Pentacam与IOL Master测量角膜屈光力的比较
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摘要
目的:比较Scheimpflug原理摄像系统Pentacam与光学相干生物测量仪IOL Master测量角膜正常的白内障患者角膜屈光力,分析两者的一致性。方法:前瞻性临床研究。选取我院2017-01/06门诊就诊的角膜正常的白内障患者41例64眼,术前分别采用IOL Master和Pentacam测量角膜屈光力,采集的数据包括:sim K、true net power、角膜中央1.0～7.0mm直径Holladay equivalent K(EKR)(Pentacam)及Km[Km=(K1+K2)/2](IOL Master)。两种仪器测量K值之间的差异采用配对样本t检验,其相关性采用Pearson相关性分析,一致性采用Bland-Altman法。结果:角膜正常的白内障患者Pentacam测量所得true net power、角膜中央1.0、2.0、3.0mm直径EKR比IOL Master测量所得Km小;角膜中央4.5、5.0、6.0、7.0mm直径EKR比IOL Master测量所得Km大,差异具有统计学意义(均P <0. 01)。Pentacam测量所得sim K、角膜中央4. 0mm直径EKR与IOL Master测量所得Km差值最小,差值均值分别为-0.03±0.252和0.04±0.244D,差异无统计学意义(t=-1.018,P=0.313; t=1.461,P=0.149);且一致性最高,95%一致性界限分别为-0.53～0.46D和-0.43～0.52D。两种仪器间所测量K值均具有较高的相关性(均r>0. 9,P<0. 01)。结论:角膜正常的白内障患者Pentacam测量所得sim K、角膜中央4.0mm直径EKR与IOL Master测量所得Km一致性最高,但使用中需结合临床意义进一步对仪器的适用范围加以判断。
AIM: To evaluate the agreement and interchangeability of a Scheimpflug camera( Pentacam) and a partial coherence interferometry keratometer( IOL Master) in eyes having preoperative assessment for routine cataract surgery.METHODS: In this prospective clinical study,41 patients( 64 eyes) with normal cornea from January 2017 to June 2017 in our hospital were enrolled. Simulated K,true net power and Holladay equivalent K( EKR) measured at 1. 0 to 7. 0 mm corneal diameters were measured by the Pentacam system and mean keratometer( Km)was measured by the IOL Master. Paired samples t test,Pearson correlation analysis and Bland-Altman method were used for statistical analysis.RESULTS: Among patients with cataract of normal cornea,the mean Scheimpflug K for true net power and EKR at 1.0 mm,2.0 mm,3.0 mm corneal diameters were statistically significantly less than the mean Km( IOL Master). The EKR at 4. 5 mm,5. 0 mm,6. 0 mm,7. 0 mm of corneal diameters were significantly greater than the mean Km( IOL Master)( P<0.01 for all). The difference between Sim K and EKR at 4.0 mm measured by Pentacam and Km measured by IOL Master was the smallest(-0.03 D± 0. 252 D and 0. 04 D ± 0. 244 D,respectively; t =-1. 018,P = 0. 313; t = 1. 461,P = 0. 149),and it had the best uniformity with 95% credible interval of-0. 53 D to 0.46 D( sim K) and-0. 43 D to 0. 52 D( equivalent K at 4. 0 mm). A Pearson correlation revealed a high correlation for corneal power measurements between the two devices( r > 0.9 for all,P < 0. 01 for all).CONCLUSION: The sim K and EKR at 4.0 mm had the closest match with the Km( IOL Master) for Chinese patients with cataract of normal cornea. However,the application of these devices should be combined with clinical features.
AIM: To evaluate the agreement and interchangeability of a Scheimpflug camera( Pentacam) and a partial coherence interferometry keratometer( IOL Master) in eyes having preoperative assessment for routine cataract surgery.METHODS: In this prospective clinical study,41 patients( 64 eyes) with normal cornea from January 2017 to June 2017 in our hospital were enrolled. Simulated K,true net power and Holladay equivalent K( EKR) measured at 1. 0 to 7. 0 mm corneal diameters were measured by the Pentacam system and mean keratometer( Km)was measured by the IOL Master. Paired samples t test,Pearson correlation analysis and Bland-Altman method were used for statistical analysis.RESULTS: Among patients with cataract of normal cornea,the mean Scheimpflug K for true net power and EKR at 1.0 mm,2.0 mm,3.0 mm corneal diameters were statistically significantly less than the mean Km( IOL Master). The EKR at 4. 5 mm,5. 0 mm,6. 0 mm,7. 0 mm of corneal diameters were significantly greater than the mean Km( IOL Master)( P<0.01 for all). The difference between Sim K and EKR at 4.0 mm measured by Pentacam and Km measured by IOL Master was the smallest(-0.03 D± 0. 252 D and 0. 04 D ± 0. 244 D,respectively; t =-1. 018,P = 0. 313; t = 1. 461,P = 0. 149),and it had the best uniformity with 95% credible interval of-0. 53 D to 0.46 D( sim K) and-0. 43 D to 0. 52 D( equivalent K at 4. 0 mm). A Pearson correlation revealed a high correlation for corneal power measurements between the two devices( r > 0.9 for all,P < 0. 01 for all).CONCLUSION: The sim K and EKR at 4.0 mm had the closest match with the Km( IOL Master) for Chinese patients with cataract of normal cornea. However,the application of these devices should be combined with clinical features.
引文
1 Lee AC,Qazi MA,Pepose JS.Biometry and intraocular lens power calculation.Curr Opin Ophthalmol 2008;19(1):13-17
2 Olsen T.Calculation of intraocular lens power:a review.Acta Ophthalmol Scand 2007;85(5):472-485
3 Vogel A,Dick HB,Krummenauer F.Reproducibility of optical biometry using partial coherence interferometry Intraobserver and interobserver reliability.J Cataract Refract Surg 2001;27(12):1961-1968
4 Seitz B,Langenbucher A,Nguyen NX,et al.Underestimation of intraocular lens power for cataract surgery after myopic photorefractive keratectomy.Ophthalmology 1999;106(4):693-702
5 Gimbel H,Sun R.Accuracy and predictability of intraocular lens power calculation after laser in situ keratomileusis.J Cataract Refract Surg2001;27(4):571-576
6 Cua IY,Qazi MA,Lee SF,et al.Intraocular lens calculations in patients with corneal scarring and irregular astigmatism.J Cataract Refract Surg 2003;29(7):1352-1357
7 Olsen T.On the calculation of power from curvature of the cornea.Br JOphthalmol 1986;70(2):152-154
8 Ho JD,Tsai CY,Tsai RJ,et al.Validity of the keratometric index:Evaluation by the Pentacam rotating Scheimpflug camera.J Cataract Refract Surg 2008;34(1):137-145
9 Savini G,Barboni P,Carbonelli M,et al.Agreement Between Pentacam and Videokeratography in Corneal Power Assessment.J Refract Surg 2009;25(6):534-538
10 Kopacz D,Maciejewicz P,Kecik D.Pentacam-the new way for anterior eye segment imaging and mapping.Klin Oczna 2005;107(10-12):728-731
11 Chen D,Lam AKC.Intrasession and intersession repeatability of the Pentacam system on posterior corneal assessment in the normal human eye.J Cataract Refract Surg 2007;33(3):448-454
12 Lackner B,Schmidinger G,Pieh S,et al.Repeatability and Reproducibility of Central Corneal Thickness Measurement With Pentacam,Orbscan,and Ultrasound.Optom Vis Sci 2005;82(10):892-899
13 McAlinden C,Khadka J,Pesudovs K.A Comprehensive Evaluation of the Precision(Repeatability and Reproducibility)of the Oculus Pentacam HR.Invest Ophthalmol Vis Sci 2011;52(10):7731-7737
14 Tang M,Li Y,Avila M,et al.Measuring total corneal power before and after laser in situ keratomileusis with high speed optical coherence tomography.J Cataract Refract Surg 2006,32(11):1843-1850
15 Holladay JT,Hill WE,Steinmueller A.Corneal power measurements using Scheimpflug imaging in eyes with prior corneal refractive surgery.JRefract Surg 2009;25(10):862-868
16潘虹,王利华,马鲁新.Pentacam与IOL Master测量角膜曲率及前房深度的比较.山东大学学报:医学版2008;46(6):624-627
17 Bland JM,Ahman DG.Statistical methods for assessing agreement between two methods of clinical measurement.Lancet 1986;1(8476):307-310
18 Ha BJ,Kim SW,Kim SW,et al.Pentacam and Orbscan IIMeasurements of Posterior Corneal Elevation Before and After Photorefractive Keratectomy.J Refract Surg 2009;25(3):290-295
19 Elbaz U,Barkana Y,Gerber Y.Comparison of different techniques of anterior chamber depth and keratometric measurements.Am J Ophthalmol2007;143(1):48-53
20 Reuland MS,Reuland AJ,Nishi Y,et al.Corneal radii and anterior chamber depth measurements using the IOL Master versus the Pentacam.J Refract Surg 2007;23(4):368-373
21 Symes RJ,Ursell PG.Automated keratometry in routine cataract surgery:Comparison of Scheimpflug and conventional values.J Cataract Refract Surg 2011;37(2):295-301
22 Woodmass J,Rocha G.A comparison of Scheimpug imaging simulated and Holladay equivalent keratometry values with partial coherence interferometry keratometry measurements in phakic eyes.Can JOphthalmol 2009;44(6):700-704
23 Holladay JT.Calculating equivalent K readings.J Cataract Refract Surg 2011;37(9):1738-1739
24 Olsen T.Improved accuracy of intraocular lens power calculation with the Zeiss IOL Master.Acta Ophthalmol Scand 2007;85(1):84-87
2 Olsen T.Calculation of intraocular lens power:a review.Acta Ophthalmol Scand 2007;85(5):472-485
3 Vogel A,Dick HB,Krummenauer F.Reproducibility of optical biometry using partial coherence interferometry Intraobserver and interobserver reliability.J Cataract Refract Surg 2001;27(12):1961-1968
4 Seitz B,Langenbucher A,Nguyen NX,et al.Underestimation of intraocular lens power for cataract surgery after myopic photorefractive keratectomy.Ophthalmology 1999;106(4):693-702
5 Gimbel H,Sun R.Accuracy and predictability of intraocular lens power calculation after laser in situ keratomileusis.J Cataract Refract Surg2001;27(4):571-576
6 Cua IY,Qazi MA,Lee SF,et al.Intraocular lens calculations in patients with corneal scarring and irregular astigmatism.J Cataract Refract Surg 2003;29(7):1352-1357
7 Olsen T.On the calculation of power from curvature of the cornea.Br JOphthalmol 1986;70(2):152-154
8 Ho JD,Tsai CY,Tsai RJ,et al.Validity of the keratometric index:Evaluation by the Pentacam rotating Scheimpflug camera.J Cataract Refract Surg 2008;34(1):137-145
9 Savini G,Barboni P,Carbonelli M,et al.Agreement Between Pentacam and Videokeratography in Corneal Power Assessment.J Refract Surg 2009;25(6):534-538
10 Kopacz D,Maciejewicz P,Kecik D.Pentacam-the new way for anterior eye segment imaging and mapping.Klin Oczna 2005;107(10-12):728-731
11 Chen D,Lam AKC.Intrasession and intersession repeatability of the Pentacam system on posterior corneal assessment in the normal human eye.J Cataract Refract Surg 2007;33(3):448-454
12 Lackner B,Schmidinger G,Pieh S,et al.Repeatability and Reproducibility of Central Corneal Thickness Measurement With Pentacam,Orbscan,and Ultrasound.Optom Vis Sci 2005;82(10):892-899
13 McAlinden C,Khadka J,Pesudovs K.A Comprehensive Evaluation of the Precision(Repeatability and Reproducibility)of the Oculus Pentacam HR.Invest Ophthalmol Vis Sci 2011;52(10):7731-7737
14 Tang M,Li Y,Avila M,et al.Measuring total corneal power before and after laser in situ keratomileusis with high speed optical coherence tomography.J Cataract Refract Surg 2006,32(11):1843-1850
15 Holladay JT,Hill WE,Steinmueller A.Corneal power measurements using Scheimpflug imaging in eyes with prior corneal refractive surgery.JRefract Surg 2009;25(10):862-868
16潘虹,王利华,马鲁新.Pentacam与IOL Master测量角膜曲率及前房深度的比较.山东大学学报:医学版2008;46(6):624-627
17 Bland JM,Ahman DG.Statistical methods for assessing agreement between two methods of clinical measurement.Lancet 1986;1(8476):307-310
18 Ha BJ,Kim SW,Kim SW,et al.Pentacam and Orbscan IIMeasurements of Posterior Corneal Elevation Before and After Photorefractive Keratectomy.J Refract Surg 2009;25(3):290-295
19 Elbaz U,Barkana Y,Gerber Y.Comparison of different techniques of anterior chamber depth and keratometric measurements.Am J Ophthalmol2007;143(1):48-53
20 Reuland MS,Reuland AJ,Nishi Y,et al.Corneal radii and anterior chamber depth measurements using the IOL Master versus the Pentacam.J Refract Surg 2007;23(4):368-373
21 Symes RJ,Ursell PG.Automated keratometry in routine cataract surgery:Comparison of Scheimpflug and conventional values.J Cataract Refract Surg 2011;37(2):295-301
22 Woodmass J,Rocha G.A comparison of Scheimpug imaging simulated and Holladay equivalent keratometry values with partial coherence interferometry keratometry measurements in phakic eyes.Can JOphthalmol 2009;44(6):700-704
23 Holladay JT.Calculating equivalent K readings.J Cataract Refract Surg 2011;37(9):1738-1739
24 Olsen T.Improved accuracy of intraocular lens power calculation with the Zeiss IOL Master.Acta Ophthalmol Scand 2007;85(1):84-87