CAJ | 학술논문

目的分析Orbscan Ⅱ、AS-OCT和Pentacam测量术前检查患者中央角膜厚度(CCT)同超声测厚仪的差异和一致性.方法连续选取行术前检查的屈光不正患者90例(180只眼),对每位患者分别用超声测厚仪、Orbscan Ⅱ、AS-OCT和Pentacam四种仪器测量其CCT,数据统计分析采用了配对t检验、简单线性相关和Bland-Ahman分析.结果超声测厚仪、Orbscan Ⅱ、AS-OCT和Pentacam测量CCT平均值分别为(542.1±30.4)μm、(541.1±37.1)μm、(530.3±29.3)μm和(544.9±28.7)μm.超声测厚仪和Orbscan Ⅱ之间的比较没有统计学意义(P>0.05).超声测厚仪和AS-OCT、Pentacam之间的差别分别为(11.7±8.9)μm(P<0.01)、(-2.8±11.0)μm(P<0.01).线性相关显示超声测厚仪和Orbscan Ⅱ、AS-OCT、Pentacam三者间分别存在正相关(P<0.01).Bland-Altman分析显示超声测厚仪与Orbscan Ⅱ、AS-OCT、Pentacam三者间有较好的一致性,95%一致性界限分别为-37.4～+39.3μm、-5.6～+29.1μm、-24.4～+18.8μm.结论对于准分子激光术前患者角膜厚度的测量,三种方法同超声的一致性好,都可用来测量角膜厚度,其中Orbscan Ⅱ的测量值大小受其声速系数的影响、AS-OCT同超声的一致性最好、Pentacam的测量值同超声最接近.但完全替代使用还须慎重.
목적 분석Orbscan Ⅱ、AS-OCT화Pentacam측량술전검사환자중앙각막후도(CCT)동초성측후의적차이화일치성.방법 련속선취행술전검사적굴광불정환자90례(180지안),대매위환자분별용초성측후의、Orbscan Ⅱ、AS-OCT화Pentacam사충의기측량기CCT,수거통계분석채용료배대t검험、간단선성상관화Bland-Ahman분석.결과 초성측후의、Orbscan Ⅱ、AS-OCT화Pentacam측량CCT평균치분별위(542.1±30.4)μm、(541.1±37.1)μm、(530.3±29.3)μm화(544.9±28.7)μm.초성측후의화Orbscan Ⅱ지간적비교몰유통계학의의(P>0.05).초성측후의화AS-OCT、Pentacam지간적차별분별위(11.7±8.9)μm(P<0.01)、(-2.8±11.0)μm(P<0.01).선성상관현시초성측후의화Orbscan Ⅱ、AS-OCT、Pentacam삼자간분별존재정상관(P<0.01).Bland-Altman분석현시초성측후의여Orbscan Ⅱ、AS-OCT、Pentacam삼자간유교호적일치성,95%일치성계한분별위-37.4～+39.3μm、-5.6～+29.1μm、-24.4～+18.8μm.결론 대우준분자격광술전환자각막후도적측량,삼충방법동초성적일치성호,도가용래측량각막후도,기중Orbscan Ⅱ적측량치대소수기성속계수적영향、AS-OCT동초성적일치성최호、Pentacam적측량치동초성최접근.단완전체대사용환수신중.
Objective To analyze the difference and the agreement in central corneal thickness(CCT) measurements between the gold standard method of ultrasound pachymetry and 3 noncontact systems(Orbscan Ⅱ, AS-OCT, Pentacam)in ametropia eyes before laser refractive surgery.Methods Ninety consecutive patients(180 eyes)who had preoperative examination in Laser Refractive Surgery Center had Orbscan Ⅱ, AS-OCT, Pentacam, and ultrasound pachymetry.Data were analyzed using the paired sample t test, linear regression, and Bland-Altman plots.Results The mean CCT measured by ultrasound,OrbscanⅡ,Pentacam,and AS-OCT pacbymetry were,respectively,(542.1 ±30.4)μ m、(541.1±37.1)μ m、(530.3±29.3)μ m and(544.9±8.7)μ m.There was no statistically significant difference between ultrasound and OrbscanⅡ measurements(P>0.05).Compared with the ultrasound measurement,AS-OCT and Pentacam measurements significantly misestimate corneal thickness by a mean of(11.7±8.9)μ m(P <0.01)and(-2.8±1.0)μ m(P <0.01),re-spectively.OrbscanⅡ, AS-OCT, Pentacam pachymetry showed a high correlation with ultrasound pachymetry. Tbe95%limitsofagreement(LoA)withultrasoundwere-37.4～+39.3 μ m for the OrbscanⅡdevice and-5.6～+29.1 μ m for the AS-OCT device and -24.4～+18.8 μ m for the Pentacam device.Conclusions OrbscanⅡ,AS-OCT and Pentacam pacbymetry can be used to measure central corneal thickness.Compared with the ultrasound pachymetry, OrbscanⅡ pachymetry was effectd by it's AF, AS-OCT pachymetry had the best agreement, Penta-cam pacbymetry had the nearest CCT.However it is cautious to use the 4 devices interchangeably.