IOLMaster700与IOLMaster500测量高度近视白内障眼生物学参数的一致性研究

摘要

目的 比较IOLMaster 700与IOLMaster 500测量高度近视白内障患者的眼轴长度(AL)、前房深度(ACD)和角膜曲率(Kf,Ks)的一致性.方法 采用横断面研究方法,纳入2017年9-10月在北京同仁医院拟行白内障手术治疗的单纯高度近视患者87例152眼,最佳矫正视力(BCVA)为0.05～1.0,屈光度为-6.25-21.00 D,平均(-13.625±7.375)D.分别采用IOLMaster 700和IOLMaster 500检测患者AL、ACD和Kf、Ks.根据IOLMaster 500 AL测量结果将患者分为AL＞26 mm～≤28 mm组、AL＞28 mm～＜30 mm组和AL≥30 mm组.采用配对样本t检验比较2种仪器测量AL、ACD和Kf、Ks的差异,采用Blant-Altman一致性分析评估2种仪器测量结果的一致性. 结果 AL＞26～≤28 mm组、AL＞28～＜30 mm组和AL≥30 mm组受检者用IOLMaster 700与IOLMaster 500测量的AL和Kf值比较差异均无统计学意义(均P＞0.05).Bland-Altamn一致性检验显示,3个组受检者用IOLMaster 700与IOLMaster 500测量的AL差值95％一致性界限外比例分别为4.10％、2.17％和3.03％,Kf差值95％一致性界限外比例分别为4.10％、4.34％和3.03％.3个组受检者用IOLMaster 700与IOLMaster 500测量的ACD值和Ks值的差异均有统计学意义(均P＜0.05),但在临床可接受范围内.Bland-Altamn一致性检验显示,3个组受检者用IOLMaster 700与IOLMaster 500测量的ACD差值一致性界限外比例分别为4.10％、4.34％和3.03％,测量Ks差值95％一致性界限外比例分别为4.10％、4.34％和3.03％. 结论 高度近视白内障患者用IOLMaster 700与IOLMaster 500测量的AL、ACD和Kf、Ks具有较好的一致性,IOLMaster 700通过扫频OCT可提供黄斑部图像,具有更大优势.%Objective To compare the agreement of axial length (AL),anterior chamber depth (ACD) and keratometry measured by IOLMaster 500 with IOLMaster 700 in cataract eyes with high myopia.Methods A cross-sectional study was performed.One hundred and fifty-two eyes of 87 cataract patients with high myopia were included from September to October 2017 in Beijing Tongren Hospital.The best corrected visual acuity (BCVA) was 0.05-1.0,and the refraction power was-6.25--21.00 D,with an average power of (-13.625 ± 7.375) D.A L,ACD and keratometry (Kf,Ks) were measured by IOLMaster 700 and IOLMaster 500 respectively for all the eyes.The eyes were assigned to AL＞26-≤28 mm group,AL＞28-＜30 mm group and AL≥30 mm according to the results of IOLMaster 500.The measured differences between two devices were assessed using paired samples t-test,and the measured consistency of the two devices was evaluated using Bland-Altman agreement analysis.This study protocol was approved by Ethics Committee of Beijing Tongren Hospital and complied with Declaration of Helsinki.Results There were no significant differences in the AL and Kf measured by the two devices in all the three groups (all at P＞0.05).Both ACD and Ks values measured by IOLMaster 700 were lower than those by IOLMaster 500 (both at P＜0.05),which were clinically acceptable.The percentage beyond 95％ agreement limit between IOLMaster 700 and IOLMaster 500 were 4.10％,2.17％ and 3.03％ for AL differences and 4.10％,4.34％ 和 3.03％ for Kf difference in the three groups.Significant differences were found in ACD and Ks between IOLMaster 700 and IOLMaster 500 at a clinically acceptable level (both at P＜0.05),and Bland-Altamn agreement analysis showed that the percentage beyond 95％ agreement limit between IOLMaster 700 and IOLMaster 500 were 4.10％,4.34％ and 3.03％ for both ACD and Ks differences in the three groups.Conclusions There is a good agreement in AL,ACD,Kf and Ks measured by IOLMaster 700 with IOLMaster 500 and is clinically interchangeable in cataract eyes with high myopia.However,IOLMaster 700 is better because it can provide the OCT image of macula.