角膜补偿眼压(IOPcc)和5种眼压校正公式所得校正眼压的一致性及IOPcc、模拟Goldmann眼压与眼球各参数的相关性分析
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摘要
目的比较眼反应分析仪测得的角膜补偿眼压(corneal-compensated intraocular pressure,IOPcc)和Sirius眼前节分析系统内置的5种眼压校正公式所得校正眼压的一致性,分析IOPcc、模拟Goldmann眼压(Goldmann-correlated intraocular pressure,IOPg)与眼球各参数的相关性。方法选取2016年11月至2017年3月在我院眼科中心行近视激光治疗的患者90例90眼,年龄18～37(24.47±5.57)岁。应用Sirius眼前节分析系统对所有患者按常规方法测量3次,选择最佳测量结果作为各参数最终结果。应用眼反应分析仪测量患者的角膜生物力学参数。根据眼反应分析仪测量的IOPg输入Sirius眼前节分析系统内置的5种眼压校正公式进行计算,得到的校正眼压分别记录为Dresdner校正眼压、Ehlers校正眼压、Kohlhaas校正眼压、Orssengo/Pye校正眼压和Shah校正眼压。将所得的5种校正眼压和非接触性眼压计眼压与眼反应分析仪测得的IOPcc进行一致性分析。对IOPcc、IOPg与角膜滞后量、角膜阻力因子、眼球各参数进行相关分析。结果 Kohlhaas校正眼压和IOPcc比较差异有统计学意义(P<0.05)。Dresdner校正眼压、Orssengo/Pye校正眼压与IOPcc的一致性较好,95%一致性界限分别为(-2.09～2.55)mm Hg、(-2.38～2.37)mmHg;其中Dresdner校正眼压与IOPcc的95%一致性界限宽度最窄。IOPcc与角膜滞后量、角膜阻力因子以及眼球各参数均无相关性,而IOPg与角膜阻力因子、中央角膜厚度、角膜体积呈正相关关系(均为P<0.05)。结论Dresdner校正眼压、Orssengo/Pye校正眼压与IOPcc的一致性较好;眼球大部分参数对IOPcc影响小。
Objective To compare the agreement between corneal-compensated intraocular pressure( IOPcc) measured by ocular response analyzer( ORA) and 5 corrected intraocular pressures from Sirius anterior system,and analyze the correlation of ocular biometries with IOPcc and Goldmann-correlated IOP( IOPg). Methods Together 90 eyes of 90 patients,aged 18-37( 24. 47 ± 5. 57) years,without refractive surgery contraindications undergoing myopic laser treatment were enrolled in this study. Each eye was measured 3 times by Sirius anterior system,with the best results of IOPcc and IOPg was selected. And patients' corneal biomechanical parameters were measured using an ORA( Reichert,Inc.,USA). The IOPg from ORA were entered into the5 IOP formulas embedded in Sirius anterior system to generate the corrected IOPs,which were recorded as the Dresdner corrected IOP,Ehlers corrected IOP,Kohlhaas corrected IOP,Orssengo/Pye corrected IOP and Shah corrected IOP,accordingly. Meanwhile the agreement of the 5 corrected IOPs and the IOP measured non-contact tonometer with IOPcc was analyzed,respectively.Corneal biomechanics,including corneal hysteresis and corneal resistance factor,and ocular biometries were also recorded,and the correlation of these parameters with IOPcc and IOPg was assessed with correlation coefficient. Results The pair comparison of IOPcc and Kohlhaas corrected IOP was statistically significant( P < 0. 05). Dresdner corrected IOP and Orssengo/Pye corrected IOP showed a good agreement with IOPcc,and the 95% limits of agreements( Lo A) were(-2. 09 ～ 2. 55) mm Hg( 1 kPa = 7. 5 mm Hg) and(-2. 38 ～ 2. 37) mm Hg,respectively. The95% Lo A of Dresdner's corrected IOP and IOPcc was the narrowest. No statistical significance was found between IOPcc and corneal hysteresis,corneal resistance factor,ocular biometries,but there was a positive correlation between IOPg and corneal resistance factor,central corneal thickness,and corneal volume( all P < 0. 05). Conclusion Dresdner and Orssengo/Pye corrected IOP had a good agreement with IOPcc,and most ocular biometries have a little effect on IOPcc.
Objective To compare the agreement between corneal-compensated intraocular pressure( IOPcc) measured by ocular response analyzer( ORA) and 5 corrected intraocular pressures from Sirius anterior system,and analyze the correlation of ocular biometries with IOPcc and Goldmann-correlated IOP( IOPg). Methods Together 90 eyes of 90 patients,aged 18-37( 24. 47 ± 5. 57) years,without refractive surgery contraindications undergoing myopic laser treatment were enrolled in this study. Each eye was measured 3 times by Sirius anterior system,with the best results of IOPcc and IOPg was selected. And patients' corneal biomechanical parameters were measured using an ORA( Reichert,Inc.,USA). The IOPg from ORA were entered into the5 IOP formulas embedded in Sirius anterior system to generate the corrected IOPs,which were recorded as the Dresdner corrected IOP,Ehlers corrected IOP,Kohlhaas corrected IOP,Orssengo/Pye corrected IOP and Shah corrected IOP,accordingly. Meanwhile the agreement of the 5 corrected IOPs and the IOP measured non-contact tonometer with IOPcc was analyzed,respectively.Corneal biomechanics,including corneal hysteresis and corneal resistance factor,and ocular biometries were also recorded,and the correlation of these parameters with IOPcc and IOPg was assessed with correlation coefficient. Results The pair comparison of IOPcc and Kohlhaas corrected IOP was statistically significant( P < 0. 05). Dresdner corrected IOP and Orssengo/Pye corrected IOP showed a good agreement with IOPcc,and the 95% limits of agreements( Lo A) were(-2. 09 ～ 2. 55) mm Hg( 1 kPa = 7. 5 mm Hg) and(-2. 38 ～ 2. 37) mm Hg,respectively. The95% Lo A of Dresdner's corrected IOP and IOPcc was the narrowest. No statistical significance was found between IOPcc and corneal hysteresis,corneal resistance factor,ocular biometries,but there was a positive correlation between IOPg and corneal resistance factor,central corneal thickness,and corneal volume( all P < 0. 05). Conclusion Dresdner and Orssengo/Pye corrected IOP had a good agreement with IOPcc,and most ocular biometries have a little effect on IOPcc.
引文
[1]MEDEIROS FA,WEINREB RN.Evaluation of the influence of corneal biomechanical properties on intraocular pressure measurements using the ocular response analyzer[J].J Glaucoma,2006,15(5):364-370.
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[6]KOHLHAAS M,SPOERL E,BOEHM AG,POLLACK K.A correction formula for the real intraocular pressure after LASIK for the correction of myopic astigmatism[J].J Refract Surg,2006,22(3):263-267.
[7]ORSSENGO GJ,PYE DC.Determination of the true intraocular pressure and modulus of elasticity of the human cornea in vivo[J].Bull Math Biol,1999,61(3):551-572.
[8]SHAH S,CHATTERJEE A,MATHAI M,KELLY SP,KWARTZ J,HENSON D,et al.Relationship between corneal thickness and measured intraocular pressure in a general ophthalmology clinic[J].Ophthalmology,1999,106(11):2154-2160.
[9]LIU J,ROBERTS CJ.Influence of corneal biomechanical properties on intraocular pressure measurement:quantitative analysis[J].J Cataract Refract Surg,2005,31(1):146-155.
[10]GARCIA-FEIJOO J,MARTINEZ-DE-LA-CASA JM,MORALES-FERNANDEZ L,SAENZ FRANCES F,SANTOS-BUESO E,GARCIA-SAENZ S,et al.New technologies for measuring intraocular pressure[J].Prog Brain Res,2015,221(1):67-79.
[11]DAVID VP,STEAD RE,VERNON SA.Repeatability of ocular response analyzer metrics:a gender-based study[J].Optom Vis Sci,2013,90(7):691-699.
[12]KIRWAN C,O’KEEFE M.Measurement of intraocular pressure in LASIK and LASEK patients using the Reichert Ocular Response Analyzer and Goldmann applanation tonometry[J].J Refract Surg,2008,24(4):366-370.
[13]LAM AK,CHEN D,TSE J.The usefulness of waveform score from the ocular response analyzer[J].Optom Vis Sci,2010,87(3):195-199.
[14]WACHTL J,TOTEBERG-HARMS M,FRIMMEL S,ROOS M,KN-IESTEDT C.Correlation between dynamic contour tonometry,uncorrected and corrected goldmann applanation tonometry,and stage of glaucoma[J].JAMA Ophthalmol,2017,135(6):601-608.
[15]GUNVANT P,O’LEARY DJ,BASKARAN M,BROADWAY DC,WATKINS RJ,VIJAYA L.Evaluation of tonometric correction factors[J].J Glaucoma,2005,14(5):337-343.
[16]GUNVANT P,NEWCOMB RD,KIRSTEIN EM,MALINOVSKYVE,MADONNA RJ,MEETZ RE.Measuring accurate IOPs:Does correction factor help or hurt[J]?Clin Ophthalmol,2010,4(7):611-616.
[17]KOHLHAAS M,SPORL E,BOHM AG,POLLACK K,SANDNERD,PILLUNAT LE.Applanation tonometry in“normal”patients and patients after LASIK[J].Klin Monbl Augenheilkd,2005,222(10):823-826.
[18]LI H,WANG Y,DOU R,WEI P,ZHANG J,ZHAO W,et al.Intraocular pressure changes and relationship with corneal biomechanics after SMILE and FS-LASIK[J].Invest Ophthalmol Vis Sci,2016,57(10):4180-4186.
[2]R CORE TEAM.R:A language and environment for statistical computing[M].Vienna,Austria:R Foundation for Statistical Computing,2016.
[3]SAVINI G,BARBONI P,CARBONELLI M,HOFFER KJ.Repeatability of automatic measurements by a new Scheimpflug camera combined with Placido topography[J].J Cataract Refract Surg,2011,37(10):1809-1816.
[4]KOHLHAAS M,BOEHM AG,SPOERL E,PURSTEN A,GREINHJ,PILLUNAT LE.Effect of central corneal thickness,corneal curvature,and axial length on applanation tonometry[J].Arch Ophthalmol,2006,124(4):471-476.
[5]EHLERS N,BRAMSEN T,SPERLING S.Applanation tonometry and central corneal thickness[J].Acta Ophthalmol(Copenh),1975,53(1):34-43.
[6]KOHLHAAS M,SPOERL E,BOEHM AG,POLLACK K.A correction formula for the real intraocular pressure after LASIK for the correction of myopic astigmatism[J].J Refract Surg,2006,22(3):263-267.
[7]ORSSENGO GJ,PYE DC.Determination of the true intraocular pressure and modulus of elasticity of the human cornea in vivo[J].Bull Math Biol,1999,61(3):551-572.
[8]SHAH S,CHATTERJEE A,MATHAI M,KELLY SP,KWARTZ J,HENSON D,et al.Relationship between corneal thickness and measured intraocular pressure in a general ophthalmology clinic[J].Ophthalmology,1999,106(11):2154-2160.
[9]LIU J,ROBERTS CJ.Influence of corneal biomechanical properties on intraocular pressure measurement:quantitative analysis[J].J Cataract Refract Surg,2005,31(1):146-155.
[10]GARCIA-FEIJOO J,MARTINEZ-DE-LA-CASA JM,MORALES-FERNANDEZ L,SAENZ FRANCES F,SANTOS-BUESO E,GARCIA-SAENZ S,et al.New technologies for measuring intraocular pressure[J].Prog Brain Res,2015,221(1):67-79.
[11]DAVID VP,STEAD RE,VERNON SA.Repeatability of ocular response analyzer metrics:a gender-based study[J].Optom Vis Sci,2013,90(7):691-699.
[12]KIRWAN C,O’KEEFE M.Measurement of intraocular pressure in LASIK and LASEK patients using the Reichert Ocular Response Analyzer and Goldmann applanation tonometry[J].J Refract Surg,2008,24(4):366-370.
[13]LAM AK,CHEN D,TSE J.The usefulness of waveform score from the ocular response analyzer[J].Optom Vis Sci,2010,87(3):195-199.
[14]WACHTL J,TOTEBERG-HARMS M,FRIMMEL S,ROOS M,KN-IESTEDT C.Correlation between dynamic contour tonometry,uncorrected and corrected goldmann applanation tonometry,and stage of glaucoma[J].JAMA Ophthalmol,2017,135(6):601-608.
[15]GUNVANT P,O’LEARY DJ,BASKARAN M,BROADWAY DC,WATKINS RJ,VIJAYA L.Evaluation of tonometric correction factors[J].J Glaucoma,2005,14(5):337-343.
[16]GUNVANT P,NEWCOMB RD,KIRSTEIN EM,MALINOVSKYVE,MADONNA RJ,MEETZ RE.Measuring accurate IOPs:Does correction factor help or hurt[J]?Clin Ophthalmol,2010,4(7):611-616.
[17]KOHLHAAS M,SPORL E,BOHM AG,POLLACK K,SANDNERD,PILLUNAT LE.Applanation tonometry in“normal”patients and patients after LASIK[J].Klin Monbl Augenheilkd,2005,222(10):823-826.
[18]LI H,WANG Y,DOU R,WEI P,ZHANG J,ZHAO W,et al.Intraocular pressure changes and relationship with corneal biomechanics after SMILE and FS-LASIK[J].Invest Ophthalmol Vis Sci,2016,57(10):4180-4186.