目的:评估眼前节生物测量仪Sirius、光学低相干反射仪Lenstar与接触式A超测量白内障患者眼生物参数的差异性和一致性。方法:选取2022年7月-2023年5月于苏州大学附属第一医院就诊的拟行白内障手术的患者121例(121眼)为研究对象，同一观察者分别应用Sirius、Lenstar和接触式A超测量眼生物参数，比较角膜中央厚度(central corneal thickness，CCT)、前房深度(anterior chamber depth，ACD)、眼轴(axial length，AL)、角膜平均 K 值(average corneal K value，Ave K)、晶状体厚度(lens thickness，LT)和白到白距离(white to white distance，WTW)的结果。对3种仪器的测量结果采用重复测量方差分析及Pearson相关性分析，并以Bland-Altman法进行一致性分析。结果:Lenstar、Sirius测得的CCT 值分别为(530。83±29。70)、(538。37±30。49)μm(P＜0。001)，Bland-Altman 分析显示两者一致性较差(95％LoA:-33。6～18。5，差值均值:-7。5);Ave K 值分别为(44。05±1。55)、(43。97±1。52)D(P＜0。001)，Bland-Altman 分析显示两者一致性较好(95％LoA:-0。49～0。63，差值均值:0。07);WTW 值分别为(11。56±0。37)、(11。31±0。36)mm(P＜0。001)，Bland-Altman 分析显示两者一致性较好(95％LoA:-0。29～0。79，差值均值:0。25);接触性 A 超、Lenstar、Sirius 测得的 ACD 值分别为(3。03±0。42)、(3。19±0。37)、(3。25±0。37)mm，三者差异有统计学意义(P＜0。001)，Bland-Altman分析显示两两仪器间的一致性较好(95％LoA分别为:-0。34～0。23，-0。49～0。16，-0。65～0。21，差值均值分别为:-0。05、-0。17、-0。22);接触式 A 超、Lenstar 测量的 AL 分别为(24。31±2。42)、(24。60±2。51)mm，差异有统计学意义(P＜0。001)，Bland-Altman 分析显示两者的一致性较差(95％LoA:-0。64～0。06，差值均值:-0。29);LT值分别为(4。30±0。60)、(4。32±0。40)mm，差异无统计学意义(P＞0。05)，Bland-Altman分析显示两者一致性较好(95％LoA:-0。75～0。71，差值均值:-0。02)。Pearson相关性分析显示对于上述眼球参数的测量结果，不同测量方法间均呈正相关。结论:Lenstar和Sirius对于白内障患者眼生物参数Ave K、LT和WTW具有较好的一致性，尤其是LT，两者的测量结果可以互相转换，而对于CCT的测量，两者间差异大且一致性差。接触式A超、Lenstar和Sirius 3种仪器对于ACD的测量虽不能互相转换，但具有较好的一致性。接触式A超与Lenstar测量AL，两者间差异大且一致性较差。
Comparison of the biometric measurements obtained using Sirius,Lenstar and contact ultrasound A-scan in cataract patients
Objective:To evaluate the difference and consistency of the biological parameters of ocular biometer Sirius,opti-cal low-coherence reflectivity Lenstar and contact A ultrasound measurement of cataract patients.Methods:121 patients(121 eyes)who had proposed cataract surgery from July 2022 to May 2023 were selected as the study subjects.The same observer used Sirius,Lenstar,and contact A-scan to measure ocular biological parameters,and compared the results of central corneal thickness(CCT),anterior chamber depth(ACD),axial length(AL),average corneal K value(Ave K),lens thickness(LT),and white to white distance(WTW).The results of the three instruments were analyzed by repeated measures ANOVA and Pearson corre-lation analysis and consistency by Bland-Altman method.Results:The CCT values measured by Lenstar and Sirius were(530.83±29.70)and(538.37±30.49)μm(P＜0.001),respectively.The Bland-Altman analysis showed a poor agreement between the two groups(95％LoA:-33.6-18.5,mean difference value:-7.5).The Ave K values were(44.05±1.55),(43.97±1.52)D(P＜0.001).The Bland-Altman analysis showed a good agreement between the two groups(95％LoA:-0.49-0.63,mean difference value:0.07).WTW values were(11.56±0.37)and(11.31±0.36)mm(P＜0.001).The Bland-Altman analysis showed a good agreement between the two groups(95％LoA:-0.29-0.79,mean difference value:0.25).The ACD values measured for the contact A ultrasound,Lenstar and Sirius are(3.03±0.42),(3.19±0.37),(3.25±0.37)mm,respectively,with statistically significant dif-ferences among the three(P＜0.001).The Bland-Altman analysis showed good agreement between the two instruments(95％LoA:-0.34-0.23,-0.49-0.16,-0.65-0.21,mean value of the difference is:-0.05,-0.17 and-0.22.The AL measured by contact A-ultrasound and Lenstar are(24.31+2.42)and(24.60±2.51)mm,respectively,with statistically significant difference(P＜0.001).The Bland-Altman analysis showed a poor agreement between the two groups(95％LoA:-0.64-0.06,mean difference value:-0.29).The LT values are(4.30±0.60),(4.32±0.40)mm,respectively,with no statistically significant difference(P＞0.05).The Bland-Altman analysis showed a good agreement between the two groups(95％LoA:-0.75-0.71,mean difference value:-0.02).Pearson correlation analysis showed a positive correlation between the different measures for the measurements of the above eyeball parameters.Conclusion:Lenstar and Sirius have good agreement for the ocular biological parameters Ave K,LT and WTW,especially LT,the measurements can be converted to each other,while for CCT,the differences and consistency between the two are large.The three instruments of contact A-ultrasound,Lenstar and Sirius cannot transform the measure-ment of ACD with each other,but they have good consistency.Contact A ultrasound and Lenstar measure AL,the difference is large and poor agreement.
万方数据
维普
