两种光学生物测量仪和接触式A超对高度近视眼球生物学测量的一致性评价

Comparison and Evaluation of Ocular Biometry Using Lenstar LS 900, IOLMaster, and Ultrasound A-scan in Highly Myopic Eyes

【目的】评估两种光学眼球生物测量仪Lenstar和IOLMaster与超声生物测量对于高度近视眼的眼球生物测量的准确性和一致性。【方法】对照观察分别由Lenstar、IOLMaster和接触式A超测量的高度近视患者的眼球生物学参数。三种方法的比较采用Friedman检验或Wilcoxon符号秩和检验,测量结果的重复性使用变异系数进行评价,采用Bland-Altman分析进行一致性评价。【结果】纳入了66个高度近视患者(66只眼),平均年龄(31.2±12.4)岁。Lenstar、IOLMaster和接触式A超测量的眼轴长度(AL)的变异系数分别为0.05%,0.07%和0.2%。AL的95%一致性界限(Lo A)范围分别为0.12 mm(Lenstar vs.IOLMaster),1.06 mm(Lenstar vs.A-scan),和1.14 mm(IOLMaster vs.A-scan),前房深度(ACD)的95%Lo A分别为0.28 mm(Lenstar vs.IOLMaster),0.51 mm(Lenstar vs.A-scan)和0.52 mm(IOLMaster vs.A-scan)。在极高度近视(AL≥27.0 mm)和巩膜后葡萄肿患眼中也得到相近的重复性和一致性结果。【结论】高度近视眼中,光学测量方法的测量结果一致性很好,能提供比超声生物测量重复性和准确性更好的眼球生物测量数据。

【Objective】 To evaluate the ocular biometric measurements in highly myopic eyes using a new optical low-coherence reflectometer-Lenstar and compare the measurements with those obtained from the IOLMaster and the applanation A-scan. 【Methods】In this prospective comparative observational study, a series of biometric measurements were taken for highly myopic subjects. The measurements obtained with the Lenstar were compared with those obtained with the IOLMaster or A-scan. The differences between three methods were assessed using Friedman test and Wilcoxon Signed-Rank test. Repeatability was evaluated by coefficient of variation（CV）. Agreement was evaluated using Bland-Altman analyses. 【Results】 The study evaluated 66 highly myopic subjects（66eyes）（mean age 31.2 ± 12.4 years）. The CVs for repeated axial length（AL） measurements in Lenstar, IOLMaster and A-scan were0.05%, 0.07%,and 0.2%, respectively. The spans of 95% limits of agreement（Lo A） for AL were 0.12 mm for Lenstar vs IOLMaster,1.06 mm Lenstar vs A-scan, and 1.14 mm IOLMaster vs A-scan. These values for anterior chamber depth（ACD） were 0.28 mm,0.51 mm, and 0.52 mm, respectively. The repeatability and agreement results were comparable in extremely myopic（AL ≥ 27.0mm） or staphylomatous eyes. 【Conclusion】 Optical biometry could provide more repeatable and interchangeable measurements in highly myopic eyes compared to ultrasound biometry.