VX120与KR1-W测量白内障角膜屈光参数的比较研究
|
摘要
目的探讨VX120与KR1-W测量白内障患者角膜高阶像差及角膜曲率结果的一致性。方法回顾性研究。收集我科2018年5～7月待行白内障手术患者26例(26只眼),平均年龄(72.08±8.82)岁。根据LOCSⅢ晶状体混浊分级系统,纳入患者晶状体核为Ⅱ～Ⅲ级,排除角膜病变、手术史及眼外伤史病变。术前扩瞳情况下分别用VX120及KR1-W仪器对其角膜高阶像差及角膜曲率进行测量。分析两种仪器测量结果的相关性并采用Blan-Altman分析评价两种仪器测量结果的一致性。结果 VX120与KR1-W测得慧差平均值分别(0.244±0.161)μm和(0.362±0.263)μm,差异有统计学意义(P=0.013),二者测量结果呈正相关(r=0.4,P=0.043);VX120与KR1-W测得球差平均值分别为(0.148±0.116)μm和(0.248±0.231)μm;差异有统计学意义(P=0.049),二者测量结果呈正相关(r=0.4,P=0.043),VX120与KR1-W测得K_1平均值分别为(42.865±2.436)D和(43.394±1.744)D,差异有统计学意义(P=0.037),二者测量结果呈正相关(r=0.847,P=0.000);VX120与KR1-W测得K_2平均值分别为(43.721±2.427)D和(44.433±1.671)D,差异有统计学意义(P=0.020),二者测量结果呈正相关(r=0.690,P=0.000);Bland-Altman分析显示两种仪器测量的角膜总体高阶像差及角膜Q值一致性较好,95%LoA界限之外的点分别占7.7%和3.8%。结论 VX120和KR1-W仪器在测量角膜总体高阶像差及角膜Q值时一致性较好;在测量角膜球差、慧差及角膜曲率时与VX120相比一致性较差,临床应用时不可相互替代。
Objective To investigate the agreement of VX120 and KR1-W in measuring corneal high-order aberrations and corneal curvature in cataract patients. Methods This was a retrospective study which enrolled 26 patients with planned cataract surgery in our department from May to July 2018, mean age of the study participants was 72.08±8.82 years old. Patients with grade II-III nucleus according to the latest LOCSIII lens opacity grading system were enrolled, while patients with corneal lesions, surgical history, and ocular trauma history were further excluded. The corneal high-order aberration and corneal curvature were measured with VX120 and KR1-W after pupil dilation and before the cataract surgery. The agreement between the two instruments was analyzed and evaluated by Bland-Altman analysis. Results The mean coma measured by VX120 and KR1-W were 0.244±0.161 μm and 0.362±0.263 μm, respectively, with a statistically significant difference(P=0.013). The results were positively correlated(r=0.4,P=0.043). The mean spherical aberrations measured by VX120 and KR1-W were 0.148±0.116 μm and 0.248±0.231 μm, respectively; the difference was statistically significant(P=0.049) and the results were positively correlated(r=0.4,P=0.043). The mean K_1 values by VX120 and KR1-W were 42.865±2.436 D and 43.394±1.744 D, respectively. The difference was statistically significant(P=0.037), and the two measurements were positively correlated(r=0.847,P=0.000). The mean K_2 values of VX120 and KR1-W were 43.721±2.427 D and 44.433±1.671 D, respectively. The difference was statistically significant(P=0.020), and the two measurements were positively correlated(r=0.690,P=0.000). Bland-Altman analysis showed an overall good agreement of these two instruments in measuring the total corneal high-order aberrations and Q values, with 7.7% and 3.8% of the measurements fell outside the 95% limit of agreement, respectively. Conclusions The VX120 and KR1-W have good agreement in measuring total high-order aberrations and corneal Q values, but worse agreement in measuring corneal sphericity, coma and corneal curvature. These two instruments cannot be used interchangeably in clinical application.
Objective To investigate the agreement of VX120 and KR1-W in measuring corneal high-order aberrations and corneal curvature in cataract patients. Methods This was a retrospective study which enrolled 26 patients with planned cataract surgery in our department from May to July 2018, mean age of the study participants was 72.08±8.82 years old. Patients with grade II-III nucleus according to the latest LOCSIII lens opacity grading system were enrolled, while patients with corneal lesions, surgical history, and ocular trauma history were further excluded. The corneal high-order aberration and corneal curvature were measured with VX120 and KR1-W after pupil dilation and before the cataract surgery. The agreement between the two instruments was analyzed and evaluated by Bland-Altman analysis. Results The mean coma measured by VX120 and KR1-W were 0.244±0.161 μm and 0.362±0.263 μm, respectively, with a statistically significant difference(P=0.013). The results were positively correlated(r=0.4,P=0.043). The mean spherical aberrations measured by VX120 and KR1-W were 0.148±0.116 μm and 0.248±0.231 μm, respectively; the difference was statistically significant(P=0.049) and the results were positively correlated(r=0.4,P=0.043). The mean K_1 values by VX120 and KR1-W were 42.865±2.436 D and 43.394±1.744 D, respectively. The difference was statistically significant(P=0.037), and the two measurements were positively correlated(r=0.847,P=0.000). The mean K_2 values of VX120 and KR1-W were 43.721±2.427 D and 44.433±1.671 D, respectively. The difference was statistically significant(P=0.020), and the two measurements were positively correlated(r=0.690,P=0.000). Bland-Altman analysis showed an overall good agreement of these two instruments in measuring the total corneal high-order aberrations and Q values, with 7.7% and 3.8% of the measurements fell outside the 95% limit of agreement, respectively. Conclusions The VX120 and KR1-W have good agreement in measuring total high-order aberrations and corneal Q values, but worse agreement in measuring corneal sphericity, coma and corneal curvature. These two instruments cannot be used interchangeably in clinical application.
引文
[1] 刘佳,王凯.影响年龄相关性白内障术后屈光误差的术前眼球生物学参数特征分析[J].中华眼视光学与视觉科学杂志,2015,17(8):480-483.
[2] 田靖,廖萱,兰长骏,等.像差仪测量白内障患者术前角膜球面像差[J].中华眼外伤职业眼病杂志,2017,39(12):919-921.
[3] Holladay JT,Piers PA,Koranyi G,et al.A new intraocular lens design to reduce spherical aberration of pseudophakic eyes[J].J Refract Surg,2002,18(6):683-691.
[4] 方锦然,杨炜.不同程度糖尿病视网膜病变干眼症患者波前像差的研究[J].国际眼科杂志,2018,18(5):950-953.
[5] 叶芬,田农,施宇华,等.糖尿病干眼患者的波前像差分析[J].眼科新进展,2012,32(4):356-358.
[6] 邱威,华焱军,徐泽全,等.Topcon KR-1W、iTrace和Topolyzer测量角膜Q值的比较[J].中华实验眼科杂志,2017,35(6):544-547.
[7] 沈政伟,周和政,吴金桃,等.正常眼角膜Q值检测分析[J].国际眼科杂志,2006,6(6):1356-1357.
[8] Liang CL,uo SH,Chang CJ.Comparison of higher-order wavefront aberrations with 3 aberrometers[J].J Cataract Refract Surg,2005,31(11):2153-2156.
[9] 邢晓杰,汤欣,宋慧.KR-1W波前像差仪测量人工晶状体眼像差可重复性研究[J].中国实用眼科杂志,2011,29(11):1127-1130.
[10] Piero DP.Technologies for anatomical and geometric characterization of the corneal structure and anterior segment:a review[J].Semin Ophthalmol,2015,30(3):161-170.
[11] Shneor E,Millodot M,Zyroff M,et al.Validation of keratometric measurements obtained with a new integrated aberrometry-topography system[J].J Optometry,2012,5(2):80-86.
[12] David P,Cabezos I,López-Navarro A,et al.Intrasession repeatability of ocular anatomical measurements obtained with a multidiagnostic device in healthy eyes[J].BMC Ophthalmol,2017,17(1):193.
[2] 田靖,廖萱,兰长骏,等.像差仪测量白内障患者术前角膜球面像差[J].中华眼外伤职业眼病杂志,2017,39(12):919-921.
[3] Holladay JT,Piers PA,Koranyi G,et al.A new intraocular lens design to reduce spherical aberration of pseudophakic eyes[J].J Refract Surg,2002,18(6):683-691.
[4] 方锦然,杨炜.不同程度糖尿病视网膜病变干眼症患者波前像差的研究[J].国际眼科杂志,2018,18(5):950-953.
[5] 叶芬,田农,施宇华,等.糖尿病干眼患者的波前像差分析[J].眼科新进展,2012,32(4):356-358.
[6] 邱威,华焱军,徐泽全,等.Topcon KR-1W、iTrace和Topolyzer测量角膜Q值的比较[J].中华实验眼科杂志,2017,35(6):544-547.
[7] 沈政伟,周和政,吴金桃,等.正常眼角膜Q值检测分析[J].国际眼科杂志,2006,6(6):1356-1357.
[8] Liang CL,uo SH,Chang CJ.Comparison of higher-order wavefront aberrations with 3 aberrometers[J].J Cataract Refract Surg,2005,31(11):2153-2156.
[9] 邢晓杰,汤欣,宋慧.KR-1W波前像差仪测量人工晶状体眼像差可重复性研究[J].中国实用眼科杂志,2011,29(11):1127-1130.
[10] Piero DP.Technologies for anatomical and geometric characterization of the corneal structure and anterior segment:a review[J].Semin Ophthalmol,2015,30(3):161-170.
[11] Shneor E,Millodot M,Zyroff M,et al.Validation of keratometric measurements obtained with a new integrated aberrometry-topography system[J].J Optometry,2012,5(2):80-86.
[12] David P,Cabezos I,López-Navarro A,et al.Intrasession repeatability of ocular anatomical measurements obtained with a multidiagnostic device in healthy eyes[J].BMC Ophthalmol,2017,17(1):193.