五种检查仪器对角膜水平直径测量的对比分析
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摘要
目的:分析五种角膜直径测量方法对角膜水平直径测量的相关性和一致性。方法:纳入2018-02/03在四川大学华西医院眼科行双眼ICL植入的患者25例50眼,术前分别采用规尺、眼前节分析系统SIRIUS、IOL Master500、眼前节OCT和UBM 5种方法测量角膜水平直径,比较5种方法测量结果的相关性及一致性。结果:规尺、眼前节分析系统SIRIUS、IOL Master500、眼前节OCT和UBM测量的角膜水平直径分别为11.54±0.30、11.77±0.33、11.98±0.33、11.63±0.35、11.53±0.34mm(P<0.05),q检验结果显示规尺法与UBM法、眼前节OCT法,UBM法与眼前节OCT法测量的WTW值之间均无差异(P>0.05),直线相关分析发现五种检查方法测量值之间均具有显著相关性,Bland-Altman分析发现,规尺与SIRIUS、UBM、眼前节OCT检查值的95%LoA上下限绝对值均≤0.50mm。结论:五种测量角膜水平直径的结果,规尺与SIRIUS,UBM和前节OCT的结果可以互换,其他结果不能互换。IOL Master500测量值最大,不宜作为测量角膜水平直径大小的诊断依据,其他测量设备检查结果应结合临床实践。
AIM: To analyze the correlation and consistency of five corneal diameter measurements.METHODS: Totally 25 cases(50 eyes) who underwent ICL implantation in West China Hospital. The preoperative horizontal corneal diameter was measured using measuring caliper, SIRIUS anterior eye assay system, IOL Master500, anterior segment OCT and UBM. RESULTS: The mean WTW distances were 11.54±0.30 mm as obtained with measuring caliper, 11.77±0.33 mm with SIRIUS anterior eye assay system, 11.98±0.33 mm with IOL Master500, 11.63±0.35 mm with anterior segment OCT and 11.53±0.34 mm with UBM. No statistical difference was found between measuring caliper and UBM, measuring caliper and anterior segment OCT, UBM and anterior segment OCT. The linear correlation analysis found significant correlation between the measurements of the five measurements. The Bland-Altman analysis for the measuring caliper and SIRIUS, measuring caliper and UBM, measuring caliper and anterior segment OCT found that the absolute values of 95% LOA upper and lower limits were less than 0.5 mm.CONCLUSION: The results of the four kinds of corneal horizontal diameter measurements can be interchanged including SIRIUS, UBM, anterior segment OCT and measuring caliper. IOL Master500 results are the largest, that cannot be used as a diagnostic basis for measuring the size of corneal horizontal diameter. The results of other measurement equipment should be combined with clinical practice.
AIM: To analyze the correlation and consistency of five corneal diameter measurements.METHODS: Totally 25 cases(50 eyes) who underwent ICL implantation in West China Hospital. The preoperative horizontal corneal diameter was measured using measuring caliper, SIRIUS anterior eye assay system, IOL Master500, anterior segment OCT and UBM. RESULTS: The mean WTW distances were 11.54±0.30 mm as obtained with measuring caliper, 11.77±0.33 mm with SIRIUS anterior eye assay system, 11.98±0.33 mm with IOL Master500, 11.63±0.35 mm with anterior segment OCT and 11.53±0.34 mm with UBM. No statistical difference was found between measuring caliper and UBM, measuring caliper and anterior segment OCT, UBM and anterior segment OCT. The linear correlation analysis found significant correlation between the measurements of the five measurements. The Bland-Altman analysis for the measuring caliper and SIRIUS, measuring caliper and UBM, measuring caliper and anterior segment OCT found that the absolute values of 95% LOA upper and lower limits were less than 0.5 mm.CONCLUSION: The results of the four kinds of corneal horizontal diameter measurements can be interchanged including SIRIUS, UBM, anterior segment OCT and measuring caliper. IOL Master500 results are the largest, that cannot be used as a diagnostic basis for measuring the size of corneal horizontal diameter. The results of other measurement equipment should be combined with clinical practice.
引文
1 Visian ICL Product Information: Visian ICL (Implantable Collamer Lens) For Myopia. http://www.accessdata.fda.gov/cdrh_docs/pdf3/P030016c.pdf.
2 Gomez-Bastar A, Jaimes M, Graue-Hernández EO, et al. Long term refractive outcomes of posterior chamber phakic (spheric and toric implantable collamer lens) intraocular lens implantation. Int Ophthalmol 2014;34(3):583-590
3 Dougherty PJ,Rivera RP,Schneider D,et al. Improving accuracy of phakic intraocular lens sizing using high-frequency ultrasound biomicroscopy. J Cataract Refract Surg 2011:37(1):13-18
4 Seo JH, Kim MK, Wee WR, et al. Effects of white-to-white diameter and anterior chamber depth on implantable collamer lens vault and visual outcome. J Refract Surg 2009; 25(8):730-738
5李秋明,郑广瑛. 眼科应用解剖学. 第2版. 郑州: 郑州大学出版社2010: 17
6张磊,甄静,朴荷妮,等.量规、IOLMaster 及 Pentacam眼前节分析系统角膜水平直径测量的一致性研究.眼科2017; 26(4):252-255
7 Domínguez-Vicent A, Pérez-Vives C, Ferrer-Blasco T, et al. Interchangeability among five devices that measure anterior eye distances. Clin Exp Optom 2015; 98(3): 254-262
8 Yeung KK, Kageyama JY, Camevali T. A comparison of fluoracaine and fluomx oll comeal epithelial cell desquamation after goldmann applanafion tonometry. Optometry 2000;71(1):49-54
2 Gomez-Bastar A, Jaimes M, Graue-Hernández EO, et al. Long term refractive outcomes of posterior chamber phakic (spheric and toric implantable collamer lens) intraocular lens implantation. Int Ophthalmol 2014;34(3):583-590
3 Dougherty PJ,Rivera RP,Schneider D,et al. Improving accuracy of phakic intraocular lens sizing using high-frequency ultrasound biomicroscopy. J Cataract Refract Surg 2011:37(1):13-18
4 Seo JH, Kim MK, Wee WR, et al. Effects of white-to-white diameter and anterior chamber depth on implantable collamer lens vault and visual outcome. J Refract Surg 2009; 25(8):730-738
5李秋明,郑广瑛. 眼科应用解剖学. 第2版. 郑州: 郑州大学出版社2010: 17
6张磊,甄静,朴荷妮,等.量规、IOLMaster 及 Pentacam眼前节分析系统角膜水平直径测量的一致性研究.眼科2017; 26(4):252-255
7 Domínguez-Vicent A, Pérez-Vives C, Ferrer-Blasco T, et al. Interchangeability among five devices that measure anterior eye distances. Clin Exp Optom 2015; 98(3): 254-262
8 Yeung KK, Kageyama JY, Camevali T. A comparison of fluoracaine and fluomx oll comeal epithelial cell desquamation after goldmann applanafion tonometry. Optometry 2000;71(1):49-54