OA-2000与IOLMaster 500、A型超声测量白内障眼部生物学参数的比较

摘要

目的:比较最新的OA-2000光学生物测量仪与广泛应用的IOLMaster 500、A型超声测量白内障眼生物学参数的一致性.方法:系列病例研究.选取2018年5-6月内蒙古医科大学附属医院眼科确诊为年龄相关性白内障的患者152例(152眼),对所有患者依次采用OA-2000、IOLMaster 500、A型超声波(A超)这3种设备进行检查,获取眼轴长度(AL)、角膜曲率(Ks、Kf)、中央前房深度(ACD)、角膜横径(W-W)、中央角膜厚度(CCT)、晶状体厚度(LT)和人工晶状体(IOL)度数等参数.数据采用方差分析、Pearson相关分析及Bland-Altamn法进行分析.结果:①OA-2000、IOLMaster 500、A超对AL和ACD的检出率分别为97.3％、78.2％、100％和99.3％、97.3％、100％;OA-2000、IOLMaster 500对Ks/Kf的检出率为99.3％、98.6％;对W-W的检出率为97.3％、94.7％.其中高度近视伴后巩膜葡萄肿且AL≥26 mm的17眼中,OA-2000、IOLMaster 500、A超对AL的检出率分别为88％(15/17)、65％(11/17)、100％(17/17).②3种设备间测得的AL、ACD总体差异有统计学意义(F=12.63,P=0.02;F=10.57,P=0.01),其中OA-2000和IOLMaster 500测得的AL、ACD参数结果差异无统计学意义,A超与其他2种设备测得的AL、ACD差异均有统计学意义(P<0.001);OA-2000和IOLMaster 500测得的Ks/Kf、IOL、W-W参数差异均无统计学意义.③3种设备对AL测量的平均差值:OA-2000和IOLMaster 500为0.03 mm,OA-2000和A超为0.13 mm;3种设备对AL≥26 mm的AL测量的平均差值:OA-2000和IOLMaster 500为0.06 mm,OA-2000和A超为0.43 mm.④Pearson相关性分析显示OA-2000和IOLMaster 500在AL测量结果中具有较高的相关性(r=0.78,P=0.02).⑤通过Bland-Altamn法对各设备的AL数据进行一致性分析,结果显示在95％的一致性范围内一致性良好.结论:OA-2000、IOLMaster 500、A超在白内障患眼中的眼部生物测量结果无差异,但OA-2000对AL的检出率明显高于IOLMaster 500,同时在高度近视伴后巩膜葡萄肿的AL测量中,OA-2000测量的精确性及可靠性更高.%Objective: To compare the consistency of OA-2000 with IOLMaster 500 and A-scan for biologicalmeasurements. The purpose of this study was to evaluate the measurements of OA-2000 in preoperative examinations of cataract patients. Methods: In this case series study, a total of 152 patients (152 eyes) diagnosed with age-related cataract were selected at the Affiliated Hospital of Nei Mongol Medical University from May to June 2018. All the patients were examined in turn by OA-2000, IOLMaster 500 and A-scan. Measurements by these three instruments were compared for axial length (AL), Ks/Kf, anterior chamber depth (ACD), white-to-white (W-W), lens thickness (LT) and intraocular lens (IOL) dioptor. The results were analyzed by one-way analysis of variance, Pearson correlation and Bland-Altman. Results: ①The detection rates of AL and ACD with OA-2000, IOLMaster 500, and A-scan were 97.3％, 78.2％, 100％, and 99.3％, 97.3％, 100％, respectively. The detection rates of Ks/Kf with OA-2000 and IOLMaster 500 were 99.3％ and 98.6％. The detection rates of W-W with OA-2000 and IOLMaster 500 were 97.3％ and 94.7％. Among them, 17 eyes had high myopia, posterior scleral grape swelling and an axial length≥26 mm. The detection rates of AL with OA-2000, IOLMaster 500 and A-scan were 88％(15/17), 65％ (11/17), and 100％ (17/17). ②There was a significant difference in AL and ACD between the three instruments (F=12.63, P=0.02; F=10.57, P=0.01). The AL, ACD parameters measured by OA-2000 and IOLMaster 500 were not significantly different. There were significant differences in AL and ACD between A-scan and the other two instruments (P<0.001). There were no significant differences in Ks/Kf, IOL or W-W parameters among the three instruments. ③The average difference in AL measurements between OA-2000 and IOLMaster 500 was 0.03 mm, between OA-2000 and A-scan was 0.13 mm. The average difference between the three instruments for AL measurements with an axial length≥26 mm:OA-2000 and IOLMaster 500 was 0.06 mm; OA-2000 and A-scan was 0.43 mm. ④A Pearson correlation analysis showed that there was a high correlation between the measured results of OA-2000 and IOLMaster 500 (r=0.78, P=0.02). ⑤The consistency of AL results using Bland-Altamn analysis showed that there was good consistency in the range of 95％ consistency. Conclusion: There was a high consistency in ocular biological measurements between the three instruments in cataract eyes. However, the detection rate of OA-2000 in AL was significantly higher than that of IOLMaster 500, and the accuracy of the OA-2000 measurement was obviously higher in the AL measurement in high myopia with posterior staphyloma.