Sirius眼前节分析仪与TMS-4角膜地形图仪测量角膜曲率及角膜散光比较

摘要

目的 研究Sirius眼前节分析仪测量近视患者角膜曲率及角膜散光的重复性,以及与TMS-4角膜地形图仪测量的一致性.方法 前瞻性研究.选取2016年3～6月在苏州大学第一附属医院眼科行近视激光治疗的患者125例(125只眼),应用Sirius眼前节分析仪测量每只眼3次,用组内变异系数、Cronbach's Alpha系数及组内相关系数评估Sirius测量角膜曲率和角膜散光的重复性.然后用TMS-4地形图仪测量,采用配对样本t检验及pearson直线相关进行统计学分析,并应用Bland-Altman分析评价两种测量方法的一致性.结果 Sirius眼前节分析仪测量的平坦角膜曲率(kf)值,陡峭角膜曲率(Ks)值、平均角膜曲率(Km)值和角膜散光及轴向具有很好的重复性,其ICC和CoA均大于0.90.Sirius系统测量的角膜Kf值,Km值较TMS-4地形图仪测量值分别大(0.11±0.14)D,(0.05±0.13)D,而角膜散光较TMS-4地形图仪测量值小(-0.12±0.19)D,结果差异均有统计学意义(P＜0.001).两种仪器测量的Kf、Ks、Km值、角膜散光值、散光轴向值差值的95％一致性界限分别为-0.17～0.38 D、-0.36～0.33 D、-0.20～0.30 D、-0.50～0.26 D、-17.61～21.37°;分另别有4.80％,5.60％,5.60％,5.60％,5.60％的点在95％一致性界限以外.结论 Sirius在测量近视患者的角膜曲率和角膜散光重复性好;与TMS-4角膜地形图仪测量值一致性稍差,不可简单互换使用.%Objective To explore the repeatability of comeal curvature and astigmatism measurements using Sirius system and the agreement with the TMS-4 conventional topographer in myopia.Methods A prospective control study of 125 patients(125eyes) with myopia before laser vision correction surgery were selected.Measurements of comeal flat keratometry(Kf),steep keratometry(Ks),mean keratometry(Km),comeal astigmatism and axis were taken firstly using Sirius anterior segment analysis system three times to assess the repeatability of the device.The best quality of imagein three acquisitions measured by TMS-4 topographer was chosen for analyzing subsequently.Paired samples t-test and Pearson linear correlation were used for statistical analysis.And a Bland-Altman analysis was used to evaluate the consistency of the two methods of measurement.Results Corneal Kf,Ks,Km,corneal astigmatism and axis measured by Sirius showed high intraobserver repeatability,with all ICC and CoA more than 0.90.Corneal Kf,Km,and astigmatism differences were 0.11± 0.14 D,0.05±0.13 D and-0.12±0.19 D,which were statistically significant,respectively.There were 4.80％,5.60％,5.60％,5.60％ and 5.60％ points exceeded 95％ LoA of-0.17 to 0.38 D,-0.36 to 0.33 D,-0.20 to 0.30 D,-0.50 to 0.26 D and-17.61 to 21.37 degrees for corneal Kf,Ks,Km,astigmatism and axis,respectively.Conclusions Sirius show high repeatability in measurement of corneal curvature and astigmatism,the measurement agreement between Sirius and TMS-4 topographer is not good.