超声乳化白内障吸除术前后不同测量中心患者角膜参数的差异和一致性

Difference and consistency in corneal parameters measured in different areas centered on corneal apex and pupil after phacoemulsification

目的探讨超声乳化白内障吸除术前后不同测量中心患者角膜参数的差异和一致性。方法选取2020年10月至2021年5月在潍坊眼科医院行超声乳化白内障吸除术及Pentacam检查的白内障患者共148例(148眼)。根据Pentacam测量模式“以角膜顶点为中心”或“以瞳孔为中心”分为角膜顶点组和瞳孔中心组。术前及术后3个月,通过Pentacam测量手术前后以角膜顶点为中心和以瞳孔为中心2 mm、4 mm、6 mm圆环和区域模式下患者角膜前表面屈光力(ASF)、角膜真实净屈光力(TNP)和总角膜屈光力(TCRP);以角膜顶点为中心和以瞳孔为中心测量的同一指标之间采用Kendall W值进行一致性分析。结果术前圆环模式下:角膜顶点组4 mm ASF、4 mm TNP、6 mm TNP、4 mm TCRP均较瞳孔中心组高,6 mm TCRP较瞳孔中心组低(均为P<0.05);其余指标两组间差异均无统计学意义(均为P>0.05)。术前区域模式下:角膜顶点组4 mm ASF、2 mm TNP、4 mm TNP、6 mm TNP、4 mm TCRP均较瞳孔中心组高(均为P<0.05);其余指标两组间差异均无统计学意义(均为P>0.05)。术后3个月仅圆环模式下角膜顶点组2 mm ASF较瞳孔中心组高,差异有统计学意义(P<0.05);其余指标两组间差异均无统计学意义(均为P>0.05)。术前及术后3个月不同模式下两组患者各指标Kendall W值位于0.978~0.999间,各项结果一致性较好(均为P<0.05)。结论超声乳化白内障吸除术前后患者角膜不同区域和不同中心范围内部分角膜参数有所变化,总体比较以角膜顶点为中心和以瞳孔为中心测量的角膜参数一致性较好。

Objective To explore the difference and consistency in corneal parameters measured in different areas before and after phacoemulsification.Methods A total of 148 cataract patients(148 eyes)who underwent phacoemulsification and Pentacam examination in Weifang Eye Hospital from October 2020 to May 2021 were enrolled and divided into the corneal apex group and pupil center group according to the Pentacam measurement mode of corneal apex-centered or pupil-centered.The axial sagittal front power(ASF),true net power(TNP),and total corneal refractive power(TCRP)at 2-,4-,and 6-mm diameter zones centered on the corneal apex and pupil in the ring and zone modes were measured by Pentacam before and three months after surgery.Kendall W values were used for consistency analysis of the same indicator.Results In the preoperative ring mode:4 mm ASF,4 mm TNP,6 mm TNP,and 4 mm TCRP were higher in the corneal apex group than those in the pupil center group,and 6 mm TCRP was lower than that in the pupil center group(all P<0.05);the remaining indicators showed no significant differences(all P>0.05).In the preoperative zone mode:4 mm ASF,2 mm TNP,4 mm TNP,6 mm TNP,and 4mm TCRP were higher in the corneal apex group than those in the pupil center group(all P<0.05);the remaining indicators showed no significant differences(all P>0.05).In the 3-month postoperative ring mode:only the 2 mm ASF in the corneal apex group was higher than that in the pupil center group(P<0.05),and the remaining indicators showed no significant differences(all P>0.05).In both ring and zone modes before and three months after surgery,the Kendall W value of each indicator in the two groups was between 0.978 and 0.999,and the results showed a good consistency(all P<0.05).Conclusion Some corneal parameters in different areas change after phacoemulsification,but overall,there is a good consistency in corneal parameters measured with the corneal apex at the center and with the pupil at the center.