不同测量方法评价近视患者角膜水平直径的大样本比较研究  

A large sample comparative study of different measurement methods to evaluate corneal horizontal diameter in patients with myopia

作　　者：曹丹凤 尹连荣[1] 康婷婷 褚慧 吕文豪 杨薇[1] CAO Danfeng;YIN Lianrong;KANG Tingting;CHU Hui;LV Wenhao;YANG Wei(Eye Hospital,China Academy of Chinese Medical Sciences,Beijing 100040,China)

机构地区：[1]中国中医科学院眼科医院,北京100040

出　　处：《中国中医眼科杂志》2022年第3期192-196,共5页China Journal of Chinese Ophthalmology

基　　金：北京中医药薪火传承“3+3”工程(2019-SZ-B-39);首都卫生发展科研专项(SF2018-2-4182)。

摘　　要：目的评价IOL Master 500与Sirius眼前节分析系统测量角膜水平直径(WTW)的差异性、相关性及一致性,为眼科生物学测量的临床应用提供理论依据。方法回顾性研究。选取2018年12月—2021年2月就诊于中国中医科学院眼科医院屈光手术科的近视患者1,124例(2,171只眼),其中未成年患者347例(642只眼)、成年患者777例(1,529只眼),均同时采用IOL Master 500(IOLM)与Sirius眼前节分析系统(Sir)2种测量方法测量WTW,并进行差异性、相关性及一致性分析。结果(1)2种方法测量WTW比较:IOL Master500与Sirius眼前节分析系统所测WTW分别为(12.02±0.35)mm和(11.80±0.31)mm;其中未成年患者WTW分别为(12.08±0.33)mm和(11.90±0.32)mm,成年患者WTW分别为(12.00±0.43)mm和(11.75±0.40)mm。(2)WTW组间比较:3组数据均显示IOL Master 500所测数值较Sirius眼前节分析系统所测数值偏大,且具有统计学差异(t_(总体)=32.632,t_(未成年)=12.445,t_(成年)=31.900,均P=0.000);2种测量方法均显示,未成年人WTW数值大于成年人,差异具有统计学意义(t_(IOLM)=4.121,t_(Sir)=7.844,均P=0.000);(3)Person相关性分析:2种测量方法所获WTW平均值在3组数据中均具有正相关性(r_(总体)=0.667,r_(未成年)=0.631,r_(成年)=0.734,均P=0.000)。(4)BlandAltman分析:2种测量方法所获WTW的95%一致性界限(LoA)为(-0.41,0.89)mm,其中未成年患者95%LoA为(-0.50,0.89)mm,成年患者95%LoA为(-0.34,0.84)mm;LoA上限值均超过临床可接受范围,说明2种测量方法一致性较差。结论IOL Master 500与Sirius眼前节分析系统相比所测WTW数值偏大,尽管两者一致性较差,临床不可相互替代,但因两者具有良好的正相关性,临床可以参考应用。OBJECTIVE To evaluate the difference,correlation and consistency of cornea horizontal diameter(WTW)measured by IOL Master 500 and Sirius anterior segment analysis system,so as to provide theoretical basis for the clinical application of ophthalmic biological measure-ment.METHODS Retrospective case study,in which 1,124 patients(2,171 eyes)with myopia were selected from December 2018 to February 2021,in the department of refractive surgery of Eye hospital,China Academy of Chinese Medical Sciences,including 347 juvenile patients(642eyes)and 777 adult patients(1,529 eyes).WTW were measured by two measurement methods,including IOL Master 500(IOLM)and Sirius anterior segment analysis system(Sir).The data was analyzed for the difference,correlation and consistency.RESULTS(1)Comparison of WTW measured by two methods:The mean WTW value measured by IOLM and Sir were(12.02±0.35)mm and(11.80±0.31)mm respectively.The mean WTW value of juvenile patients were(12.08±0.33)mm and(11.90±0.32)mm respectively,while the mean WTW value of adult patients were(12.00±0.43)mm and(11.75±0.40)mm respectively.(2)Comparison of WTW among groups:The data of the three groups showed that the value measured by IOLM was larger than that measured by Sir,and there was statistical difference(t_(total)=32.632,t_(Juv)=12.445,t_(Adu)=31.900,all P=0.000).The two methods both showed that the mean WTW value of juvenile patients was greater than that of adult patients,and the difference was statistically significant(t_(IOLM)=4.121,t_(Sir)=7.844,all P=0.000).(3)Person correlation analysis:The mean WTW values obtained by the two methods had positive correlation in the three groups of data(r_(total)=0.667,r_(Juv)=0.631,r_(Adu)=0.734,all P=0.000).(4)Bland-Altman analysis:The 95%limit of agreement(LoA)of WTW obtained by the two methods was(-0.41,0.89)mm,of which the 95%LoA of juvenile patients was(-0.50,0.89)mm,while the 95%Lo A of adult patients was(-0.34,0.84)mm.The upper limit of LoA exceeded the clinically acceptable range,indicating that the consistency

关 键 词：角膜水平直径 白到白 IOL Master 500 Sirius眼前节分析系统 

分 类 号：R770.43[医药卫生—眼科]