背景 Kappa角是指人眼视轴与瞳孔轴相交所成的角度,是调整角膜屈光手术的切削中心和设计斜视手术矫正量的重要参数.以往的研究表明Kappa角的大小和变化受年龄和屈光状态的影响,其检测结果也受检测仪器精度的影响. 目的 采用温州医科大学眼视光学院实验室设计的Kappa角测量仪评价正常人眼轴长度、角膜曲率、前房深度对Kappa角变化的影响,并进行权重分析.方法 采用横断面研究方法,于2009年12月至2010年8月纳入年龄18 ～38岁、平均屈光度为-1.0D的健康志愿者50人,采用温州医科大学眼视光学院实验室设计的Kappa角测量仪测量受试者双眼水平和垂直Kappa角,每个受试者测量3次移动距离,取平均值,计算水平和垂直的Kappa角.采用IOLMaster测量受试者的眼轴长度、前房深度和角膜曲率半径,采用多元线性回归模型分析眼轴长度、角膜曲率、前房深度对Kappa角变化的影响. 结果 以眼轴长度(X1)、前房深度(X2)和角膜曲率半径(X3)作为自变量、水平Kappa角(Y)作为因变量建立的有效回归方程为:Y=15.554-0.587X1 +0.724X2 +0.232X3(R=0.788,R2=0.621,P=0.000),眼轴长度与水平Kappa角呈明显负相关,差异有统计学意义(b1=-0.587,β1=-1.002,P=0.000);前房深度与水平Kappa角呈明显正相关,差异有统计学意义(b2=0.724,β2=0.296,P=0.030),角膜曲率半径与水平Kappa角无明显相关,差异无统计学意义(b3=-0.232,β3=-0.068,P=0.338),剔除角膜曲率半径变量后回归方程为:Y=14.235-0.622X1+0.824X2(R=0.786,R2=0.618,P=0.000),眼轴长度与水平Kappa角呈负相关,差异有统计学意义(b1=-0.622,β1=-1.062,P＜0.05);前房深度与水平Kappa角呈正相关,差异有统计学意义(b2=0.824,β2=0.337,P＜0.05).眼轴长度、前房深度及角膜曲率半径与垂直Kappa角的回归方程为:Y=0.492-0.020X1+0.038X2+0.089X3,该回归方程中的自变量与因变量呈弱相关(R=0.436,R2=0.191,P=0.000),3个自变量与垂直Kappa角均无明显相关,差异均无统计学意义(P＞0.05). 结论 水平Kappa角与眼轴长度呈负相关,与前房深度呈正相关,眼轴长度对水平Kappa角的影响更为明显,但眼轴长度、前房深度和角膜曲率半径对垂直Kappa角均无明显影响.
揹景 Kappa角是指人眼視軸與瞳孔軸相交所成的角度,是調整角膜屈光手術的切削中心和設計斜視手術矯正量的重要參數.以往的研究錶明Kappa角的大小和變化受年齡和屈光狀態的影響,其檢測結果也受檢測儀器精度的影響. 目的 採用溫州醫科大學眼視光學院實驗室設計的Kappa角測量儀評價正常人眼軸長度、角膜麯率、前房深度對Kappa角變化的影響,併進行權重分析.方法 採用橫斷麵研究方法,于2009年12月至2010年8月納入年齡18 ～38歲、平均屈光度為-1.0D的健康誌願者50人,採用溫州醫科大學眼視光學院實驗室設計的Kappa角測量儀測量受試者雙眼水平和垂直Kappa角,每箇受試者測量3次移動距離,取平均值,計算水平和垂直的Kappa角.採用IOLMaster測量受試者的眼軸長度、前房深度和角膜麯率半徑,採用多元線性迴歸模型分析眼軸長度、角膜麯率、前房深度對Kappa角變化的影響. 結果 以眼軸長度(X1)、前房深度(X2)和角膜麯率半徑(X3)作為自變量、水平Kappa角(Y)作為因變量建立的有效迴歸方程為:Y=15.554-0.587X1 +0.724X2 +0.232X3(R=0.788,R2=0.621,P=0.000),眼軸長度與水平Kappa角呈明顯負相關,差異有統計學意義(b1=-0.587,β1=-1.002,P=0.000);前房深度與水平Kappa角呈明顯正相關,差異有統計學意義(b2=0.724,β2=0.296,P=0.030),角膜麯率半徑與水平Kappa角無明顯相關,差異無統計學意義(b3=-0.232,β3=-0.068,P=0.338),剔除角膜麯率半徑變量後迴歸方程為:Y=14.235-0.622X1+0.824X2(R=0.786,R2=0.618,P=0.000),眼軸長度與水平Kappa角呈負相關,差異有統計學意義(b1=-0.622,β1=-1.062,P＜0.05);前房深度與水平Kappa角呈正相關,差異有統計學意義(b2=0.824,β2=0.337,P＜0.05).眼軸長度、前房深度及角膜麯率半徑與垂直Kappa角的迴歸方程為:Y=0.492-0.020X1+0.038X2+0.089X3,該迴歸方程中的自變量與因變量呈弱相關(R=0.436,R2=0.191,P=0.000),3箇自變量與垂直Kappa角均無明顯相關,差異均無統計學意義(P＞0.05). 結論 水平Kappa角與眼軸長度呈負相關,與前房深度呈正相關,眼軸長度對水平Kappa角的影響更為明顯,但眼軸長度、前房深度和角膜麯率半徑對垂直Kappa角均無明顯影響.
배경 Kappa각시지인안시축여동공축상교소성적각도,시조정각막굴광수술적절삭중심화설계사시수술교정량적중요삼수.이왕적연구표명Kappa각적대소화변화수년령화굴광상태적영향,기검측결과야수검측의기정도적영향. 목적 채용온주의과대학안시광학원실험실설계적Kappa각측량의평개정상인안축장도、각막곡솔、전방심도대Kappa각변화적영향,병진행권중분석.방법 채용횡단면연구방법,우2009년12월지2010년8월납입년령18 ～38세、평균굴광도위-1.0D적건강지원자50인,채용온주의과대학안시광학원실험실설계적Kappa각측량의측량수시자쌍안수평화수직Kappa각,매개수시자측량3차이동거리,취평균치,계산수평화수직적Kappa각.채용IOLMaster측량수시자적안축장도、전방심도화각막곡솔반경,채용다원선성회귀모형분석안축장도、각막곡솔、전방심도대Kappa각변화적영향. 결과 이안축장도(X1)、전방심도(X2)화각막곡솔반경(X3)작위자변량、수평Kappa각(Y)작위인변량건립적유효회귀방정위:Y=15.554-0.587X1 +0.724X2 +0.232X3(R=0.788,R2=0.621,P=0.000),안축장도여수평Kappa각정명현부상관,차이유통계학의의(b1=-0.587,β1=-1.002,P=0.000);전방심도여수평Kappa각정명현정상관,차이유통계학의의(b2=0.724,β2=0.296,P=0.030),각막곡솔반경여수평Kappa각무명현상관,차이무통계학의의(b3=-0.232,β3=-0.068,P=0.338),척제각막곡솔반경변량후회귀방정위:Y=14.235-0.622X1+0.824X2(R=0.786,R2=0.618,P=0.000),안축장도여수평Kappa각정부상관,차이유통계학의의(b1=-0.622,β1=-1.062,P＜0.05);전방심도여수평Kappa각정정상관,차이유통계학의의(b2=0.824,β2=0.337,P＜0.05).안축장도、전방심도급각막곡솔반경여수직Kappa각적회귀방정위:Y=0.492-0.020X1+0.038X2+0.089X3,해회귀방정중적자변량여인변량정약상관(R=0.436,R2=0.191,P=0.000),3개자변량여수직Kappa각균무명현상관,차이균무통계학의의(P＞0.05). 결론 수평Kappa각여안축장도정부상관,여전방심도정정상관,안축장도대수평Kappa각적영향경위명현,단안축장도、전방심도화각막곡솔반경대수직Kappa각균무명현영향.
Background Angle Kappa is the angle between the pupillary axis and visual axis,and it is a major consideration in corneal refractive surgery and strabismic surgery.Researches showed that age and refractive status affect angle Kappa value,and additionally,the measuring results of angle Kappa are associated with instruments.Objective This study was to investigate and weight the influences of axial length,anterior chamber depth and corneal curvature to angle Kappa.Methods A cross-sectional study was designed.Fifty health volunteers were included from Dec 2009 to Aug 2010,with the age of 18-38 years and average diopter of-1.0 D and best corrected visual acuity of 1.0.The horizontal and vertical angle Kappa was binocular measured with a testing machine designed by laboratory of School of Optometry & Ophthalmology Wenzhou Medical University.IOLMaster was employed to measure the ocular axial length,anterior chamber depth and corneal curvature radius.A multiple linear regression model was established to analyze the influences of axial length,anterior chamber depth and corneal curvature radius to angle Kappa.Results An efficacious regression equation was established as Y =15.554-0.587X1+0.724X2+ 0.232X3 with the independent variables as axial length(X1),anterior chamber depth (X2),corneal curvature (X3) and dependent variable as horizontal angle Kappa (Y) (R =0.788,R2 =0.621,P =0.000).Horizontal angle Kappa showed a negative correlation with axial length (b1 =-0.587,β1 =-1.002,P =0.000) and a positive correlation with anterior chamber depth (b2 =0.724,β32 =0.296,P =0.030).No significant correlation was found between corneal curvature radius and horizontal angle Kappa (b3 =-0.232,β3 =-0.068,P=0.338).A new regression equation was Y =14.235-0.622X1 + 0.824X2 after removed the corneal curvature variable (R =0.786,R2=0.618,P =0.000),with a negative correlation between horizontal angle Kappa and axial length (b1 =-0.622,β1 =-1.062,P＜0.05) or positive correlation between horizontal angle Kappa and the anterior chamber depth (b2 =0.824,β2 =0.337,P＜0.05).In addition,a multiple linear regression equation among 3 independent variables and dependent variable of vertical angle Kappa was Y =0.492-0.020X1 +0.038X2 +0.089X3 (R =0.436,R2 =0.191,P =0.000).However,no significant correlations were seen between vertical angle Kappa and axial length,anterior chamber depth or corneal curvature radius (all at P ＞ 0.05).Conclusions Ocular axial length and anterior chamber depth have an obvious influence to horizontal but not vertical angle Kappa.Axial length appears to have more influence to horizontal angle Kappa than anterior chamber depth.
