国产回弹式眼压计的临床评价

Clinical evaluation on domestic rebounder tonometer

目的通过比较国产回弹式眼压计(rebounder tonometer,RBT)与Goldmann压平式眼压计(Goldmann applanation to-nometer,GAT)的差别来评价RBT测量的准确性,通过计算测量者间和测量者内的差异来评价其精确性,探讨其临床应用价值。方法选择2009年6月至12月在北京同仁医院眼压监测室接受昼夜眼压曲线测量的可疑青光眼患者69例138眼。其中,男40例,女29例,年龄(40.0±22.4)岁。所有患者均按RBT、GAT的顺序分别由两名检查者完成眼压测量,每种眼压计的测量均重复3次,分别记录并计算平均数作为该种眼压计的测量结果。测量者一、二需在5min内完成眼压的测量。比较两位测量者间的差值评价RBT的精确性,比较两种眼压计测量结果间的差值评价RBT的准确性。并分析眼压高低及中央角膜厚度对RBT准确性的影响。结果 RBT和GAT所测右眼的眼压值分别为(20.0±5.1)mmHg(1kPa=7.5mmHg)和(20.4±5.2)mmHg,差值为(0.4±2.5)mmHg,二者比较,差异无统计学意义(t=1.211,P=0.230)。RBT和GAT所测左眼的眼压值分别为(20.5±4.7)mmHg和(20.4±4.8)mmHg,差值为(0.1±2.0)mmHg,二者比较,差异也无统计学意义(t=-0.318,P=0.751)。两种眼压计所测眼压之间均有明显相关,左、右两眼r值分别为0.878(P=0.000)和0.912(P=0.000)。RBT不同测量者间的差异不具有显著性,测量者间相关系数在左、右眼分别为0.956和0.939,有较好的一致性。RBT测量者内相关系数在0.978～0.991,与GAT的结果接近。低眼压患者RBT的值大于GAT,高眼压患者RBT值小于GAT,正常眼压时两种仪器测得眼压的差值最小;中央角膜厚度较薄时RBT值偏低,中央角膜厚度较厚时RBT值偏高。结论 RBT的准确性和精确性可以满足临床工作的需求。

Objective To investigate the clinical value of domestic rebounder tonometer（RBT） by comparing its accuracy with Goldmann applanation tonometer（GAT） and evaluating its precision with calculating the differences between examiners and intra-examiner.Methods This study included 69 cases（138 eyes）,who were suspicious of glaucoma and taken detection of day and night intraocular pressure（IOP） in IOP detection room of Beijing Tongren Hospital from June 2009 to October 2009.There were 40 male patients and 29 female patients,and with an average of （40.0±22.4） years old.IOP was measured by two experienced examiners in an order of RBT and GAT.Each tonometer was used to detect for three times and get the mean value as the final result.All measursments should be finished in 5 minutes.The precision of RBT was evaluated by comparing the differences between the two examiners.The accuracy of RBT was evaluated by comparing the differences of results between the two tonometers.The effects of IOP levels and central corneal thickness on precision of RBT were analyzed.Results IOP of right eye were （20.0±5.1）mmHg（1 kPa=7.5 mmHg） and （20.4±5.2）mmHg with RBT and GAT,and the difference was （0.4±2.5）mmHg.There was no statistical difference（t=1.211,P=0.230）.IOP of left eye were （20.5±4.7）mmHg and （20.4±4.8）mmHg with RBT and GAT,and the difference was （0.1±2.0）mmHg.There was no statistical difference（t=-0.318,P=0.751）.There was correlation between the two tonometers.The relevant values were 0.878 for left eye（P=0.000）,and 0.912 for right eye（P=0.000）.The difference was not significant between examiners with RBT.The relevant values were 0.956 for left eye and 0.939 for right eye,and fine consistency was found.The relevant value was from 0.978 to 0.991 in examiners with RBT,which consisted with the result with GAT.The value with RBT was higher than that with GAT for ocular hypotension patients,lower for ocular hypertension patients and the difference was the least for normal IOP patients.The value with RBT was relatively lower for thin central corneal thickness,while higher for thick central corneal thickness.Conclusion The accuracy and precision of RBT can meet the clinical needs.