Icare回弹眼压计在青光眼急性发作眼的眼压测量

iCare rebound tonometer in acute attack of primary angle closure glaucoma

目的观察Icare回弹眼压计（RBT）在青光眼急性发作角膜水肿眼的眼压测量隋况。方法临床病例对照研究。对2014年3-8月在天津市眼科医院采用RBT、非接触眼压（NCT）、Goldmann压平眼压（GAT）三种眼压计对青光眼急性发作眼进行眼压测量。以GAT为金标准，RBT和NCT眼压计测量值分别与GAT测量值进行比较。结果急性闭角型青光眼急性发作患者38例45只眼，男11例，女27例；年龄42-72岁，平均（59．0-8．2）岁。RBT和GAT组间眼压测量值差异无统计学意义（P=0．961，t=0．049）；两组眼压测量值高度相关（，=0．963）；Bland—Altman法分析一致性界限-5．9-6．0mmHg，4．4％（2／45）的测量值在一致性界限范围之外。NCT眼压计40．0％（18／45）只眼未测出眼压；NCT与GAT眼压测量结果差异有统计学意义（P=0．035，t=-2．224）：两组眼压测量值高度相关（r=0．905）；Bland—Ahman法分析一致性界限-11．0-7．0mmHg，0％（0／27）的测量值在一致性界限范围之外。结论RBT在青光眼急性发作眼眼压测量结果可靠，优于NCT，与GAT测量结果有较好地相关性和一致性。且测量简便，眼部创伤小，学习简单，仪器小巧、便携，建议在青光眼急性发作眼推广使用。

Objective To observe the result of iCare rebound tonometer （RBT） using in acute attach eyes of primary angle closer glaucoma （PACG）. Methods RBT, non contact tonometer （NCT） and goldmann applanation tonometer （GAT） were used to test the PACG acute attack eyes. The mean intraocular pressure （IOP） measurements were analyzed by paired t-test. Pearson correlation analysis was performed to assess the correlations （SPSS17.0 soft ware）. Agreement between the to- nometers was calculated using the Bland-Airman method （MedCalc soft ware）. Results Forty-five PACG acute attack eyes of 38 patients were included, 11 males, 27 females; aged 42-72 （averaged 59.0-8.2）. There was no statistical difference between the IOP tested by RBT and GAT （P =0.961, t =0.049）. High positive correlation were found between RBT and GAT （r =0.963）. Bland-Altman scatter plots showed reasonable inter-method agreement between RBT and GAT. 40.0% （18/45） eyes failed to test the IOP by NCT. There was statistical difference between the IOP tested by NCT and GAT （P =0.035, t =-2.224）. High positive correlation were found between NCT and GAT （r =0.963, r =0.905）. Bland-Altman scatter plots showed reasonable inter-method agreement between NCT and GAT. Conclusions RBT is more reliable tonometer than NCT to test the IOP of PACG acute at- tack eyes, it has a good positive correlation and reasonable inter-method agreement with GAT. This