三种新型眼前节生物分析系统测量角膜参数的比较研究

Comparison of corneal parameters measured by three optical anterior segment analysis systems

目的评估OPD-scan Ⅲ、Sirius和Scansys测量眼前节生物参数的差异性与一致性。方法系列病例研究。选取2020年7~8月在沈阳爱尔卓越眼科医院预行近视激光治疗患者103只眼,等效球镜:-6.0~-2.0 D,采用随机数表法测量OPD scan Ⅲ、Sirius、Scansys。收集角膜曲率(Sim K)、角膜散光值(CA)及轴位、中央角膜厚度(CCT)、白到白(WTW)、角膜高阶像差(HOA.6 mm)、角膜球差(SA.6 mm)等参数。方差分析比较差异性,Bland-Altman分析评定一致性。结果三种仪器测量SimK、角膜散光值、J_(0)、J_(45)、WTW差异均无统计学意义(P=0.934、0.736、0.683、0.712、0.158),三种仪器测量HOA、SA差异均有统计学意义(P=0.029、<0.001),多重比较发现,Scansys测量的HOA偏高、SA偏低,且与OPD、Sirius差异均有统计学意义(P=0.012、0.042、<0.001、<0.001)。Sirius和Scansys测量CCT差异均有统计学意(F=-9.167,P<0.001)。结合一致性界限LoA、平均差值及95%LoA线外点比例,三种仪器测量simk、散光值、WTW、CCT的一致性较好。结论OPD scan Ⅲ、Sirius、Scansys在角膜参数测量中存在一定的一致性,建议在临床工作中,不同测量原理仪器相互结合使用,以保证数据的精准可靠。Scansys可以成为眼前节参数测量一种新的选择。

Objective To evaluate the difference and agreement of biological parameters measured by OPD-scan Ⅲ,Sirius and Scansys.Methods In this case series study,103 eyes who underwent pre-laser treatment for refractive surgery were recruited in Shenyang Aier Excellent Eye Hospital from July to August 2020.Spherical equivalent lens:from-6.0D to-2.0D.Measurements were obtained by OPD-scan Ⅲ,Sirius and Scansys.Sim K,astigmatism,axial position,CCT,HOA,SA were recorded.While one-way ANOVOA and Bland-Altman plots were used to compare the differentiation and agreement by three anterior segment analysis systems.Results The results of one-way ANOVOA showed that there were no significant differences in simk、astigmatism、J_(0)、J_(45)、WTW(P=0.934、0.736、0.683、0.712、0.158),HOA and SA measured by the three instruments were statistically significant(P=0.029,<0.001).Pairwise comparisons showed that the HOA measured by Scansys was higher and the SA was lower,and the differences were statistically significant compared with OPD and Sirius(P=0.012,0.042,<0.001,<0.001).The difference of CCT measured by Sirius and Scansys was statistically significant(F=-9.167,P<0.001).According to the LoA,mean difference and 95%LoA,The agreement of simk,astigmatism,WTW and CCT of the three instruments is good.Conclusions OPD scan Ⅲ,Sirius and Scansys have a certain agreement in the measurement of corneal parameters.It is suggested that different measuring principles should be used together to ensure the accuracy and reliability.Scansys could be a new option.