CASIA2对扩瞳前后晶状体和人工晶状体偏心和倾斜测量的重复性  

Repeatability of CASIA2 for measuring the tilt and decentration of crystalline lens and intraocular lens under non-mydriatic and mydriatic conditions

作　　者：唐玉玲 廖萱[1] 谭青青[1] 钱玖林 杨丽 周桂梅 兰长骏[1] Tang Yuling;Liao Xuan;Tan Qingqing;Qian Jiulin;Yang Li;Zhou Guimei;Lan Changjun(Department of Ophthalmology,Affiliated Hospital of North Sichuan Medical College,Medical School of Ophthalmology&Optometry,North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院眼科川北医学院眼视光医学院,南充637000

出　　处：《中华实验眼科杂志》2022年第5期440-447,共8页Chinese Journal Of Experimental Ophthalmology

基　　金：四川省卫计委重点课题项目(18ZD022);南充市校合作重大攻关项目(18SXHZ0492)。

摘　　要：目的评价新型眼前节扫频光相干断层扫描仪CASIA2测量扩瞳前后白内障患者晶状体和人工晶状体(IOL)偏心和倾斜的重复性及相关性。方法采用诊断性试验研究方法,纳入2020年3—7月在川北医学院附属医院行白内障手术的单纯性白内障患者109例157眼。由同一检查者应用CASIA2于白内障术前和术后1周对患者质量分数0.5%复方托吡卡胺滴眼液扩瞳前后晶状体或IOL的偏心量和倾斜度分别进行3次测量,采用组内标准差、重测试重复性(TRT)、变异系数(CoV)、组内相关系数(ICC)评价测量重复性;采用Pearson相关系数检验双眼晶状体和IOL扩瞳前与扩瞳后偏心量和倾斜度的相关性。结果CASIA2测量白内障患者扩瞳前和扩瞳后晶状体偏心量分别为(0.217±0.112)mm和(0.220±0.110)mm,倾斜度分别为(5.017±1.422)°和(5.310±1.645)°,扩瞳前和扩瞳后IOL偏心量分别为(0.245±0.136)mm和(0.250±0.145)mm,倾斜度分别为(5.144±1.345)°和(5.437±1.646)°,差异均无统计学意义(均P>0.05)。扩瞳前及扩瞳后双眼晶状体均向颞下方偏心和倾斜;右眼IOL均向下方偏心,向颞下方倾斜,左眼IOL均向颞下方偏心和倾斜。除晶状体偏心量外,白内障患者晶状体倾斜度、IOL偏心量和倾斜度在扩瞳前后的测量重复性均较好,ICC值范围0.815~0.984,均TRT的百分比<50%,均CoV≤14.840%。对不同眼别进行分析显示,除晶状体偏心量测量重复性较差,双眼晶状体扩瞳前后偏心轴向、倾斜度、倾斜轴向,IOL扩瞳前后偏心量和倾斜度的测量重复性均较好,ICC值范围为0.757~0.998,均TRT的百分比<50%,均CoV≤17.763%。各眼别晶状体和IOL扩瞳前与扩瞳后偏心量、偏心轴向、倾斜度和倾斜轴向的相关性均较好(r≥0.679,均P<0.01)。结论扩瞳前后CASIA2测量晶状体和IOL的倾斜度、偏心轴向、倾斜轴向及IOL偏心量的重复性均较好,扩瞳前与扩瞳后各测量值相关性较好。Objective To investigate the repeatability and correlation in tilt and decentration measurement of crystalline lens and intraocular lens(IOL)under non-mydriatic and mydriatic conditions using swept-source ocular coherence tomography CASIA2.Methods A diagnostic test study was conducted.A total of 109 cataract patients(157 eyes)who received phacoemulsification with IOL implantation surgery in the Affiliated Hospital of North Sichuan Medical College from March to July 2020 were enrolled.The decentration and tilt of crystalline lens and IOL under non-mydriatic and mydriatic conditions were measured for three times by a single examiner using CASIA2 before and one week after surgery.The 0.5%compound tropicamide eye drops were used to dilate.Repeatability was evaluated by within-standard deviation,test-retest repeatability(TRT),coefficient of variation(CoV)and intraclass correlation coefficient(ICC).The correlation in decentration and tilt of crystalline lens and IOL between before and after mydriasis was assessed by Pearson correlation coefficient.This study adhered to the Declaration of Helsinki,and the study protocol was approved by an Ethics Committee of the Affiliated Hospital of North Sichuan Medical College(No.2020ER030-1).Written informed consent was obtained from all subjects before any medical examination.Results The decentration of crystalline lens under non-mydriatic and mydriatic conditions was(0.217±0.112)mm and(0.220±0.110)mm,respectively,and the tilt was(5.017±1.422)°and(5.310±1.645)°,respectively.The decentration of IOL under non-mydriatic and mydriatic conditions was(0.245±0.136)mm and(0.250±0.145)mm,respectively,and the tilt was(5.144±1.345)°and(5.437±1.646)°,respectively.No significant difference was found between non-mydriatic and mydriatic conditions(all at P>0.05).Under both non-mydriatic and mydriatic conditions,the crystalline lenses of both eyes decentered and tilted toward the inferotemporal direction,and the IOL of right eyes decentered toward the inferior and tilted toward the in

关 键 词：扫频光相干断层扫描 诊断试验 白内障 人工晶状体 偏心 倾斜 重复性 

分 类 号：R779.6[医药卫生—眼科]