不同角膜形态在Pentacam测量中的差异分析  

Variation analysis and influencing factors in different corneal morphologies measured by the Pentacam system

作　　者：袁冬青[1,2] 钟华[3] 陈琴[1,2] Dong-Qing YUAN;Hua ZHONG;Qin CHEN(Department of Ophthalmology,Jiangsu Province Hospital,Nanjing 210029,China;Department of Ophthalmology,The First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China;Department of Ophthalmology,The First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]江苏省人民医院眼科,南京210029 [2]南京医科大学第一附属医院眼科,南京210029 [3]昆明医科大学第一附属医院眼科,昆明650032

出　　处：《医学新知》2021年第3期161-168,共8页New Medicine

基　　金：国家自然科学基金(81760170)。

摘　　要：目的探讨不同角膜形态在Pentacam Scheimpflug断层扫描结果中的差异及其辅助诊断角膜后表面高度异常的可行性。方法选取2020年4月至9月在江苏省人民医院行角膜屈光手术术前检查的近视患者120例(240眼)。患者均进行了全面的眼部屈光度数检查,并行Pentacam三维眼前节分析系统检查。选取Pentacam眼前节分析系统中角膜前表面曲率(ASK)、后表面曲率(PSK)、前表面散光(AAstig)、后表面散光(PAstig)、中央角膜厚度(CCT)、角膜直径(W-W)、角膜前表面差异图的偏差(Df)、角膜后表面差异图的偏差(Db)、角膜平均厚度进展的偏差(Dp)、角膜最薄点的厚度偏差(Dt)、Ambrosio关联厚度参数偏差(Da)和总体正态性偏差(BAD-Do)共12个参数进行分析。根据角膜直径大小分组,比较组间和组内差异,分析BAD-Do的影响因素,并建立多元线性回归模型。结果根据角膜直径大小将120例患者分为四组。其中,A组(直径≤11.0 mm)纳入36眼,B组(直径为11.1~11.5 mm)纳入76眼,C组(直径为11.6~12.0 mm)纳入82眼,D组(直径>12.0 mm)纳入46眼。各组间的球镜度数、柱镜度数、角膜厚度差异无统计学意义。Pentacam测量发现PSK在不同角膜直径组患者中差异具有统计学意义。在BAD-Do方面,除A、B两组组间无差异外,其余两两比较均显示组间差异具有统计学意义。将每组患者BAD-Do与Pentacam参数进行相关性分析发现,BAD-Do与PSK存在低度相关(r=-0.27,P=0.001),与角膜直径存在弱相关(r=-0.39,P=0.001),但与屈光度数、角膜厚度等参数相关性无统计学意义(P>0.05)。结论角膜形态学参数中角膜直径和PSK是影响BAD-Do的主要因素,角膜直径越小的患者出现BAD-Do异常的可能性越大,在Pentacam结果判读中需考虑角膜直径和PSK变化对结果的影响。Objective To explore the variation in different corneal morphologies in Pentacam Scheimpflug tomography and the feasibility of assisting diagnosis of abnormal corneal posterior surface height.Methods In this retrospective study 120 myopia patients(240 eyes)who underwent preoperative examination of corneal refractive surgery in Jiangsu province hospital from April 2020 to September 2020 were selected.All patients had a comprehensive eye refractive power examination,and were examined by Pentacam three-dimensional anterior segment analysis system.The anterior surface curvature(ASK),posterior surface curvature(PSK),anterior surface astigmatism(AAstig),posterior surface astigmatism(PAstig),central corneal thickness(CCT),corneal diameter(W-W),deviation(Df)of corneal anterior surface difference map,deviation(Db)of corneal posterior surface difference map and progress of corneal average thickness were selected from Pentacam anterior segment analysis system.They were divided into four groups according to corneal diameter,and the differences between groups and within groups were compared.Spearman rank correlation analysis was used to explore the related influencing factors of BAD-Do(belin/ambrosio enhenced ectasia display-overall deviation of normality),and a multiple linear regression model was established to find the main influencing factors of BAD-Do.Results All patients included in the study were divided into four groups according to corneal diameter,including group A,B,C and D.There are 36 eyes in group A,76 eyes in group B,82 eyes in group C and 46 eyes in group D.There was no significant difference in refractive power between groups,that is,spherical power,cylindrical power and corneal thickness.Pentacam measurement showed that there were significant differences between PSK groups in patients with different corneal diameters.In the aspect of overall normal deviation BAD-Do,there were significant differences between group A,group C and D.There were also significant differences between group B,group C and D,but there

关 键 词：PENTACAM 角膜直径 角膜后表面曲率 BAD-Do 

分 类 号：R770.4[医药卫生—眼科]