中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2014年
4期
450-455
,共6页
王科华%王建洲%蒋剑%江海波%夏晓波
王科華%王建洲%蔣劍%江海波%夏曉波
왕과화%왕건주%장검%강해파%하효파
超声乳化白内障吸除术/方法%晶体,人工%角膜地形图%白内障/治疗
超聲乳化白內障吸除術/方法%晶體,人工%角膜地形圖%白內障/治療
초성유화백내장흡제술/방법%정체,인공%각막지형도%백내장/치료
Phacoemulsification/methods%Lenses,intraocular%Corneal topography%Cataract/therapy
目的：通过对比光学相干生物测量仪（IOL Master）与A超联合角膜地形图测量人工晶体度数的精确性，探讨两种测量方法在临床应用中的差异。方法选取2010年3月至2011年9月中南大学湘雅医院眼科行白内障超声乳化吸取联合人工晶体（IOL）植入术的白内障患者60例（84眼），其中年龄相关性白内障42例（57眼），并发性白内障18例（27眼），分为IOL Master组和A超联合角膜地形图测量组。术前IOL Master组使用IOL Master测量眼轴长度和角膜曲率，采用Haigis、SRK/T等公式计算IOL度数，同时使用A超联合角膜地形图测量眼轴长度和角膜曲率，采用SRK/Ⅱ公式计算IOL度数；术前A超联合角膜地形图测量组使用A超联合角膜地形图测量眼轴长度和角膜曲率，采用SRK/Ⅱ公式计算IOL度数。术后3个月复查两组患者的屈光状态，计算绝对屈光误差（MAE），并对以上结果进行统计学分析。结果⑴IOL Master组，术前IOL Master和A超测得的眼轴长度比较差异无统计学意义（ P ＞0.05），但是在眼轴长度＞26 mm患者中，两种检查方法检测眼轴长度[（28.53±0.57）mm vs （29.42±0.64）mm]比较差异有统计学意义（ P ＜0.05）；IOL Master和角膜地形图测得的角膜曲率[（42.12±0.31）D vs （43.09±0.27）D]比较差异有统计学意义（ P ＜0.01）；IOL Master和A超联合角膜地形图测量计算的IOL度数平均值[（17.06±0.48）D vs （16.37±0.56）D]比较差异有统计学意义（ P ＜0.05）。⑵术后3个月IOL Master组和A超联合角膜地形图测量组的MAE[（0.07±1.05）D vs （0.16±0.81）D]比较差异有统计学意义（ P ＜0.05）。结论在正常眼轴白内障患者，IOL Master与A超联合角膜地形图对于眼轴测量及IOL度数测算具有高度一致性，但在高度近视白内障患者，IOL Master对于眼轴测量及IOL度数测算精确性更高。
目的：通過對比光學相榦生物測量儀（IOL Master）與A超聯閤角膜地形圖測量人工晶體度數的精確性，探討兩種測量方法在臨床應用中的差異。方法選取2010年3月至2011年9月中南大學湘雅醫院眼科行白內障超聲乳化吸取聯閤人工晶體（IOL）植入術的白內障患者60例（84眼），其中年齡相關性白內障42例（57眼），併髮性白內障18例（27眼），分為IOL Master組和A超聯閤角膜地形圖測量組。術前IOL Master組使用IOL Master測量眼軸長度和角膜麯率，採用Haigis、SRK/T等公式計算IOL度數，同時使用A超聯閤角膜地形圖測量眼軸長度和角膜麯率，採用SRK/Ⅱ公式計算IOL度數；術前A超聯閤角膜地形圖測量組使用A超聯閤角膜地形圖測量眼軸長度和角膜麯率，採用SRK/Ⅱ公式計算IOL度數。術後3箇月複查兩組患者的屈光狀態，計算絕對屈光誤差（MAE），併對以上結果進行統計學分析。結果⑴IOL Master組，術前IOL Master和A超測得的眼軸長度比較差異無統計學意義（ P ＞0.05），但是在眼軸長度＞26 mm患者中，兩種檢查方法檢測眼軸長度[（28.53±0.57）mm vs （29.42±0.64）mm]比較差異有統計學意義（ P ＜0.05）；IOL Master和角膜地形圖測得的角膜麯率[（42.12±0.31）D vs （43.09±0.27）D]比較差異有統計學意義（ P ＜0.01）；IOL Master和A超聯閤角膜地形圖測量計算的IOL度數平均值[（17.06±0.48）D vs （16.37±0.56）D]比較差異有統計學意義（ P ＜0.05）。⑵術後3箇月IOL Master組和A超聯閤角膜地形圖測量組的MAE[（0.07±1.05）D vs （0.16±0.81）D]比較差異有統計學意義（ P ＜0.05）。結論在正常眼軸白內障患者，IOL Master與A超聯閤角膜地形圖對于眼軸測量及IOL度數測算具有高度一緻性，但在高度近視白內障患者，IOL Master對于眼軸測量及IOL度數測算精確性更高。
목적：통과대비광학상간생물측량의（IOL Master）여A초연합각막지형도측량인공정체도수적정학성，탐토량충측량방법재림상응용중적차이。방법선취2010년3월지2011년9월중남대학상아의원안과행백내장초성유화흡취연합인공정체（IOL）식입술적백내장환자60례（84안），기중년령상관성백내장42례（57안），병발성백내장18례（27안），분위IOL Master조화A초연합각막지형도측량조。술전IOL Master조사용IOL Master측량안축장도화각막곡솔，채용Haigis、SRK/T등공식계산IOL도수，동시사용A초연합각막지형도측량안축장도화각막곡솔，채용SRK/Ⅱ공식계산IOL도수；술전A초연합각막지형도측량조사용A초연합각막지형도측량안축장도화각막곡솔，채용SRK/Ⅱ공식계산IOL도수。술후3개월복사량조환자적굴광상태，계산절대굴광오차（MAE），병대이상결과진행통계학분석。결과⑴IOL Master조，술전IOL Master화A초측득적안축장도비교차이무통계학의의（ P ＞0.05），단시재안축장도＞26 mm환자중，량충검사방법검측안축장도[（28.53±0.57）mm vs （29.42±0.64）mm]비교차이유통계학의의（ P ＜0.05）；IOL Master화각막지형도측득적각막곡솔[（42.12±0.31）D vs （43.09±0.27）D]비교차이유통계학의의（ P ＜0.01）；IOL Master화A초연합각막지형도측량계산적IOL도수평균치[（17.06±0.48）D vs （16.37±0.56）D]비교차이유통계학의의（ P ＜0.05）。⑵술후3개월IOL Master조화A초연합각막지형도측량조적MAE[（0.07±1.05）D vs （0.16±0.81）D]비교차이유통계학의의（ P ＜0.05）。결론재정상안축백내장환자，IOL Master여A초연합각막지형도대우안축측량급IOL도수측산구유고도일치성，단재고도근시백내장환자，IOL Master대우안축측량급IOL도수측산정학성경고。
Objective To investigate the difference of IOL Master and A-ultrasound combined with corneal topography meas-urement in intraocular lens ( IOL) power calculation .Methods A total of 84 eyes of 60 cataract patients received phacoemulsification and intraocular lens implantation surgery were selected in Xiangya Hospital from March 2010 to September 2011.There were 57 eyes of 42 age-related cataract patients and 27 eyes of 18 complicated cataract patients .The patients were divided into IOL Master group and A ultrasound combined with corneal topography measurement group .Before surgery , in IOL Master group , axial length ( AL) and corneal curvature were measured with IOL Master , IOL power was calculated according to the Haigis , SRK/T formula and so on.At the same time the axial length ( AL) and corneal curvature were measured with A ultrasound combined with corneal topography respectively and IOL power was calculated by SRK/Ⅱ formula.In A ultrasound combined with corneal topography measurement group , axial length ( AL) and corneal curvature were measured with A ultrasound combined with corneal topography respectively , IOL power was calculat-ed according to the SRK/Ⅱformula.3 months postoperatively , all the patients were conducted refractive outcome and calculating mean absolute refractive error(MAE).Finally the data were analysed.Results ⑴In IOL Master group, before operation there was no sig-nificant difference in mean axial length between IOL Master and A-ultrasound measurement ( P >0.05 ) , while in the patients with AL>26 mm the axial length was (28.53 ±0.57)mm and (29.42 ±0.64)mm using IOL Master and A-ultrasound measurement respec-tively ( P <0.05).The mean corneal curvature was (42.12 ±0.31)D and (43.09 ±0.27)D using IOL Master and corneal topogra-phy measurement respectively ( P <0.01).The mean IOL power were (17.06 ±0.48)D and (16.37 ±0.56)D in IOL Master group and A ultrasound combined with corneal topography measurement group respectively ( P <0.05 ) .⑵3 months postoperatively , the MAE was (0.07 ±1.05)D and (0.16 ±0.81)D in IOL Master group and A-ultrasound combined with corneal topography measure-ment group( P <0.05) respectively.Conclusions In cataract patients with normal axial length , IOL Master and A-ultrasound com-bined with corneal topography have high consistency for axial length measurement and IOL power calculation .But in cataract patients with high myopia , IOL Master is more accurate for axial length measurement and IOL power calculation compared to A -ultrasound com-bined with corneal topography .
