小梁切除术后功能性滤过泡大小与眼压的相关分析

Correlation between intraocular pressure and functional bleb size after trabeculectomy

目的探讨计算机图像分析系统获取小梁切除术后，功能性滤过泡的相对面积及分析功能性滤过泡大小与眼压的关系。方法采用裂隙灯照相系统对小梁切除术后的功能性滤过泡进行图像采集；利用计算机图像分析系统（EPCO2000软件）对滤过泡的相对面积进行定量分析和一致性分析；用Goldmann眼压计测量眼压；将功能性滤过泡相对面积与眼压进行线性相关回归分析。结果人选的青光眼患者36例（43只眼）行小粱切除术后的平均随访时间为（2．5±2．9）年（0.5～11.0年），平均眼压为（13．0±3．6）mmHg（5．0～19．7mmHg）。用计算机图像分析系统测量滤过泡相对面积平均值为0．44±0．27（0．10～1．44）。一致性分析结果表明测量者内的类内相关系数（ICC）为0．984（P〈0．01）；测量者间的ICC值为0．97l（P〈0．01）。滤过泡相对面积与眼压值的相关系数为r=0．713（P〈O．01），两者的回归方程为：y=17．043-9．249X。结论计算机图像分析系统（EPCO2000软件）可较准确地测量小梁切除术后功能性滤过泡的相对面积；功能性滤过泡越大，眼压越低。

Objective To investigate the relative size of functional filtering bleb obtained by the computer image analysis system and the relationship between the relative bleb size （RBS） and the intraocular pressure （IOP）. Methods Functional filtering bleb image was obtained by slit-lamp camera system. Both quantitative analysis of the RBS with image analysis system （EPCO2000 Software） and consistency of analysis were conducted. IOP was measured by Goldmann tonometer. A linear regression analysis of RBS and IOP was carried on. Results Forty-three eyes of 36 patients were involved in this study. The average follow-up time post operation was 2.5±2.9 （0.5 to 11.0） years and the average value of IOP was 13.0±3.6 （5.0-19.7） mmHg. The average of RBS by Image Analysis System was 0.44±0.27 （0.10 to 1.44）.Consistency analysis showed that the intraclass correlation coefficient （ICC） value was 0.984 （P〈0.01 ） by one same observer and the ICC among three different observers was 0.971 （P〈0.01 ）. Correlation coefficient （r） of RBS and IOP value was -0.713 （P〈0.01）, and the regression equation was： Y=17.043-9.249X. Conclusion Image analysis system （EPCO2000 software） could be a more accurate measurement of RBS after trabeculectomy. The bigger the functional filtering bleb was, the lower the IOP.