CAJ | 학술논문

目的探讨Sirius三维角膜地形图及眼前节分析仪测量前弹力层下准分子激光原位角膜磨镶术(SBK)术前及术后患者中央角膜厚度(CCT)的重复性,以及其与A超角膜测厚仪测量结果的一致性和差异性.方法临床病例回顾性研究.收集2011年5月至11月于重庆明达眼科门诊接受SBK手术的近视患者35例(68只眼),回顾性分析术前及术后2周、1月、3月Sirius和A超测量的CCT值,采用组内相关系数(ICC)评价Sirius测量值的重复性,配对资料t检验评价两种方法所测得角膜厚度的差异性,Bland-Altman法检验其一致性,Pearson直线相关分析检验其相关性,重复测量的方差分析比较术前与术后CCT的变化情况.结果 Sirius的测量结果稳定,重复性好,SBK术前、术后2周、1月、3月测量CCT的组内相关系数(ICC)分别为0.988、0.993、0.992、0.996.Sirius与A超具有较好的一致性,95％的一致性界限术前、术后2周、1月、3月分别为-14.04～+11.20 μm、-21.10～+5.16 μm、-28.00～+10.76 μm、-27.18～+12.30 μm.Sirius与A超的测量值具有显著的正相关性,术前、术后2周、1月、3月CCT的相关系数r分别为0.970、0.987、0.980、0.978.术前CCT的测量值Sirius为(541.45±25.78)μm,A超为(542.87±23.41) μm,两者测量结果差异无统计学意义(P＞0.05)；术后2周、1月、3月Sirius的CCT测量值分别为(428.29±43.30) μm、(430.02±45.71) μm、(435.73 ±46.10)μm,A超的CCT测量值分别为(436.26±41.61) μm、(438.65±41.14)μm、(443.16±42.91) μm,Sirius测得的值均小于A超,两者差异均有统计学意义(P＜0.01).结论 Sirius测量SBK术前及术后中央角膜厚度具有很好的重复性,与A超角膜测厚仪之间具有较好的一致性和显著的正相关性,但术后两者测量值存在一定的差异性.
목적 탐토Sirius삼유각막지형도급안전절분석의측량전탄력층하준분자격광원위각막마양술(SBK)술전급술후환자중앙각막후도(CCT)적중복성,이급기여A초각막측후의측량결과적일치성화차이성.방법 림상병례회고성연구.수집2011년5월지11월우중경명체안과문진접수SBK수술적근시환자35례(68지안),회고성분석술전급술후2주、1월、3월Sirius화A초측량적CCT치,채용조내상관계수(ICC)평개Sirius측량치적중복성,배대자료t검험평개량충방법소측득각막후도적차이성,Bland-Altman법검험기일치성,Pearson직선상관분석검험기상관성,중복측량적방차분석비교술전여술후CCT적변화정황.결과 Sirius적측량결과은정,중복성호,SBK술전、술후2주、1월、3월측량CCT적조내상관계수(ICC)분별위0.988、0.993、0.992、0.996.Sirius여A초구유교호적일치성,95％적일치성계한술전、술후2주、1월、3월분별위-14.04～+11.20 μm、-21.10～+5.16 μm、-28.00～+10.76 μm、-27.18～+12.30 μm.Sirius여A초적측량치구유현저적정상관성,술전、술후2주、1월、3월CCT적상관계수r분별위0.970、0.987、0.980、0.978.술전CCT적측량치Sirius위(541.45±25.78)μm,A초위(542.87±23.41) μm,량자측량결과차이무통계학의의(P＞0.05)；술후2주、1월、3월Sirius적CCT측량치분별위(428.29±43.30) μm、(430.02±45.71) μm、(435.73 ±46.10)μm,A초적CCT측량치분별위(436.26±41.61) μm、(438.65±41.14)μm、(443.16±42.91) μm,Sirius측득적치균소우A초,량자차이균유통계학의의(P＜0.01).결론 Sirius측량SBK술전급술후중앙각막후도구유흔호적중복성,여A초각막측후의지간구유교호적일치성화현저적정상관성,단술후량자측량치존재일정적차이성.
Objective To assess the repeatability of central comeal thickness (CCT) performed by Sirius before and after SBK,and to compare the agreement and differentiation of the Sirius with ultrasound pachymetry in the measurements of CCT.Methods Retrospective case series.Sixty eight myopic eyes of 35 consecutive patients in Chongqing Medal Eye Institute from May to Novenber 2011 were enrolled in this study.Central corneal thicknesses were examined using Sirius and ultrasound pachymetry preoperatively and at two weeks,one month,three months postoperatively.The data were analyzed using intraclass correlation coefficient (ICC),paired t tests,the correlation coefficient,the Bland-Altman technique and repeated measures analysis of variance.Results The ICC of the Sirius were 0.988 (pre-op),0.993 (2 w),0.992 (1 mo),0.996 (3 mo),respectively.The 95％ limits of agreement in CCT were-14.04 to 11.20μm (pre-op),-21.10 to 5.16μm (2 w),-28.00 to 10.76μ m (1 mo),-27.18 to 12.30μm (3 mo),respectively.The CCT values of the Sirius and ultrasound pachymetry were positively related by linear correlation analysis,r =0.970 (pre-op),0.987 (2 w),0.980 (1 mo),0.978 (3 mo).The preoperative CCT measurements by Sirius and ultrasound pachymetry were (mean ± standard deviation) (541.45±25.78)μm,(542.87±23.41)μm,respectively.Preoperative Sirius was not significantly different compared to ultrasound pachymetry (P ＞0.05).Postoperative Sirius measurements were (428.29±43.30)μm (2 w),(430.02±45.71)μm (1 mo),(435.73±46.10)μm (3mo),respectively.Ultrasound pachymetry measurements were (436.26±41.61)μm (2 w),(438.65±41.14)μm (1 mo),(443.16±42.91)μm (3 mo),respectively.Postoperative measurements were significant difference between Sirius and ultrasound pachymetry (P ＜0.01).Conclusions The measurements of CCT with Sirius yield excellent repeatability.There is great agreement and positive correlation between Sirius and ultrasound pachymetry.But postoperative Sirius measurements are significantly thinner than ultrasound pachymetry measurements.