采用彩色多普勒超声在筛查白内障患者中的价值研究

The value of color Doppler ultrasound in screening cataract patients

目的回顾性分析彩色多普勒超声(彩超)、A型超声(A超)、人工晶体生物测量仪(IOLMaster 700)测量白内障患者术前眼轴的差异性,探讨彩超、A超能否代替IOLMaster 700。方法选择2020年5月—2021年5月在蚌埠医学院第一附属医院眼科接受白内障手术治疗的老年性白内障患者100例(100眼),所有入组病例均于术前进行IOLMaster 700、A超和眼球彩超检查,检查测量同一患者的双眼眼轴长度(AL),反复测量5次,取平均值;分别观察比较IOLMaster 700、A超与彩超测量的AL值。结果IOLMaster 700测量AL值为23.75(22.91,24.36)mm,A超测量AL值为23.75(22.93,24.36)mm,彩超测量AL值为23.80(22.98,24.40)mm,3种设备组内相关系数ICC=0.998,组内相关系数95%CI为0.997~0.999,3种设备之间一致性高。经Pearson相关性分析IOLMaster 700与A超测量的AL值呈正相关关系(r=0.999,P<0.001);IOLMaster 700与彩超测量的AL值呈正相关关系(r=0.992,P<0.001);A超与彩超测量的AL值呈正相关关系(r=0.994,P<0.001)。Bland-Altman散点结果显示3种设备间两两比较的AL数据在95%的差异性范围内一致性良好。结论彩超与A超、IOLMaster 700在测量眼轴时无明显差异,彩超检查在基层医院白内障患者术前筛查中具有较高的应用价值,可以常规应用于白内障术前眼轴检查。

Objective To retrospectively analyze the difference of color Doppler ultrasound(color ultrasound),A-mode ultrasound(A ultrasound)and intraocular lens biometric instrument(IOLMaster 700)in preoperative ocular axis measurement of cataract patients,and explore whether color ultrasound and A ultrasound can replace IOLMaster 700.Methods A total of 100 senile cataract patients(100 eyes)who received cataract surgery in the Department of Ophthalmology of the First Affiliated Hospital of Bengbu Medical College from May 2020 to May 2021 were selected.All the enrolled patients underwent preoperative IOLMaster 700,A ultrasound and color ultrasound,and the axial length of both eyes(AL)of the same patient was measured and repeated for 5 times to obtain the average value.The AL values measured by IOLMaster 700,A ultrasound and color ultrasound were observed and compared.Results The AL measured by IOLMaster 700 was 23.75(22.91,24.36)mm,the AL measured by A-ultrasound was 23.75(22.93,24.36)mm,and the AL measured by color ultrasound was 23.80(22.98,24.40)mm.The intra-group correlation coefficient ICC of the three devices was 0.998.The intra-group correlation coefficient(95%CI)was 0.997-0.999,indicating high consistency among the three devices.The Pearson correlation analysis showed that IOLMaster 700 was positively correlated with the AL value of Aultrasound measurement(r=0.999,P<0.001).There was a positive correlation between IOLMaster 700 and AL value measured by color ultrasound(r=0.992,P<0.001).There was a positive correlation between the AL values measured by A ultrasound and color ultrasound(r=0.994,P<0.001).Blandaltman scatter results showed that the AL data of pairwise comparison between the three devices were in good agreement within the 95%difference range.Conclusion There was no significant difference between color Doppler ultrasound,Amode ultrasound and IOLMaster 700 in ocular axis measurement.Color Doppler ultrasound has high application value in preoperative screening of cataract patients in primary hospitals,and can be routinely used in preoperative ocular axis measurement of cataract.