中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2011年
9期
834-838
,共5页
彭海鹰%庞辰久%魏秋彩%杜连心%孔众%王丽娅
彭海鷹%龐辰久%魏鞦綵%杜連心%孔衆%王麗婭
팽해응%방신구%위추채%두련심%공음%왕려아
准分子激光角膜原位磨镶术%光学相干生物测量仪%OrbscanⅡ%A型超声%角膜曲率%前房深度%眼轴
準分子激光角膜原位磨鑲術%光學相榦生物測量儀%OrbscanⅡ%A型超聲%角膜麯率%前房深度%眼軸
준분자격광각막원위마양술%광학상간생물측량의%OrbscanⅡ%A형초성%각막곡솔%전방심도%안축
Laser in situ keratomileusis%IOLMaster%Orbscan Ⅱ%A-ultrasound%Keratometry%Anterior chamber depth%Axial length
背景 角膜曲率、前房深度、眼轴长度的精确测量对人工晶状体(IOL)度数的计算至关重要，不同方法的测量结果可能对IOL度数的计算结果产生误差。 目的 比较光学相干生物测量仪( IOLMaster)、OrbscanⅡ眼前节分析仪(OrbscanⅡ)以及A型超声法测量近视患者准分子激光角膜原位磨镶术( LASIK)手术前后角膜曲率(K)、前房深度以及眼轴长度的结果。方法 收集近视患者65例130眼，对LASIK手术前及手术后1个月随访到的28例56眼分别行IOLMaster、OrbscanⅡ以及A型超声法眼部生物测量，并对其结果进行比较。结果 LASIK手术前，IOLMaster和OrbscanⅡ测量角膜K值分别为(43.32±1.52)D和(42.99±1.45)D，二者相差(0.33±0.03)D，差异有统计学意义(t=10.380,P=0.000)。手术后K值分别为(39.02±2.14)D和(38.91 ±2.04)D，二者相差(0.12±0.33)D，差异有统计学意义(t=2.715,P=0.009)。Bland-Altman分析显示，2种方法测量K值的一致性较差。手术前I0LMaster、OrbscanⅡ和A型超声法测得前房深度分别为(3.72±0.22)、(3.69±0.22)、(3.75±0.27)mm，差异无统计学意义(P=0.100)。A型超声法测量眼轴长度为(25.22±0.99)mm，IOLMaster测得长度为(25.59±1.01 )mm，二者相差(-0.37±0.30)mm，差异有统计学意义(t=-14.098,P=0.000)，Pearson相关性分析显示二者呈正相关(r=0.954,P=0.000)。手术前后IOLMaster测量眼轴长度分别为(25.54±1.05 )mm和(25.48±1.01)mm，二者相差(0.052±0.412 )mm，差异无统计学意义(t=0.946,P=0.348)。结论IOLMaster测量角膜曲率与OrbscanⅡ测量结果差别较大，临床上二者不可替代。IOLMaster与OrbscanⅡ测量前房深度结果一致性较好，临床上可替代使用。与A型超声法比较，IOLMaster测得的眼轴长度较长，临床应用要引起注意。
揹景 角膜麯率、前房深度、眼軸長度的精確測量對人工晶狀體(IOL)度數的計算至關重要，不同方法的測量結果可能對IOL度數的計算結果產生誤差。 目的 比較光學相榦生物測量儀( IOLMaster)、OrbscanⅡ眼前節分析儀(OrbscanⅡ)以及A型超聲法測量近視患者準分子激光角膜原位磨鑲術( LASIK)手術前後角膜麯率(K)、前房深度以及眼軸長度的結果。方法 收集近視患者65例130眼，對LASIK手術前及手術後1箇月隨訪到的28例56眼分彆行IOLMaster、OrbscanⅡ以及A型超聲法眼部生物測量，併對其結果進行比較。結果 LASIK手術前，IOLMaster和OrbscanⅡ測量角膜K值分彆為(43.32±1.52)D和(42.99±1.45)D，二者相差(0.33±0.03)D，差異有統計學意義(t=10.380,P=0.000)。手術後K值分彆為(39.02±2.14)D和(38.91 ±2.04)D，二者相差(0.12±0.33)D，差異有統計學意義(t=2.715,P=0.009)。Bland-Altman分析顯示，2種方法測量K值的一緻性較差。手術前I0LMaster、OrbscanⅡ和A型超聲法測得前房深度分彆為(3.72±0.22)、(3.69±0.22)、(3.75±0.27)mm，差異無統計學意義(P=0.100)。A型超聲法測量眼軸長度為(25.22±0.99)mm，IOLMaster測得長度為(25.59±1.01 )mm，二者相差(-0.37±0.30)mm，差異有統計學意義(t=-14.098,P=0.000)，Pearson相關性分析顯示二者呈正相關(r=0.954,P=0.000)。手術前後IOLMaster測量眼軸長度分彆為(25.54±1.05 )mm和(25.48±1.01)mm，二者相差(0.052±0.412 )mm，差異無統計學意義(t=0.946,P=0.348)。結論IOLMaster測量角膜麯率與OrbscanⅡ測量結果差彆較大，臨床上二者不可替代。IOLMaster與OrbscanⅡ測量前房深度結果一緻性較好，臨床上可替代使用。與A型超聲法比較，IOLMaster測得的眼軸長度較長，臨床應用要引起註意。
배경 각막곡솔、전방심도、안축장도적정학측량대인공정상체(IOL)도수적계산지관중요，불동방법적측량결과가능대IOL도수적계산결과산생오차。 목적 비교광학상간생물측량의( IOLMaster)、OrbscanⅡ안전절분석의(OrbscanⅡ)이급A형초성법측량근시환자준분자격광각막원위마양술( LASIK)수술전후각막곡솔(K)、전방심도이급안축장도적결과。방법 수집근시환자65례130안，대LASIK수술전급수술후1개월수방도적28례56안분별행IOLMaster、OrbscanⅡ이급A형초성법안부생물측량，병대기결과진행비교。결과 LASIK수술전，IOLMaster화OrbscanⅡ측량각막K치분별위(43.32±1.52)D화(42.99±1.45)D，이자상차(0.33±0.03)D，차이유통계학의의(t=10.380,P=0.000)。수술후K치분별위(39.02±2.14)D화(38.91 ±2.04)D，이자상차(0.12±0.33)D，차이유통계학의의(t=2.715,P=0.009)。Bland-Altman분석현시，2충방법측량K치적일치성교차。수술전I0LMaster、OrbscanⅡ화A형초성법측득전방심도분별위(3.72±0.22)、(3.69±0.22)、(3.75±0.27)mm，차이무통계학의의(P=0.100)。A형초성법측량안축장도위(25.22±0.99)mm，IOLMaster측득장도위(25.59±1.01 )mm，이자상차(-0.37±0.30)mm，차이유통계학의의(t=-14.098,P=0.000)，Pearson상관성분석현시이자정정상관(r=0.954,P=0.000)。수술전후IOLMaster측량안축장도분별위(25.54±1.05 )mm화(25.48±1.01)mm，이자상차(0.052±0.412 )mm，차이무통계학의의(t=0.946,P=0.348)。결론IOLMaster측량각막곡솔여OrbscanⅡ측량결과차별교대，림상상이자불가체대。IOLMaster여OrbscanⅡ측량전방심도결과일치성교호，림상상가체대사용。여A형초성법비교，IOLMaster측득적안축장도교장，림상응용요인기주의。
Background It is important to measure the corneal curvature, anterior chamber depth (ACD) and axial length accurately for calculating IOL power. The interchange outcomes from different measuring methods and apparatus will cause unreliable IOL power. Objective The present study was to compare the differences of corneal curvature, anterior chamber depth (ACD) measured by IOLMaster and Orbscan Ⅱ before and after laser in situ keratomileusis(LASIK) and further compare the axial length measured by IOLMaster and A-ultrasound. Methods One hundred and thirty eyes from 65 consecutive myopic patients before LASIK and 56 eyes of 28 cases with 1-month follow-up duration after LASIK in Henan Eye Institute were enrolled in this study. The K value, ACD between IOLMaster and Orbscan Ⅱ as well as results of axial length between IOLMaster and A-ultrasound were compared by using paired t test. The agreements of the measured values among IOLMaster, Orbscan Ⅱ and A-ultrasound were evaluated using Bland-Altman plot. Results Before LASIK,the K value measured by IOLMaster,Orbscan Ⅱ were ( 43.32 ± 1.52 ) D and ( 42.99 ± 1.45 ) D respectively with the difference value of( 0. 33 ±0. 03 ) D, showing a significant difference(t=10. 380,P=0.000) and a positive relation between them(r=0.971,P=0.000). After LASIK,the K value measured by IOLMaster, Orbscan Ⅱ were(39. 02±2. 14) D and ( 38.91 ±2. 04) D with the difference value (0. 12±0. 33 ) D, presenting a significant differences between them (t =2.715, P =0.009). Bland-Altman plots indicated the disagreement in K value and uninterchangeable. Before LASIK, the ACD measured by IOLMaster,Orbscan Ⅱ and A-ultrasound were ( 3.72 ± 0. 22 ) mm, ( 3.69 ±0. 22 ) mm and ( 3.75± 0.27 )mm respectively and no significant differences were found between them (P ＞ 0. 05 ). Axial length measured by IOLMaster significantly prolonged in comparison with A-ultrasound(25.59± 1. 01 mm vs 25.22±0.99 mm ) , and the difference was( -0. 37 ±0. 30 ) mm, showing significant difference ( t =- 14. 098, P =0. 000 ) and positive correlation ( r =0. 954, P =0. 000 ). Axial length values measured by IOLMaster were ( 25.54 ± 1.05 ) mm in preoperation and ( 25.48 ± 1.01 ) mm in postoperation with the difference (0.052±0. 412)mm, showing statistically insignificant difference between them (t=0. 946,P=0. 348). Conclusions Keratometries measured by IOLMaster,Orbscan Ⅱ are much more different. Therefore,these two methods are not recommended to use interchangely. ACD measured by IOLMaster,Orbscan Ⅱ and A ultrasound are proved to obtain the similar results and is clinically interchange. Axial length measured by IOLMaster is longer than that measured by A-ultrasound.
