Sirius、Oculyzer、AS-OCT和A超测量近视患者角膜最薄点厚度的比较

Comparison of the thinnest corneal thickness measured by Sirius,Oculyzer,AS-OCT and A-mode ultrasonography in myopic patients

目的:比较Sirius、Oculyzer、AS-OCT和A超对近视患者角膜最薄点厚度测量结果的差异性、相关性和一致性,为临床的应用提供参考。方法:选取2016-03/04在武警陕西省总队医院眼科近视眼激光部行飞秒激光辅助LASIK患者81例162眼,用Sirius、Oculyzer、AS-OCT和A超四种仪器分别测量以上患者的角膜最薄点厚度,对其进行统计学分析。结果:A超、Sirius、Oculyzer、AS-OCT测量结果分别为537.91±24.12、538.12±22.64、538.20±23.74、527.04±23.11μm(P<0.01)。AS-OCT的测量结果明显小于其他三种方法测量结果,A超、Sirius、Oculyzer之间无差异。将A超、Sirius、Oculyzer、AS-OCT测得的角膜厚度最薄点数值进行两两相关分析,表明四种方法测量角膜最薄点厚度均有高度相关性(r=0.920、0.914、0.951、0.908、0.929、0.919,均P<0.001)。A超分别与Sirius、Oculyzer、AS-OCT测量角膜最薄点厚度在95%CI为-18.77~18.33、-19.79~19.19、-3.79~25.53μm,结合Bland-Altman图,提示Sirius、Oculyzer、AS-OCT分别与A超间均具有较好的一致性。结论:与A超测得的角膜最薄点厚度结果相比,AS-OCT测量的结果偏薄。四种方法测量的角膜厚度最薄点值具有高度的相关性及一致性,但95%的一致性界限较宽,临床使用中两者可以相互参考,不能替换。

AIM:To compare the difference, correlation and consistency of the thinnest corneal thickness (TCT) in myopic patients among Sirius, Oculyzer, anterior segment optical coherence tomography (AS-OCT) and A-mode ultrasound pachymetry, in order to provide a reference for clinical applications. METHODS: TCT was measured in 81 patients (162 eyes) treated between March and April, 2016 using Sirius, Oculyzer, AS-OCT and A-mode ultrasound pachymetry before femtosecond LASIK, and then the values were statistically analyzed. RESULTS: TCT measured by A-mode ultrasound pachymetry, Sirius, Oculyzerand AS-OCT were respectively (537.91±24.12)μm,(538.12±22.64)μm,(538.20±23.74)μm,(527.04±23.11)μm ( P <0.01). There was a significant difference in TCT measurements among the four measurements. The results of AS-OCT were significantly smaller than those of the other three methods. There was no statistical difference among A-mode ultrasound pachymetry, Sirius and Oculyzer.Pearson correlation coefficient of measured value by the four measurements were more than 0.9 ( r =0.920, 0.914, 0.951, 0.908, 0.929, 0.919, P <0.001), which means there were highly correlation between each other. The 95% CI of the consistency interval of A-mode ultrasound pachymetry and Sirius, A-mode ultrasound pachymetry and Oculyzer, A-mode ultrasound pachymetry and AS-OCT were (-18.77- 18.33)μm,(-19.79- 19.19)μm,(-3.79-25.53)μm, respectively. The Bland-Altman Plots demonstrates relatively good consistency between A-mode ultrasound pachymetry and the other three methods. CONCLUSION:The TCT measured by AS-OCT were thinner than that measured by A-mode ultrasound pachymetry. There were a high correlation and consistency of the thinnest corneal thickness in myopic patients among Sirius, Oculyzer, AS-OCT and A-mode ultrasound pachymetry. The TCT measured by the four measurements can be referenced but not replaced since the 95% of the consistency intervals were wide.