CAJ | 학술논문

目的探讨Orbscan-Ⅱ、Pentacam及超声角膜测厚仪三种仪器测量角膜中央厚度的差异及其临床意义.方法对预行准分子激光角膜手术的近视患者159例(318眼),采用Orbscan-Ⅱ、Pentacam及超声角膜测厚仪三种仪器测量角膜中央厚度,并对测量结果进行统计学分析.再根据超声角膜测厚仪所测得的角膜厚度进一步将患者分为三组(<500 μm组、500～570 μm组和≥570μm组),在每个组中对三种方法所测得的结果进行统计学分析.结果 Orbscan-Ⅱ、Pentacam、超声角膜测厚仪测得的角膜中央厚度平均值分别为(527.9±43.0)μm、(526.3±38.4)μm、(522.6±37.8)μm.经方差分析,三者差异无统计学意义(F=1.491,P=0.226).分组后,角膜厚度<500μm和500～570 μm组,三种方法所得数据差异无统计学意义(F=1.546,P=0.215;F=-2.107,P=0.123);而≥570μm组,三种方法测量结果差异存在统计学意义(F=5.396,P=0.006),进一步采用Bonferroni检验分析组间差异,Orbcan-Ⅱ组测量值明显高于Pentacam组(P=0.029)和超声测厚仪组(P=0.010),Pentacam组和超声测厚仪组之间无差异(P>0.05).结论三种方法用于测量准分子激光角膜手术前近视患者的角膜中央厚度时虽然存在一定差异,但总体上无统计学意义,具有很好的协同性,但相互间还不能完全替代.
목적 탐토Orbscan-Ⅱ、Pentacam급초성각막측후의삼충의기측량각막중앙후도적차이급기림상의의.방법 대예행준분자격광각막수술적근시환자159례(318안),채용Orbscan-Ⅱ、Pentacam급초성각막측후의삼충의기측량각막중앙후도,병대측량결과진행통계학분석.재근거초성각막측후의소측득적각막후도진일보장환자분위삼조(<500 μm조、500～570 μm조화≥570μm조),재매개조중대삼충방법소측득적결과진행통계학분석.결과 Orbscan-Ⅱ、Pentacam、초성각막측후의측득적각막중앙후도평균치분별위(527.9±43.0)μm、(526.3±38.4)μm、(522.6±37.8)μm.경방차분석,삼자차이무통계학의의(F=1.491,P=0.226).분조후,각막후도<500μm화500～570 μm조,삼충방법소득수거차이무통계학의의(F=1.546,P=0.215;F=-2.107,P=0.123);이≥570μm조,삼충방법측량결과차이존재통계학의의(F=5.396,P=0.006),진일보채용Bonferroni검험분석조간차이,Orbcan-Ⅱ조측량치명현고우Pentacam조(P=0.029)화초성측후의조(P=0.010),Pentacam조화초성측후의조지간무차이(P>0.05).결론 삼충방법용우측량준분자격광각막수술전근시환자적각막중앙후도시수연존재일정차이,단총체상무통계학의의,구유흔호적협동성,단상호간환불능완전체대.
Objective To assess the reliability of Orbscan-Ⅱ , Pentacam and ultrasonic pachymetry (US) for central corneal thickness (CCT) measurements. Methods Central corneal thick- ness was measured using Orbscan-Ⅱ, Pentacam and ultrasonic pachymetry in 159 preoperative cases (318 eyes). Patients were further divided into three groups according to corneal thickness (<500 μm group, 500～570 μm group and ≥570 μm group) as determined by ultrasonic pachymetry and the differences in the measurements obtained by all three methods were statistically analyzed for the three groups. Results The mean CCT readings with Orbscan-Ⅱ, Pentacam, and ultrasonic pachymetry were (527.9±43.0)μm, (526.3±38.4)μm, and (522.6±37.8)μm, respectively. No statistically significance differences were found among the three instruments (F=1.491, P=0.226) using analysis of variance. After the patients were divided into three groups based on the ultrasonic pachymetry measurements, the results showed that there was no statistically significant difference in measurements by the three instruments for the <500 μm group and the 500～570 μm group (F=1.546, P=0.215;F=2.107, P= 0.123), while there was a significant difference for the ≥570 μm group (F=5.396, P=0.006). Differ-ences among the groups using Bonferroni tests show that central corneal thickness (CCT) measured with Orbcan-Ⅱ was significantly thicker than that obtained with the Pentacam (P=0.029) and ultra-sonic pachymetry (P=0.010). No statistically significant difference was found between measurements with Pentacam and ultrasonic pachymetry. Conclusion There are some differences in the three meth-ods used to measure the CCT of patients before excimer laser myopic surgery, but overall there was no statistically significant difference, and the methods could be concordant in clinics. However, the three instruments still cannot completely replace one other.