3种仪器测量白内障患者水平角膜直径、平坦轴角膜曲率和陡峭轴角膜曲率的对比研究  

Comparative analysis of horizontal corneal diameter,flat axial corneal curvature and steep axial corneal curvature in cataract patients with three different instruments

作　　者：周歆 王从毅[1] 李妍[1] 折喜龙 党冠星 ZHOU Xin;WANG Congyi;LI Yan;SHE Xilong;DANG Guanxing(Cataract and Intraocular Lens Center,No.4 Hospital of Xi′an,Xi′an 710000,China)

机构地区：[1]西安市第四医院眼科,陕西西安710000

出　　处：《延安大学学报（医学科学版）》2021年第4期33-38,共6页Journal of Yan'an University:Medical Science Edition

基　　金：西安市科技局科学计划项目[201805097YX53F31(6)]。

摘　　要：目的对比IOLMaster 700、OPD-ScanⅢ与MODi 2角膜地形图仪3种仪器在测量白内障患者水平角膜直径(white to white,WTW)、平坦轴角膜曲率(keratometry of flataxial,Kf)和陡峭轴角膜曲率(keratometry of steepaxial,Ks)的差异性和一致性。方法选取2019年11月至12月于西安市第四医院眼科白内障人工晶状体中心就诊并拟行白内障超声乳化抽吸联合人工晶状体植入术的患者54例(92只眼),其中男17例(28只眼),女37例(64只眼),平均年龄(52.83±15.00)岁。采用3种仪器分别测量患者的WTW、Kf、Ks。采用方差分析及LSD-t检验比较仪器间的差异性,Pearson相关性分析分析仪器相关性及Bland-Altman法评价仪器的一致性。结果 3种仪器测量WTW、Kf、Ks值时,只有IOLMaster 700与OPD-ScanⅢ的WTW值、OPD-ScanⅢ与MODi 2角膜地形图仪的WTW值差异有统计学意义(P<0.001),余测量值差异均无统计学意义(P>0.05)。相关性分析中,3种仪器测量值均呈现出显著正相关性,相关系数r在0.75~0.98之间。Bland Altman法评价仪器的一致性时,IOLMaster 700与OPD-ScanⅢ、IOLMaster 700与MODi 2角膜地形图仪、OPD-ScanⅢ与MODi 2角膜地形图仪测量WTW、Kf、Ks值95%一致性界限外比例分别为(5.43%、6.52%、4.34%)、(4.34%、4.34%和7.61%)、(5.43%、5.43%和7.61%)。结论 3种仪器测量Kf、Ks值差异无统计学意义,IOLMaster 700与MODi 2角膜地形图仪测量WTW值差异无统计学意义,但3种仪器测量Kf、Ks、WTW差异均有临床意义,不能互换使用。Objective To compare the difference and consistency of white to white(WTW),keratometry of flataxial(Kf) and keratometry of steepaxial(Ks) in cataract patients with IOL Master 700,OPD-Scan Ⅲ and MODi 2 corneal topographer.Methods A total of 54 patients(92 eyes) from Cataract and Intraocular Lens Center,No.4 Hospital of Xi ′an during November to December 2019 were recruited.They were 17 males(28 eyes) and 37 females(64 eyes),with an average age of(52.83±15.00)years.Three instruments were used to measure WTW,Kf and Ks.One-way ANOVA analysis and LSD-t test were used to compare differences between instruments,and Pearson correlation analysis was used to analyze instrument correlation and Bland-Altman method to evaluate the consistency of instruments.Results When the WTW,Kf and Ks values were measured by three instruments,only the WTW values of IOLMaster 700 and OPD-scan Ⅲ,OPD-scan Ⅲ and MODi 2 corneal topographer showed statistically significant differences(P<0.001),while the differences of the remaining measured values were not statistically significant(P>0.05).In the correlation analysis,the measured values of the three instruments all showed significant positive correlation,with the correlation coefficient r between 0.75~0.98.When Bland-Altman method was used to evaluate instrument consistency,the measured WTW,Kf,and Ks values at 95% of the consistency threshold were respectively(5.43%,6.52%,4.34%),(4.34%,4.34%,and 7.61%),and(5.43%,5.43%,and 7.61%) of IOLMaster 700 and OPD-scan Ⅲ,IOLMaster 700 and MODi 2 corneal topographer,and OPD-scan Ⅲ and MODi 2 corneal topographer.Conclusion There was no difference in Kf and Ks values measured by the three instruments,and there was no statistically significant difference in WTW value measured by IOLMaster 700 and MODi 2 corneal topographer.However,the differences of Kf,Ks and WTW measured by the three instruments were clinically significant difference and could not be used interchangeably.

关 键 词：水平角膜直径 平坦轴角膜曲率 陡峭轴角膜曲率 IOLMaster 700 

分 类 号：R776.1[医药卫生—眼科]