目的比较IOLMaster 700与Pentacam AXL测量白内障患者眼生物学参数的一致性。
方法采用横断面研究方法，纳入2018年1月2日—11日于北京同仁医院眼科中心就诊的单纯白内障患者76例146眼，其中男36例69眼，女40例77眼；受检者年龄35～88岁，平均(64.52±11.36)岁。所有患者均分别采用IOLMaster 700及Pentacam AXL测量眼轴长度(AL)、平均角膜曲率(Km)、前房深度(ACD)、中央角膜厚度(CCT)和角膜直径(WTW)。比较2种检查仪器各测量值的差异，评估两种测量结果的相关性和一致性。
结果IOLMaster 700与Pentacam AXL测量的AL分别为(24.03±1.72)mm和(23.98±1.73)mm，Km分别为(44.04±1.71)D和(43.88±1.72)D，ACD分别为(3.24±0.47)mm和(3.28±0.47)mm，WTW分别为(11.82±0.51)mm和(11.49±0.49)mm，IOLMaster 700测得的AL、Km、WTW值较大，ACD值较小，差异均有统计学意义( t＝18.06、8.94、23.83、-15.36，均 P<0.01)，IOLMaster 700与Pentacam AXL测量的CCT分别为(534.18±30.12)μm和(533.42±28.71)μm，差异无统计学意义( t＝1.04， P＝0.30)。Pearson线性相关分析结果显示，2种仪器测量的AL、Km、ACD、CCT及WTW值均呈明显正相关( r＝0.999、0.992、0.998、0.956、0.942，均 P<0.01)。Bland-Altman分析结果显示，2种仪器测量的AL、Km、ACD、CCT及WTW值的95%一致性界限分别为-0.02～0.11 mm、-0.27～0.59 D、-0.10～0.02 mm、-16.5～18.1 μm及0.00～0.67 mm。
结论IOLMaster 700与Pentacam AXL测量AL、ACD、CCT具有较好的一致性及较窄的95%一致性界限，临床上可以互换使用。两种仪器测量WTW和Km的95%一致性界限超出临床可接受范围，均不建议互换使用。
ObjectiveTo compare the agreement of biometric parameters measured by a new swept-source optical coherence tomography IOLMaster 700 and a new Scheimpflug imaging combined with partial coherence interferometry biometer Pentacam AXL in cataractous eyes.
MethodsA cross-sectional study was performed.A total of 146 eyes from 76 cataract patients were enrolled in Beijing Tongren Eye Center from 2 to 11 in January 2018, including 69 eyes in 36 males and 77 eyes in 40 females, the age ranged from 35 to 88 years, the mean age was (64.52±11.36) years.Axial length (AL), mean keratometry (Km), anterior chamber depth (ACD), central corneal thickness (CCT) and white-to-white (WTW) were measured with IOLMaster 700 and Pentacam AXL, respectively.The differences and correlations of the biometry parameters between the two devices were assessed.Bland-Altman method was used to evaluate the agreement of these parameters between the two devices and the 95% limits of agreement was calculated.This study adhered to the tenets of the Declaration of Helsinki and was approved by an Ethics Committee of Beijing Tongren Hospital (TRECKY2018-049).
ResultsThe mean values of the AL measured by IOLMaster 700 and Pentacam AXL were (24.03±1.72)mm and (23.98±1.73)mm, Km were (44.04±1.71)D and (43.88±1.72)D, ACD were (3.24±0.47)mm and (3.28±0.47)mm, WTW were (11.82±0.51)mm and (11.49±0.49)mm, respectively.Compared with the values in Pentacam AXL, the AL, Km and WTW were larger while ACD was smaller in IOLMaster 700 with significant differences ( t=18.06, 8.94, 23.83, -15.36, all at P<0.01). The mean CCT values from the IOLMaster 700 and Pentacam AXL were (534.18±30.12)μm and (533.42±28.71)μm, respectively, with no significant difference ( t=1.04, P=0.30). The AL, Km, ACD, CCT and WTW from IOLMaster 700 were highly correlated with those from Pentacam AXL ( r=0.999, 0.992, 0.998, 0.956, 0.942; all at P<0.01). The Bland Altman analysis showed that the 95% limits of agreement of AL, Km, ACD, CCT and WTW were-0.02-0.11 mm, -0.27-0.59 D, -0.10-0.02 mm, -16.5-18.1 μm and 0.00-0.67 mm.
ConclusionsIOLMaster 700 and Pentacam AXL have good agreements and narrow 95% limits of agreement in the measurements of AL, ACD, CCT, which can be clinically interchangeable.The 95% limits of agreement of WTW and Km are out of the clinically acceptable range, so the WTW and Km measured by the two devices are not interchangeable.
李栋军,杨文利,王子杨,等. IOLMaster 700与Pentacam AXL测量白内障患者眼生物学参数的一致性[J]. 中华实验眼科杂志,2020,38(11)：962-966.
DOI:10.3760/cma.j.cn115989-20200924-00663版权归中华医学会所有。
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