Pentacam AXL与IOLMaster700测量人工晶状体度数计算参数的比较

Comparison of the Parameters for Intraocular Lens Power Calculation in Cataract Patients Measured by Pentacam AXL and IOLMaster 700

目的:比较Pentacam AXL与IOLMaster 700两种生物测量仪测量人工晶状体(IOL)度数计算所需参数——眼轴长度(AL)、角膜曲率、散光大小及轴向、前房深度(ACD)等的差异性及一致性。方法:前瞻性对照研究。收集2019年1—5月在厦门大学附属厦门眼科中心就诊的白内障患者92例(106眼),同一观察者分别应用Pentacam AXL与IOLMaster 700测量AL、角膜曲率(K1、K2、Km)、散光大小及轴向(矢量表示法J0、J45)、ACD。分析2种生物测量仪测量参数结果的差异性和相关性,2种仪器测量结果的差异性采用t检验,相关性采用Pearson检验,一致性采用Bland-Altman法分析。结果:Pentacam AXL与IOLMaster 700测量的AL平均值分别为(23.63±2.06)mm和(23.64±2.05)mm,Km值分别为(44.37±1.70)D和(44.45±1.71)D,J0分别为(0.011±0.555)D和(0.009±0.598)D,J45分别为(0.002±0.278)D和(0.013±0.289)D,ACD值分别为(2.96±0.41)mm和(2.91±0.41)mm,差异均无统计学意义(t=0.035,P=0.972;t=0.348,P=0.728;t=-0.020,P=0.984;t=0.300,P=0.764;t=-0.931,P=0.407),且均具有良好的相关性(r=1.000、0.988、0.911、0.811、0.994,均P<0.001)。Bland-Altman一致性分析显示,2种仪器对AL、J0、J45、ACD的测量具有较好的一致性,分别为-0.01 mm(95%LoA:-0.07~0.05 mm),0 D(95%LoA:-0.48~0.48 D),-0.01 D(95%LoA:-0.35~0.33 D)及0.05 mm(95%LoA:0~0.09 mm)。而Km为-0.08 D(95%LoA:-0.59~0.43 D)。结论:Pentacam AXL与IOLMaster 700测量参数间差异无统计学意义,AL、ACD及散光具有良好的一致性,可替换使用,而在角膜曲率测量方面变异幅度较大,替换使用需谨慎。

Objective:To evaluate the differences and consistency in axial length,corneal curvature,anterior chamber depth and astigmatism in cataract patients measured by Pentacam AXL and IOLMaster 700.Methods:This was a prospective controlled study.Ninety cataract patients(106 eyes)were enrolled in Xiamen Eye Center of Xiamen University from January to May 2019.Biometry measurements were performed by the same examiner with Pentacam AXL and IOLMaster 700.The axial length(AL),keratometry reading(K1,K2,Km),J0 and J45 vectoral components of astigmatism and anterior chamber depth(ACD)were obtained.The difference between the two instruments was analyzed.Differences and correlations of biometry measurements obtained with the two biometers were analyzed.The agreement between the two biometers was analyzed by Bland-Altman plot.Results:There were no significant differences in AL,Km,J0,J45 or ACD(t=0.035,P=0.972;t=0.348,P=0.728;t=-0.020,P=0.984;t=0.300,P=0.764;t=-0.931,P=0.407)between Pentacam AXL and IOLMaster 700(23.63±2.06 mm vs.23.64±2.05 mm,44.37±1.70 D vs.44.45±1.71 D,0.011±0.555 D vs.0.009±0.598 D,0.002±0.278 D vs.0.013±0.289 D,2.96±0.41 mm vs.2.91±0.41 mm).All of the biometric parameters showed good correlation(r=1.000,0.988,0.911,0.811,0.994,P<0.01).The Bland-Altman analysis of AL,J0,J45,ACD with Pentacam AXL and IOLMaster 700 showed a mean difference of 0.01 mm(95%LoA:-0.07-0.05 mm),0 D(95%LoA:-0.48-0.48 D),-0.01 D(95%LoA:-0.35-0.33 D)and 0.05 mm(95%LoA:0-0.09 mm)between the 2 devices,respectively,while the mean difference in Km was-0.08 D(95%LoA:-0.59-0.43 D).Conclusions:There is no significant difference in biometric parameters between Pentacam AXL and IOLMaster 700;the 2 devices can be used interchangeably to measure AL,J0,J45 and ACD in cataract patients.However,the Km value is not interchangeable since the devices have a slightly larger variation in measurements.