不同方法测量中高度近视患者角膜曲率、散光、前房深度的差异及对后房型人工晶体计算的影响  

Differences of corneal curvature,astigmatism and depth of anterior chamber in patients with moderate and high myopia measured by different instruments and their effects on the calculation of posterior chamber intraocular lens

作　　者：侯莉娜 谷浩 蒋浩 周京 HOU Li'na;GU Hao;JIANG Hao;ZHOU Jing(Department of Ophthalmology,Guizhou Medical University,Guiyang 550025,Guizhou,China)

机构地区：[1]贵州医科大学 [2]贵州医科大学附属医院眼科,贵州贵阳550025

出　　处：《贵州医科大学学报》2023年第8期931-937,共7页Journal of Guizhou Medical University

基　　金：贵州省科学技术厅(黔科合支撑〔2022〕一般184)。

摘　　要：目的探讨不同仪器测量中高度近视患者角膜曲率、散光、前房深度(ACD)的差异及对后房型人工晶体计算的影响。方法选取中高度近视患者97例194眼,于术前使用三维眼前节分析仪(Pentacam)、光学相干生物测量仪(IOL-Master)、自动电脑验光仪及超声生物显微镜(UBM)分别测量ACD、角膜曲率(Kf、Ks)及散光参数[包括散光度(Cyl)、陡峭轴轴位(Axis)及平坦轴轴位(Axif)],并将UBM与自动电脑验光仪(A组)、IOL-Master(B组)及Pentacam(C组)测量的ACD、Kf、Ks值带入有晶状体眼后房型人工晶状体(ICL)计算公式,得出预期等效球镜值,并分别与术后3月、6月、12月用自动电脑验光仪测量的实际等效球镜值比较,采用Pesrson相关分析预期等效球镜与实际等效球镜的相关性。结果3种仪器在测量Kf、Cyl、Axif一致性好,IOL-Master与其他两种仪器在测量Ks一致性较差,Pentacam与电脑验光仪在测量Axis时一致性较差;UBM与IOL-Master和Pentacam测量ACD值差异有统计学意义(P<0.05),UBM和其他两种仪器测量的ACD一致性较差;3种方法计算后房型人工晶体得出的预期等效球镜具有差异性(F=90.218,P<0.001),其中以A组预期等效球镜与实际等效球镜一致性较高,其在3月、6月、12月时与实际等效球镜一致性较B组、C组两种方法更高(r=0.200、0.154、0.176,P<0.05)。结论Pentacam、IOL-Master、自动电脑验光仪在测量中高度近视患者角膜曲率、散光参数时的相关性好,必要时可互换使用;IOL-Master与Pentacam测量ACD值相关性好,测量值可互换使用,但UBM测量的ACD值不建议替换使用;UBM测量的ACD及自动验光仪测量的Kf、Ks代入后计算得出的预期等效球镜与实际等效球镜相关性相对更高,可继续用于ICL的计算。Objective To investigate the differences of corneal curvature,astigmatism and anterior chamber depth(ACD)of patients with moderate and high myopia measured by different instruments and their effects on the calculation of posterior chamber intraocular lens.Method One and ninety-four eyes of 97 patients with moderate and high myopia were selected.The ACD,Kf,Ks,Cyl,Axis,and Axif were measured by Pentacam,IOL-Master,automatic computer optometry and UBM.The values of ACD,Kf,and Ks measured by different instruments were brought into the calculation formula of ICL in Phakic eyes to obtain the expected equivalent spherical lens,and the correlation between the expected equivalent spherical lens and the actual equivalent spherical lens were analyzed by Pesrson correlation.Results The three instruments had good consistency in measuring Kf,Cyl,and Axif.The consistency of IOL-Master and other two instruments in measuring Ks was poor.The consistency between Pentacam and computer optometer in measuring Axis was poor.There was significant difference in ACD measured by UBM(P<0.05),IOL-Master,and Pentacam,but no significant difference in ACD measured by IOL-Master and Pentacam(P>0.05).The other two had statistical significance.The consistency of ACD measured by UBM and other two instruments was poor.The expected equivalent spherical lenses of posterior chamber intraocular lenses calculated by the three methods were different(F=90.218,P<0.001).Among them,the expected equivalent spherical lens calculated by group A had higher consistency with the actual equivalent spherical lens,and the consistency with the actual equivalent spherical lens in March,June and December was higher than that in group B and group C(r=0.200,0.154,0.176;P<0.05).Conclusion Pentacam,IOL-Master,and automatic computer optometry have a positive correlation in measuring corneal curvature and astigmatism parameters in patients with moderate and high myopia,and can be used interchangeably if necessary.There is a positive correlation between ACD measured by IOL-Mast

关 键 词：近视 角膜曲率 前房深度 角膜散光 后房型人工晶体 自动电脑验光仪 光学相干生物测量仪 

分 类 号：R778.1[医药卫生—眼科]