ICL术前四种仪器与量规测量角膜直径的对比
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摘要
目的:对比眼前节分析仪(Wavelight)、IOL Master、光学生物测量仪(LS900)及AS-OCT与量规测量角膜直径的差异。方法:选取2015-06/2018-01拟于本院行ICL V4c矫正屈光不正患者89例177眼,ICL植入手术前分别用Wavelight、IOL Master、LS900测量角膜横径(WTW),用AS-OCT测量房角之间的距离(ATA),也就是从内部测量角膜横径,然后显然验光及散瞳验光,第2d用量规测量角膜直径并做比较,以量规测量值输入厂家公式计算ICL直径,并做植入。用OCT检查术后3mo拱高等参数。结果:Wavelight、IOL Master、LS900测量WTW平均值分别为12.45±0.73、11.96±0.39、11.92±0.36mm,用AS-OCT测量ATA平均为11.80±0.44mm。量规测量WTW为11.49±0.30mm,量规测量值均比四种仪器测量值小(P<0.01)。LS900测量值比IOL Master小(P=0.098),可相互替代,其他仪器之间均有差异(P<0.01)。以量规测量值为基础计算的ICL V4c直径平均为12.77±0.37mm,植入术后3mo用OCT检查拱高为537.41±181.22μm。结论:四种仪器测量角膜直径值可做参考;以量规为基础计算的ICL术后拱高是理想的;在设计ICL大小时,量规是理想的测量角膜直径的工具,不可替代。
AIM: To compare the differences of corneal diameter measured with wavelight anterior segment analyzer(Wavelight),IOL-master optical bio-measurement(LS900), anterior segment OCT(AS-OCT) and gauge.METHODS: Totally 89 patients(177 eyes) with myopia who want to accept ICL were examined before operation with more than five kinds of instruments respectively, white to white(WTW) were examined with Wavelight, IOL-master, LS900 and gauge, angle to angle(ATA) with AS-OCT. Then the size of ICL was calculated based on the value of gauge. The vault of ICL was examined with OCT 3 mo after operation.RESULTS: WTW was(12.45±0.73, 11.96±0.39, 11.92±0.36, 11.49±0.30)mm measured by Wavelight, IOL-Master, LS900 and gauge respectively, ATA was(11.80±0.44)mm with AS-OCT. The value of gauge was the smallest one among them(all P<0.01). Among four instruments, there was no statistical difference between LS900 and AS-OCT(P=0.098), they can instead of each other; there were differences among other instruments(P<0.01). The size of ICL based on gauge was(12.77±0.37)mm. The vault of ICL is(537.41±181.22)μm 3 mo after implantation obtained by OCT.CONCLUSION: Gauge is ideal tool for measuring corneal diameter, it cannot be instead. Wavelight, IOL Master, LS900 and AS-OCT can be taken as reference.
AIM: To compare the differences of corneal diameter measured with wavelight anterior segment analyzer(Wavelight),IOL-master optical bio-measurement(LS900), anterior segment OCT(AS-OCT) and gauge.METHODS: Totally 89 patients(177 eyes) with myopia who want to accept ICL were examined before operation with more than five kinds of instruments respectively, white to white(WTW) were examined with Wavelight, IOL-master, LS900 and gauge, angle to angle(ATA) with AS-OCT. Then the size of ICL was calculated based on the value of gauge. The vault of ICL was examined with OCT 3 mo after operation.RESULTS: WTW was(12.45±0.73, 11.96±0.39, 11.92±0.36, 11.49±0.30)mm measured by Wavelight, IOL-Master, LS900 and gauge respectively, ATA was(11.80±0.44)mm with AS-OCT. The value of gauge was the smallest one among them(all P<0.01). Among four instruments, there was no statistical difference between LS900 and AS-OCT(P=0.098), they can instead of each other; there were differences among other instruments(P<0.01). The size of ICL based on gauge was(12.77±0.37)mm. The vault of ICL is(537.41±181.22)μm 3 mo after implantation obtained by OCT.CONCLUSION: Gauge is ideal tool for measuring corneal diameter, it cannot be instead. Wavelight, IOL Master, LS900 and AS-OCT can be taken as reference.
引文
1瞿佳,王勤美,周翔天. 中国屈光手术安全性和有效性的多中心协同研究初步分析. 眼视光学杂志2008;10(5):321-324
2杨路,陈曦,胡东瑞. 高度近视有晶状体眼后房型人工晶状体植入术后超声观测. 中国实用眼科杂志2010;28(6):530-532
3廉井财,周正申,张雷,等. 前房型人工晶状体植入治疗高度近视眼. 中华眼科杂志2006;42(8):709-713
4 Seo JH,Kim MK,Wee WR,et al. Eflects of white-to-white diameter and anterior chamber depth on implantable collamer lens vault and visual outcome. Refract Surg 2009;25(8):730-738
5王大江,盛豫,黄一飞. 使用Pentacam测量分析系统对近视眼眼前节测量. 军医进行学院学报2010;31(3):230-234
6朱梦钧,瞿小妹. Pentacam及A型超声测量近视眼前房深度、晶状体厚度的研究. 眼科研究2008;26(1):63-66
7周行涛,褚仁远. 眼科新技术应用丛书-眼前节全景仪. 第1版. 上海:复旦大学出版社2009:1-4
8黎冬平,刘磊,李新宇,等. ICL植入术治疗高度近视术后早期眼前节形态的变化. 国际眼科杂志2014;14(1):49-51
9 左志高,尹黎,刘苏冰,等. ICL或TICL植入术矫治超高度近视的应用研究. 眼科新进展2011;31(5):460-463
10梁日雄,周炜. 后房型人工晶状体植入术治疗有晶状体高度近视眼. 国际眼科杂志2009;9(10):1941-1944
11杜改萍,黄一飞,余继峰,等. 有晶状体眼后房型人工晶状体拱高相关因素分析. 中国实用眼科杂志2011;29(1):36-39
12史铭宇. 有晶状体眼后房型人工晶状体植入矫正高度近视对眼前节形态的影响. 眼科新进展2009;29(6):448-451
13林英杰,梁先军,何锦贤,等. 高度近视眼ICL植入术后Pentacam眼前节全景分析仪观察. 国际眼科杂志2011;11(2):346-348
14 Kamiya K,Shimizu K,Igarashi A,et al. Four-year follow-up of posterior chamber phakic intraocular lens implantation for moderate to high myopia. Arch Ophthalmol 2009;127(7):845-850
15王元贵,刘运良,王佐祥,等. 后房型人工晶状体植入术矫治中高度近视临床应用. 眼科新进展2007;27(11):853-854
16张磊,甄静,朴荷妮,等. 量规,IOL Master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
2杨路,陈曦,胡东瑞. 高度近视有晶状体眼后房型人工晶状体植入术后超声观测. 中国实用眼科杂志2010;28(6):530-532
3廉井财,周正申,张雷,等. 前房型人工晶状体植入治疗高度近视眼. 中华眼科杂志2006;42(8):709-713
4 Seo JH,Kim MK,Wee WR,et al. Eflects of white-to-white diameter and anterior chamber depth on implantable collamer lens vault and visual outcome. Refract Surg 2009;25(8):730-738
5王大江,盛豫,黄一飞. 使用Pentacam测量分析系统对近视眼眼前节测量. 军医进行学院学报2010;31(3):230-234
6朱梦钧,瞿小妹. Pentacam及A型超声测量近视眼前房深度、晶状体厚度的研究. 眼科研究2008;26(1):63-66
7周行涛,褚仁远. 眼科新技术应用丛书-眼前节全景仪. 第1版. 上海:复旦大学出版社2009:1-4
8黎冬平,刘磊,李新宇,等. ICL植入术治疗高度近视术后早期眼前节形态的变化. 国际眼科杂志2014;14(1):49-51
9 左志高,尹黎,刘苏冰,等. ICL或TICL植入术矫治超高度近视的应用研究. 眼科新进展2011;31(5):460-463
10梁日雄,周炜. 后房型人工晶状体植入术治疗有晶状体高度近视眼. 国际眼科杂志2009;9(10):1941-1944
11杜改萍,黄一飞,余继峰,等. 有晶状体眼后房型人工晶状体拱高相关因素分析. 中国实用眼科杂志2011;29(1):36-39
12史铭宇. 有晶状体眼后房型人工晶状体植入矫正高度近视对眼前节形态的影响. 眼科新进展2009;29(6):448-451
13林英杰,梁先军,何锦贤,等. 高度近视眼ICL植入术后Pentacam眼前节全景分析仪观察. 国际眼科杂志2011;11(2):346-348
14 Kamiya K,Shimizu K,Igarashi A,et al. Four-year follow-up of posterior chamber phakic intraocular lens implantation for moderate to high myopia. Arch Ophthalmol 2009;127(7):845-850
15王元贵,刘运良,王佐祥,等. 后房型人工晶状体植入术矫治中高度近视临床应用. 眼科新进展2007;27(11):853-854
16张磊,甄静,朴荷妮,等. 量规,IOL Master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