数码裂隙灯照相系统、数显卡尺、Pentacam眼前节分析系统及IOLMaster测量角膜水平直径的比较

Comparison of the measurement of corneal horizontal diameter by digital slit-lamp photographic system,digital caliper,Pentacam and IOLMaster

目的采用数码裂隙灯照相系统、数显卡尺、Pentacam眼前节分析系统和IOLMaster四种方法测量角膜水平直径,比较其测量结果的差异性和一致性,评估四种方法在中央孔型有晶状体眼后房型人工晶状体(implantable collamer lens,ICL)(ICL V4c)植入术中的应用。方法选取2016年1月至2017年11月我院拟行双眼ICL V4c植入术的患者25例50眼,术前应用数码裂隙灯照相系统、数显卡尺、Pentacam眼前节分析系统及IOLMaster四种测量方法测量角膜水平直径,将测量数据进行统计学分析。结果数码裂隙灯照相系统、Pentacam眼前节分析系统、IOLMaster及数显卡尺测量50眼的角膜水平直径依次分别为(11. 66±0. 43) mm、(11. 78±0. 37) mm、(12. 04±0. 32) mm、(11. 72±0. 44) mm,IOLMaster测量值最大,数码裂隙灯照相系统测量值最小,且数码裂隙灯照相系统与数显卡尺的差异均值最小,重复性最好。95%一致性界限结果示,数码裂隙灯照相系统与数显卡尺、Pentacam眼前节分析系统与IOLMaster一致性较好,其余组别一致性较差。数码裂隙灯照相系统与数显卡尺两次所测水平角膜直径差值分别为(0±0. 04) mm、(-0. 07±0. 16) mm,两者的95%一致性界限分别为-0. 09~0. 08 mm、-0. 39~0. 24 mm,数码裂隙灯照相系统两次测量的95%一致性界限较数显卡尺更窄,一致性较数显卡尺更佳。结论数码裂隙灯照相系统与数显卡尺在ICL V4c植入术测量角膜水平直径的应用中一致性较好,临床应用中可相互替代,且数码裂隙灯照相系统具有更高的可重复性、更简便的操作以及更佳的患者依从性。

Objective To compare the difference and consistency of four measurements of corneal horizontal diameter by digital slit-lamp photographic system,digital caliper,Pentacam and IOLMaster,and to evaluate the application of the four methods in implantable collamer lens with a central hole(ICL V4c)implantation.Methods Totally 50 eyes of 25 patients who underwent ICL V4c implantation in our hospital during January 2016 to November 2017 were selected.The preoperative horizontal corneal diameter was measured using the digital slit-lamp photographic system,digital caliper,Pentacam and IOLMaster.The measured data were analyzed with statistical methods.Results The values of the horizontal corneal diameter of the 50 eyes measured by the digital slit-lamp photographic system,Pentacam,IOLMaster and digital caliper were(11.66±0.43)mm,(11.78±0.37)mm,(12.04±0.32)mm,(11.72±0.44)mm,respectively,IOLMaster had the largest measurement value and the digital slit-lamp photographic system had the smallest measurement value,and the digital slit-lamp photographic system and digital caliper group had the smallest difference value of horizontal corneal diameter and the best repeatability.The results of 95%limits of agreement(LoA)showed that the consistency of digital slit-lamp photographic system and digital caliper,Pentacam and IOLMaster were better in both groups,and the rest groups had poorer consistency.Difference in horizontal corneal diameter measured by digital slit-lamp photographic system and digital caliper for two times were(0±0.04)mm,(-0.07±0.16)mm,respectively,and the 95%LoA was(-0.09-0.08)mm,(-0.39-0.24)mm,respectively.The digital slit-lamp photographic system had a 95%consistency limit for two measurements that is narrower than that from digital caliper and is more consistent than digital caliper.Conclusion The consistency of digital slit-lamp photographic system and digital caliper is satisfactory,and they could be replaced each other to measure horizontal corneal diameter in clinical application.The digital slit-lamp photographic system are more repeatable,easier to operate,and better patient compliance.