玻璃体切割术后三种不同眼压计眼压测量的比较

Comparison of intraocular pressure values measured by three different tonometers in patients after vitrectomy

目的比较分析ICare回弹式眼压计（ICare rebound tonometer，RBT）、Goldmann眼压计（Goldmann applanation tonometer，GAT）及非接触眼压计（noncontacted tonometer，NCT）在玻璃体切割术后眼的眼压测量结果，探讨RBT作为玻璃体切割术后患者眼压测量方法的应用前景。方法选取玻璃体切割合并惰性气体充填术及合并硅油充填术的患者各40例40只眼，分别在术后第三天使用RBT、GAT及NCT进行眼压测量，使用配对t检验、Pearson相关性分析及Bland—Altman法比较三种眼压计的测量值，探讨RBT对玻璃体切割术后患者进行眼压测量的可行性。结果实际入选玻璃体切割术后患者共80例80只眼，其中气体充填眼40只，RBT与NCT，RBT与GAT，NCT与GAT测量值的相关系数（r）分别为0．929（P〈0．01），0．899（P〈O．01），0．882（P〈0．01）。三组测量值两两之间的均差异无统计学意义。Bland—Altman散点图显示三组测量值两两之间均具有较好的一致性。另入选硅油眼40只，RBT与NCT，RBT与GAT，NCT与GAT测量值的相关系数（r）分别为0．831（P〈0．01），0．785（p〈0．01），0．874（P〈0．01）。三组测量值两两之间差异均无统计学意义。Bland—Altman散点图显示三组测量值两两之间均具有较好的一致性。结论对于玻璃体切割术后惰性气体充填眼或硅油眼，RBT与GAT及NCT具有较好的相关性、一致性，由于前者独特的优越性，将一定程度地解决玻璃体切割术后眼压测量比较困难的问题。

Objective To compare intraocular pressure （IOP） values measured in post-vitrectomy eyes by means of ICare rebound tonometer （RBT）, Goldmann applanation tonometer （GAT） and non- contacted tonometer （NCT）, and to evaluate the feasibility of RBT. Methods The patients selected including 40 who had undergone vitrectomy with intraocular tamponade of perfluorocarbon gas and the other 40 who had undergone vitrectomy with silicon oil filling. IOP of all of the patients was measured by GAT, NCT and RBT 3 days after the operation. The results of the three measurements were evaluated by means of paired t test, Pearson correlation analysis and Bland-Airman plot. Results A total of 80 patients were recruited including 40 who had undergone vitrectomy with intraocular tam- ponade of perfluorocarbon gas, the correlation coefficients （r） of RBT and NCT, RBT and GAT, NCT and GAT were 0.929 （P 〈0.01）, 0.899（P 〈0.01）, 0.882（P 〈0.01） respectively, and there was no significant difference in the mean IOP measured by the three tonometers. Bland-Altman scatter plot showed reasonable inter-method agreements between IOP measurements of each technique. Another 40 patients who was performed vitrectomy with silicon oil filling, the correlation coefficients （r） of RBT and NCT, RBT and GAT, NCT and GAT were 0.831 （P 〈0.01）, 0.785 （P 〈0.01）, 0.874 （P 〈0.01）, respectively. Bland-Airman scatter plot showed reasonable inter-method agreements between IOP measurements of each technique. Conclusions In post-vitrectomy eyes, the IOP measured by RBT is accurate and credible. At the same time, there are closely correlations between the IOP of RBT and the IOP of GAT and NCT.