利用OPD scanⅢ与传统裂隙灯法评估Toric IOL轴位的对比研究

Comparative study on the evaluation of Toric intraocular lens axial position using OPD scanⅢand traditional slit lamp method

目的:分析利用OPD ScanⅢ(光程差分析仪)与传统裂隙灯法评估散光矫正型人工晶状体(Toric IOL)轴位的一致性和准确性。方法:前瞻性观察对照研究。选取2018-07/2019-10在我院行白内障超声乳化摘除联合Toric IOL植入术的患者118例156眼。术后1wk,1、3mo随访观察残余散光,并分别在小瞳孔下和散瞳后采用OPD scanⅢ测量Toric IOL轴位(轴位眼内散光法和轴位OPD法),同时采用传统裂隙灯法测量Toric IOL轴位(轴位Slit法),分析三种方法测量结果的差异性和一致性,并计算三种方法测量结果与目标轴位相比的IOL轴位偏差度(LAD)。结果:术后1wk,1、3mo本组患者残余散光度均较术前明显降低(P<0.05),术后3mo残余散光度≤0.75D者占73.7%。术后3mo,轴位Slit法、轴位OPD法、轴位眼内散光法测得Toric IOL轴位分别为111.0°(10,178)°、113.5°(12,180)°、113.0°(15,178)°。一致性分析结果显示,术后3mo,轴位OPD法与轴位Slit法、轴位眼内散光法与轴位Slit法、轴位OPD法与轴位眼内散光法测量结果差值的均值分别是-0.58°、-0.19°、0.40°,均接近于0°,一致性较高,95%LoA分别为(-7.01~5.84)°、(-12.44~12.07)°、(-10.69~11.49)°。术后3mo,轴位Slit法、轴位OPD法、轴位眼内散光法测得LAD≤5°的患者占比分别为82.0%、80.1%、59.0%。结论:OPD scanⅢ可以散瞳直接测量Toric IOL轴位,是一种客观准确的测量方法,可以代替传统裂隙灯法测量轴位,避免主观局限性,也可在小瞳孔下通过眼内散光法测出Toric IOL轴位,结合眼科临床有一定的实际应用价值。

AIM:To analyze the consistency and accuracy of the axial position of the astigmatism correction intraocular lens(Toric IOL)measured by OPD scanⅢ(optical path difference analyzer)and the traditional slit lamp method.METHODS:A prospective observational control study.A total of 118 patients with 156 eyes who underwent phacoemulsification combined with Toric IOL implantation in our hospital from July 2018 to October 2019 were selected.The residual astigmatism was followed up at 1wk,1mo and 3mo after the operation,and the axial position of Toric IOL was measured with OPD scanⅢunder the small pupil(Axial intraocular astigmatism method)and after dilated pupils(Axial OPD method),while using traditional slit lamp method to measure Toric IOL axis position(Axial Slit method).Analyze the difference and consistency of the measurement results of the three methods,and calculate the Lens axis deviation(LAD)between the measurement results of the three methods and the target axis.RESULTS:The residual astigmatism of the patients in this group was significantly lower than that before the operation at 1wk,1mo and 3mo after operation(P<0.05).The proportion of residual astigmatism≤0.75D at 3mo after surgery was 73.7%.Three months after the operation,the axial position of the Toric IOL measured by the axial Slit method,the axial OPD method,and the axial intraocular astigmatism method were:111.0°(10,178)°,113.5°(12,180)°,and 113.0°(15,178)°.Consistency analysis showed that the average value of the difference between the axial OPD method and the axial Slit method,the axial intraocular astigmatism method and the axial slit method,the axial OPD method and the axial intraocular astigmatism method at 3mo after the operation,they were-0.58°,-0.19°,0.40°,which were all close to 0°,with high consistency.95%LoA were(-7.01-5.84)°,(-12.44-12.07)°,(-10.69-11.49)°.At 3mo postoperatively,the proportions of patients with LAD≤5°measured by axial Slit method,axial OPD method,and axial intraocular astigmatism were 82.0%,80.1%,and 59.0%,respectively.CONCLUSION:OPD scanⅢcan directly measure Toric IOL axial position after dilated pupils.It was an objective and accurate measurement method,which can replace the traditional slit lamp method to measure axial position and avoid subjective limitations.The Toric IOL axial position can also be measured by intraocular astigmatism under the small pupil,which has certain practical application value in ophthalmology clinical work.