯白内障患者进行LT测量，按照白内障类型不同分为核性白内障组50例60眼、后囊下性白内障组40例40眼和皮质性白内障组43例43眼；核性白内障组患眼根据Emery核硬度分级标准亚分为Ⅱ级核白内障14例20眼、Ⅲ级核白内障17例20眼和Ⅳ级核白内障19例20眼，采用配对t检验法对2种方法测量的LT值的差异进行比较；采用Bland—Altman图对2种测量方法的测量值进行一致性分析。结果浸润式A型超声法对核性白内障眼测量的LT值为（4．85±0．39）mm，明显高于Lenstar测量仪的测量值（4．74±0．37）mm，差异有统计学意义（t=3．020，P=0．004），2种测量方法间对后囊下性白内障眼和皮质性白内障眼测量的LT值差异均无统计学意义（t=1．015，P=0．316；t=1．275，P=0．209）。浸润式A型超声法对Ⅱ、Ⅲ、Ⅳ级核白内障患者测量的LT值均明显高于Lenstar测量仪的测量值，差异均有统计学意义（t=2．175、2．378、2．383，均P〈0．05）。浸润式A型超声法与Lenstar测量仪在后囊下性白内障眼测得的LT值一致性较好，95％一致性界限（LoA）为-0．21-0．18mm，而在核性白内障眼和皮质性白内障眼中2种测量方法测得的LT值一致性较差，95％LoA分别为-0．64-0．43mm和-0．50-0．41mm。�Background Cataract is the main cause of global blindness,and surgery is the main method for the treatment of cataract, so precise preoperative parameters have an important significance for improving postoperative visual quality. Objective This study was to analyze the difference of lens thickness （LT） measured by immersion A-scan ultrasound versus optical biometry and consistency of these two methods in measuring the LT for different types of cataract eyes,and to investigate whether A-scan ultrasound for the LT measurement needs to correct the ultrasound speed parameter. Methods A reliability evaluation of diagnosis test was designed. The LT was measured on 143 cataract eyes using immersion A-scan ultrasound and Lenstar optical biometry in Tianjin Eye Hospital from September 2013 to May 2014. The eyes were assigned to nuclear cataract group （60 eyes of 50 patients） , posterior subcapsular cataract group （40 eyes of 40 patients） and cortical cataract group （43 eyes of 43 patients） based on the types of cataract,and the hardness of nucleus was grade 11 in 20 eyes of 14 patients,grade m in 20 eyes of 17 patients and grade IV in 20 eyes of 19 patients. The outcomes measured by immersion A-scan ultrasound versus Lenstar optical biometry were compared with paired t test, and the consistency between the two devices was analyzed by Bland-Altman agreement plot. This study complied with Helsinki declaration, and written informed consent was obtained from each patient prior to any examination. Results The mean LT value was （4.85± 0. 39）mm from the immersion A-scan ultrasound and （4. 74 ±0. 37） mm from the Lenstar optical biometry, with a significant difference between the two devices （ t = 3. 020, P = 0. 004）. No significant differences were found in the LT values of the posterior subcapsular cataractous eyes and cortical cataractous eyes between the two devices （ t = 1.015 ,P = 0.316 ; t = 1. 275, P = 0. 209 ）. The LT values by immersion A-scan ultrasound were significantly higher in grad

关 键 词：生物测量/仪器 白内障/诊断 白内障/超声波检查法 光学设备 晶状体厚度 

分 类 号：R776.1[医药卫生—眼科]