IOLMaster700光学生物测量仪与Pentacam三维眼前节分析仪检测白内障患者眼部参数的临床研究

Comparisons of biometric parameters measurements by Pentacam and IOLMaster700 in cataract patients

目的比较IOLMaster700光学生物测量仪与Pentacam三维眼前节分析仪在白内障患者术前检测角膜参数的差异性、相关性及一致性。方法前瞻性研究。收集2018年3月至2019年11月就诊于潍坊眼科医院的白内障患者84例(155只眼)。其中,男性38例(69只眼),女性46例(86只眼);年龄33-81岁,平均年龄(59.7±10.5)岁。分别用IOLMaster700光学生物测量仪与Pentacam三维眼前节分析仪检测白内障患者术前的平坦轴角膜曲率(K1)、陡峭轴角膜曲率(K2)、平均角膜曲率(Km)、角膜散光度(△K)、角膜前表面至晶状体前表面前房深度(ACD_(IOLMaster700))、角膜后表面至晶状体前表面前房深度(AQD_(IOLMaster700))、角膜前表面至晶状体前表面前房深度[ACD(Ext)_(Pentacam)]、角膜后表面至晶状体前表面前房深度[ACD(Int)_(Pentacam)]及中央角膜厚度(CCT)。K1、K2、Km、△K、ACD_(IOLMaster700)、AQD_(IOLMaster700)、ACD(Ext)_(Pentacam)及ACD(Int)_(Pentacam)CCT等资料呈正态分布且方差齐,以x^(-)±s表示。分别以配对样本t检验、Pearson检验及Bland-Altman检验分析IOLmaster700与simk(15°)及simk(2.5 mm)检测结果的差异性、相关性及一致性。结果K1_(IOLmaster700)、K1_(Pentacam simk(15°))及K1_(Pentacam simk(2.5 mm))分别为(43.41±1.59) D、(43.46±1.61) D及(43.44±1.61) D,K2_(IOLmaster700)、K2_(Pentacam simk(15°))及K2_(Pentacam simk(2.5 mm))分别为(44.24±1.71) D、(44.25±1.72) D及(44.28±1.72) D,Km_(IOLmaster700)、Km_(Pentacam simk(15°))及Km_(Pentacam simk(2.5 mm))分别为(43.82±1.61) D、(43.85±1.64) D及(43.86±1.63) D,△K_(IOLmaster700)、△K_(Pentacam simk(15°))及△K_(Pentacam simk(2.5 mm))分别为(0.83±0.68) D、(0.80±0.63) D及(0.84±0.64) D,ACD_(IOLMaster700)和ACD(Ext)_(Pentacam)分别为(3.11±0.48) mm和(3.17±0.46) mm,AQD_(IOLMaster700)和ACD(Int)_(Pentacam)分别为(2.58±0.48) mm和(2.64±0.46) mm,CCT_(IOLMaster700)和CCT_(IOLMaster700)分别为(529.39±25.91)μm和(530.35±25.21)μm。ACD_(IOLMaster700)与ACD(Ext)_(Pentacam)、AQD_(IOLMaster700)与(ACD(Int)_(Pentacam))及CCT_(IOLMaster700)和CCT_(Pentacam)的差异均无统计学意义(t=-1.555,-1.506,-0.385;P>0.05);IOLMaster700光学生物测量仪与Pentacam三维眼前节分析仪simk(15°)检测的K1、K2、Km及△K比较,其差异均无统计学意义(t=-1.955,-0.223,-1.480,-0.953;P>0.05);IOLMaster700光学生物测量仪与Pentacam三维眼前节分析仪simk(2.5 mm)检测的K1、K2及△K比较,其差异均无统计学意义(t=-1.037,-1.406,-0.324;P>0.05);而Km之间的差异具有统计学意义(t=-2.002,P<0.05)。经Pearson相关性分析,两种设备检测的K1、K2、Km及△K的相关系数分别为0.978、0.979、0.988,0.751,显示具有良好的相关性。Bland-Altman分析结果显示ACD_(IOLMaster700)与ACD(Ext)_(Pentacam)、AQD_(IOLMaster700)与ACD(Int)_(Pentacam)以及两设备检测的CCT差值的平均值及95%LoA范围分别为-0.06 mm(-1.06--0.94) mm、-0.06 mm(-1.06--0.94) mm、-1.0μm(-61.4--59.5)μm,K1_(IOLmaster700)与K1_(Pentacam simk(15°))、K2_(IOLmaster700)与K2_(Pentacam simk(15°))、Km_(IOLmaster700)与Km_(Pentacam simk(15°))、K1_(IOLmaster700)与K1_(Pentacam simk(2.5 mm))、K2_(IOLmaster700)与K2_(Pentacam simk(2.5 mm))、Km_(IOLmaster700)与Km_(Pentacam simk(2.5 mm))、△K_(IOLmaster700)与△K_(Pentacam simk(15°))及△K_(IOLmaster700)与△K_(Pentacam simk(2.5 mm))差值的平均值及95%LoA范围分别为-0.05 D(-0.69--0.59) D、-0.02 D(-0.68--0.62) D、-0.01 D(-0.72--0.71) D、-0.04 D(-0.73--0.65) D、-0.03 D(-0.53--0.47) D、-0.04 D(-0.53--0.45) D、0.03 D(-0.90--0.83) D及-0.01 D(-0.93--0.90) D。结论IOLMaster700光学生物测量仪与Pentacam三维眼前节分析仪检测患者前房深度和中央角膜厚度的一致性较好,Pentacam三维眼前节分析仪simk(15°)检测的角膜曲率与IOLMaster700光学生物测量仪更接近,Pentacam三维眼前节分析仪simk(2.5 mm)检测的Km与IOLMaster700光学生物测量仪存在差异。

Objective To assess the difference, correlation and agreement of the biometry parameters measured by Pentacam and IOLmaster700 in cataract patients. Methods A. 84 cataract surgery candidates(155 eyes) were enrolled in Weifang Eye Hospital from March, 2018 to November, 2019 and analyzed from a prospective cohort study. There were 38 males(69 eyes)and 46 females(86 eyes)with the mean age of(59.7±10.5) years-old(ranging from 3 to 81 years-old). Keratometry values at the flat(K1) and steep(K2) axis, mean corneal power(Km) and magnitude of corneal astigmatism(△K) and anterior chamber depth from anterior corneal surface to anterior lens surface(ACD), anterior chamber depth from posterior corneal surface to anterior lens surface(AQD), and central corneal thickness(CCT) were examined by IOLMaster 700 and Pentacam. Pentacam takes two range values of simk(15°), simk(2.5 mm). The difference, correlation and consistency of the measurement results of IOLmaster700, simk(15 °) and simk(2.5 mm) were expressed as x^(-)±s after normality testing and analyzed by t-test of paired samples and Bland-Altman. Results The K1 values measured by IOLMaster700 and Pentacam simk(15 °) and simk(2.5 mm) were(43.41±1.59)D,(43.46±1.61)D,(43.44±1.61)D, respectively;and the K2 values were(44.24±1.71)D,(44.25±1.72)D,(44.28±1.72)D, km values(43.82±1.61)D,(43.85±1.64)D,(43.86±1.63)D, respectively;and △K values were(0.83±0.68) D,(0.80±0.63) D and(0.84±0.64) D, respectively. ACD values measured by IOLMaster700 and Pentacam(Ext) were(3.11±0.48)mm,(3.17±0.46)mm, respectively;and AQD values measured by IOLMaster700 and Pentacam(Int) were(2.58±0.48) mm,(2.64±0.46)mm;the mean CCT values were(529.39±25.91) μm,(530.35±25.21) μm, respectively. There was no significant difference in ACD(Ext), ACD(Int) and CCT between two instruments(t=-1.555,-1.506,-0.385;P>0.05). There was no significant difference in K1, K2, Km, △K between IOLmaster700 and Pentacam simk(15°)(t=-1.955,-0.223,-1.480,-0.953;P>0.05). There was no significant difference in K1, K2 and △K between IOLmaster700 and Pentacam simk(2.5 mm)(t=-1.037,-1.406,-0.324;P>0.05), but there was significant difference between Km(t=-2.002, P<0.05). Pearson correlation analysis showed that there was a good correlation in K1, K2, Km, △K between the results of two instruments(r=0.978, 0.979, 0.988, 0.751;P<0.05). The results of Bland-Altman analysis showed that the average value and 95%LoA range of the difference of ACD(Ext), ACD(Int) and CCT between IOLMaster700 and Pentacam were-0.06(-1.06—-0.94)mm,-0.06(-1.06—-0.94)mm and-1.0(-61.4—-59.5)μm, respectively. The average value and 95%LoA range of the difference of K1, K2, Km, Km, △K between IOLMaster700 and Pentacam simk(15 °) and simk(2.5 mm) were-0.05(-0.69—-0.59)D,-0.02(-0.68—-0.62)D,-0.01(-0.72—-0.71)D,-0.04(-0.73—-0.65) D,-0.03(-0.53—-0.47)D,-0.04(-0.53—-0.45)D, 0.03(-0.90—-0.83)D and-0.01(-0.93—-0.90)D, respectively. Conclusions IOLMaster700 and Pentacam have good consistency in measuring the parameters of ACD and CCT for cataract patients. The corneal curvature value from pentacam simk(15 °) is closer to IOLmaster700, and the average Km of pentacam simk(2.5 mm) is significantly different from that of IOLmaster700.