首页|Scansys与Pentacam三维眼前节分析仪测量瞳孔偏移量的对比研究

Scansys与Pentacam三维眼前节分析仪测量瞳孔偏移量的对比研究

Comparative study on the measurement of papillary offset values with Scansys and Pentacam anterior segment analyzers

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目的 评估Scansys与Pentacam两种Scheimpflug成像原理的三维眼前节分析仪测量近视患者瞳孔偏移量的差异性和一致性,并探讨两台仪器测量的瞳孔偏移量与飞秒激光小切口基质透镜取出术(small incision lenticule extraction,SMILE)术后偏心切削量及高阶像差变化量之间的相关性.设计一致性评价.研究对象中部战区总医院近视手术中心SMILE手术患者96例185眼.方法 由同一医师随机应用Scansys和Pentacam两种眼前节分析仪测量患者术前瞳孔偏移量,记录Pentacam测量的手术前后的高阶像差及术后偏心切削量.两种仪器测量瞳孔相关参数的差异性及手术前后高阶像差的变化采用配对样本Wilcoxon秩和检验,两种仪器测量瞳孔相关参数的一致性采用组内相关系数(intraclass correlation coefficient,ICC)及 Bland-Alt-man 分析法评估,瞳孔偏移量与术后偏心切削量及高阶像差变化量之间的相关性采用Pearson相关性分析.主要指标SMILE手术患者瞳孔偏移量的ICC及相关系数.结果 两台仪器测量的多数近视患者瞳孔中心均向鼻上方及颞上方偏离.Scansys和Pentacam两种三维眼前节分析仪测得瞳孔的水平偏移量、垂直偏移量、总偏移量、偏移角的ICC右眼分别为0.74、0.78、0.73、0.59;左眼分别为0.77、0.78、0.84、0.66;双眼分别为0.75、0.78、0.79、0.63.Scansys和Pentacam三维眼前节分析仪测得的水平偏移量、垂直偏移量、总偏移量、偏移角的差值右眼分别为(-0.04±0.08)mm、(0.02±0.07)mm、(0.02±0.07)mm、(8.2±66)°(P均<0.05);左眼分别为(0.01±0.09)mm(P=0.527)、(0.02±0.07)mm(P<0.05)、(0.00±0.06)mm(P=0.650)、(-20±72)°(P=0.225),双眼分别为(-0.01±0.09)mm(P<0.05)、(0.02±0.07)mm(P<0.05)、(0.01±0.06)mm(P<0.05)、(-5.8±70)°(P=0.409).其中 Scansys 和 Pentacam测量的垂直偏移量比较,差异有统计学意义(P均<0.05).SMILE术后水平彗差及斜轴三叶草差无明显变化,总高阶像差、球差、垂直彗差及水平三叶草差均显著增加(P<0.001),但Scansys及Pentacam测得的瞳孔偏移量与SMILE术后偏心切削量及各高阶像差增加量均无相关性.结论 Scansys测量的瞳孔偏移量略大于Pentacam测量值,但两台仪器测得的瞳孔偏移量对SMILE术后高阶像差的增加量及偏心切削量均未见明显影响,因此,两种仪器获得的瞳孔偏移量及瞳孔偏移角数据临床上可相互参考.(眼科,2024,33:205-211)
Objective To evaluate the difference and consistency of papillary offset values of myopic patients measured by two anterior segment analyzers:Scansys and Pentacam.Meanwhile,to discuss the correlation of increment of higher order abberations(HOAs)after SMILE and papillary offset values as well as the correlation of ablation induced decentration after SMILE and papillary offset values.Design Consistency evaluation study.Participants 185 eyes of 96 patients who received SMILE at General Hospital of Central Theater Command.Methods Parameters of papillary offset values were recorded preoperatively by Scansys and Pentacam.Abla-tion induced decentration and preoperative and postoperative HOAs were recorded by Pentacam.Wilcoxon signed rank test was used to compare the difference between Scansys and Pentacam,the intraclass correlation coefficient(ICC)and Bland-Altman analysis were used to evaluate the agreement between Scansys and Pentacam.Pearson correlation analysis was used to discuss the correlation analysis.Main Outcome Measures ICC of papillary offset values by Scansys and Pentacam,correlation index.Results The highest proportion of the deviation of the pupil center from corneal vertex measured by Scansys and Pentacam was in the superotemporal and supernasal.The ICC for horizontal offset value,vertical offset value,total offset value and offset axis of the right eyes were 0.74,0.78,0.73 and 0.59;0.77,0.78,0.84 and 0.66 for the left eyes;0.75,0.78,0.79 and 0.63 for both eyes.The mean difference in horizontal offset value,verti-cal offset value,total offset value and offset axis for the right eyes were(-0.04±0.08)mm,(0.02±0.07)mm,(0.02±0.07)mm,(8.2±66)°(all P<0.05);(0.01±0.09)mm(P=0.527),(0.02±0.07)mm(P<0.05),(0.00±0.06)mm(P=0.650),(-20±72)°(P=0.527)for the left eyes;(-0.01±0.09)mm(P<0.05),(0.02±0.07)mm(P<0.05),(0.01±0.06)mm(P<0.05),(-5.8±70)°(P=0.409)for both eyes.The total HOA,spherical aberration,vertical coma,trefoil 0 increased signifiicantly after SMILE(all P<0.05).There was no correlation between papillary offset values and HOAs increments or ablation induced decentration.Conclusion Results of papillary offset values of Scansys were slightly larger than the results of Pentacam,but the differences have no effect on the HOAs increments or ablation induced decentration.So,the results of two devices can be referred to each other.(Ophthalmol CHN,2024,33:205-211)

ScansysPentacampupillary offset values

刘银、曾波、江文珊、吴金桃、徐赤、韩杨

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解放军中部战区总医院眼科,武汉 430070

Scansys Pentacam 瞳孔偏移量

湖北省自然科学基金

1403

2024

眼科
中日友好医院,北京同仁医院,北京市眼科研究所

眼科

CSTPCD
影响因子:0.483
ISSN:1004-4469
年,卷(期):2024.33(3)