A型超声、IOLMaster和Pentacam测量白内障患者眼部生物学参数的比较  

Comparison of ocular biometry parameter measurements using A-scan,IOLMaster and Pentacam in patients with cataract

作　　者：刘嫣[1] 方思捷 姚钦科 王静[1] 陆琳娜[1] Liu Yan;Fang Sijie;Yao Qinke;Wang Jing;Lu Linna(Department of Ophthalmology,The Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncolo-gy,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院眼科上海市眼眶病眼肿瘤重点实验室

出　　处：《临床眼科杂志》2019年第3期206-209,共4页Journal of Clinical Ophthalmology

基　　金：国家自然科学基金(81800873);上海市重点实验室资助(资助号17DZ2260100)

摘　　要：目的探讨A型超声、IOLMaster和Pentacam三种仪器测量眼轴长度(AL)、前房深度(ACD)等白内障患者眼部生物学参数结果的差异性、相关性及一致性。方法选取2018年3~10月在上海交通大学医学院附属第九人民医院眼科拟行白内障超声乳化手术的患者共108例(176只眼),平均年龄(71.18±10.52)岁。采用A型超声、IOLMaster和Pentacam三种仪器对其进行术前检查,测量AL、ACD值并统计分析。结果在4组患者中,A型超声测得的短眼轴组、正常眼轴组、长眼轴组、超长眼轴组患者的AL值分别为(22.56±0.31)mm、(23.57±0.29)mm、(24.92±0.53)mm、(27.91±1.50)mm;IOL Master测得的短眼轴组、正常眼轴组、长眼轴组、超长眼轴组患者的AL值分别为(22.58±0.32)mm、(23.58±0.33)mm、(24.93±0.52)mm、(27.96±1.46)mm。在超长眼轴组患者中,A型超声与IOLMaster之间测得的AL差异均有统计学意义(P<0.05)。两种仪器测得所有眼AL差值的平均值为0.0181 mm,Bland-Altman分析显示95%的一致性界限为(-0.154, 0.191)mm,3.41%(6/176)在95%的一致性界限外,两种测量方法有较好的一致性,可相互替代。IOLMaster和Pentacam测得的ACD平均值分别是(3.13±0.48)mm和(3.17±0.53)mm,两种仪器测得白内障眼ACD值的Bland-Altman分析显示两种测量方法有较好的一致性(3.98%的点在95%的一致线外)。结论 A型超声与IOLMaster在测量白内障患者术前的AL值中存在差别,但两者的相关性和一致性较好,可以相互替代使用。AL值在26 mm<AL≤31 mm时,术前测量需谨慎,如行A型超声检查需反复测量,可辅以B型超声等检查减少测量误差。在测量白内障患者ACD时,IOLMaster和Pentacam两种测量方法有较好的相关性和一致性。Objective To investigate the difference, correlation and consistency of the ocular biometry parameter measurements, including axial length(AL) and anterior chamber depth(ACD) by A-scan, IOLMaster and Pentacam in patients with cataract.Methods 108 cataract patients(176 eyes) with a mean age of 71.18±10.52 years were enrolled. The ocular biometry parameters including AL and ACD were measured by A-scan, IOL Master and Pentacam before the cataract surgery.Results The patients were divided into four groups based on AL: The short AL group(21 mm≤AL<23 mm), normal AL group(23 mm≤AL≤24 mm), long AL group(24 mm< AL≤26 mm) and extremely long AL group(26 mm<AL≤31 mm). AL in each group measured by A-scan were 22.56±0.31 mm, 23.57±0.29 mm, 24.92±0.53 mm and 27.91 ±1.50 mm, respectively, While AL in each group measured by IOLMaster were 22.58±0.32 mm, 23.58±0.33 mm, 24.93±0.52 mm, 27.96±1.46 mm, respectively. In the extremely long AL group, AL measurement showed statistically significant difference between A-scan and IOLMaster(P<0.05). The mean difference in AL measurement by A-scan and IOLMaster was 0.0181 mm,the 95% confidence interval(CI)of limit of agreement(LOA) by Bland-Altman analysis was-0.154 to 0.191 mm,with 3.14%(6/176) of measurements fell outside the LOA, suggesting that these two measurements had good agreement and can be used interchangeably. ACD measured by IOL Master and Pentacam were(3. 13±0.48)mm and(3.17±0. 53)mm, respectively. Bland-Altman analysis showed that these two measurement also had good agreement in ACD measurement(3.98% of measurements fell outside the 95%CI of LOA).Conclusions Difference exists in AL measurement by A-scan and IOLMaster in patients with cataract. However, these two measurements showed overall good agreement and could be used interchangeably. For AL in the range of 26 to 31 mm, A-scan needs to be measured repeatedly, and compared with the IOLMaster measurements or aided by B-scan to minimize the measurement error.

关 键 词：白内障 超声检查 IOLMASTER PENTACAM 

分 类 号：R779.6[医药卫生—眼科]