显微定量角膜检查镜测量角膜敏感性的检测分析

Quantitative detection and analysis of sensitivity by micro-keratoscope

目的检测分析显微角膜检查镜在手术显微镜下定量测量角膜散光的敏感性。方法序贯选取温州医学院附属第二医院眼科门诊患者及部分志愿者共49人92眼,进行角膜地形图、角膜曲率计、显微定量角膜检查镜的检查,按不同散光量(diopter,D)进行分组:A组:0～,B组:1～,C组:2～,D组:3～,并对检查结果进行散光轴向及散光量的定量分析。结果(1)散光轴向:A组散光轴向的检出率稍低(为80%),B、C、D3组均能全部检出(为100%),且与角膜地形图(rs=0.464)、角膜曲率计(rs=0.613)的结果相关性良好。(2)散光量:角膜检查镜与角膜地形图(r=0.965)、角膜曲率计(r=0.951)相关性良好;角膜检查镜与角膜曲率计读数差异无统计学意义(t=-1.799,P=0.075),不同分组间差异无统计学意义(F=0.678,P=0.568);与角膜地形图差异有显著统计学意义(t=5.513,P=0.000),不同分组间差异有显著统计学意义(F=4.531,P=0.005);进一步分组两两比较后发现,D组与其他3组间的差异有显著统计学意义(P=0.001、0.001、0.018),其余各组间差异无统计学意义。结论本研究的显微定量角膜检查镜在不同散光量分组的屈光不正人群中,无论是散光轴向还是散光量的检测均有较高的敏感性。

Objective To quantitative analyze and detect the sensitivity of astigmatism by micro-keratoscope under operating microscope.Methods Forty-nine cases （92 eyes） were selected consecutively from the Second Affiliated Hospital of Wenzhou Medical College and some volunteers.All cases were detected with corneal topography,keratometer and quantitative micro-keratoscope,and divided into 4 groups according to the power of astigmatism （diopter,D）：A（0~）,B（1~）,C（2~）,D（3~）.The astigmatism axial direction and astigmatic quality were quantitatively analyzed.Results The detection rate of astigmatism axial direction was a little lower in group A （80%）,was 100% in group B,C and D,which had a fine correlation with corneal topography （rs =0.464） and keratometer（rs =0.613）.With astigmatic quality,keratoscope had a fine correlation with corneal topography（r=0.965）and keratometer（r=0.951）;No statistical difference of astigmatic quality was found between keratoscope and keratometer （t=-1.799,P=0.075）,and there was no significant difference among each group（F=0.678,P=0.568）,but there was significant difference between keratoscope and corneal topography（t=5.513,P=0.000）.There was significant difference of astigmatic quality among groups（F=4.531,P=0.005）,but after comparison between each two groups,statistical difference was found between group D and each of other three groups（P=0.001,0.001,0.018）,but no difference among other three groups.Conclusion Quantitative micro-keratoscope has a high sensitivity for the detection of astigmatism axial direction and astigmatic quality in ametropic patients with varied astigmatic quality.