目的分析OPD-Scan Ⅲ测量角膜屈光力及散光的可重复性及其与Pentacam检测结果的一致性。
方法采用诊断试验研究方法，收集2018年8月于南通大学第二附属医院及苏州大学附属理想眼科医院就诊的屈光不正患者50例100眼，采用主觉验光测量受检者球镜度数、散光度数及轴位。分别采用OPD-ScanⅢ和Pentacam行角膜生物测量且连续测量3次，记录平坦轴角膜曲率(K1)、陡峭轴角膜曲率(K2)、散光度数、散光轴位、散光矢量参数J0(0°或180°轴位的Jackson交叉柱镜值)、J45(45°轴位的Jackson交叉柱镜值)。采用组内相关系数(ICC)评价2种仪器测量数据的可重复性。分别采用Wilcoxon符号秩检验、Spearman秩相关性分析和Bland-Altman图表法分析2种仪器测量数据的差异、相关性及一致性。
结果OPD-Scan Ⅲ测得K1、K2、散光度数及轴位、J0以及J45的ICC均>0.900；Pentacam测得散光度数的ICC为0.896，其余测量数据均ICC>0.900。OPD-Scan Ⅲ测量K2、散光度数、J0及J45值明显高于Pentacam测量值，差异均有统计学意义(均 P<0.05)。OPD-Scan Ⅲ测量K1、K2、散光度数及轴位、J0和J45值与Pentacam的测量值均呈正相关( r s ＝0.981、0.982、0.900、0.737、0.921、0.703，均 P<0.01)。OPD-Scan Ⅲ与Pentacam测量K1、K2、散光度数及轴位、J0及J45差值的95%一致性界限(LOA)分别为-0.52~0.50 D、-0.39~0.59 D、-0.37~0.48 D、-17.29°~20.38°、-0.12~0.24 D和-0.22~0.28 D。
结论OPD-Scan Ⅲ在测量高度角膜散光患者的角膜屈光力及角膜散光度数时具有较好的可重复性和准确性，其测量散光轴位的95% LOA较大，不能被临床所接受。
ObjectiveTo analyze the repeatability of keratometry and astigmatism values measured by the OPD-Scan Ⅲ and the agreement of the parameters measured by OPD-Scan Ⅲ and Pentacam.
MethodsA diagnostic test study design was adopted.Fifty patients (100 eyes) with refractive errors, aged from 21 to 35 years old, were selected from Second Affiliated Hospital of Nantong University and Lixiang Eye Hospital of Soochow University during August 2018.Spherical equivalent, astigmatim degree and axis were measured by Autorefraction.Corneal biometric measurements were measured three times continuously with the above two instruments.Keratometry values at the flat axis (K1), keratometry values at the steep axis (K2), astigmatim degree, axis, vector parameters J0 (Jackson cross cylinder at 0°or 180°) and J45 (Jackson cross cylinder at 45°) were recorded.Intraclass correlation coefficient (ICC) was used for repeatability analysis.Wilcoxon signed rank test, Spearman correlation analysis and Bland-Altman graphs were employed to analyze the comparability.This study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Lixiang Eye Hospital of Soochow University (No.SLER2018112). Written informed consent was obtained from each patient prior to any examination.
ResultsThe ICC of K1, K2, astigmatism, astigmatic axis, J0 and J45 measured by OPD-Scan Ⅲ were all greater than 0.900; the ICC of the astigmatism measured by Pentacam was 0.896, and the ICC of the other parameters measured by Pentacam were greater than 0.900; The values of K2, astigmatism, J0 and J45 measured by OPD-Scan Ⅲ were greater than those measured by Pentacam, and the differences were statistically significant (all at P<0.05). The values of K1, K2, astigmatism degree, axis, J0 and J45 measured by OPD-Scan Ⅲ were positively correlated with those measured by Pentacam (r s=0.981, 0.982, 0.900, 0.737, 0.921, 0.703, all at P<0.01). The 95% agreement of limits (LOA) of K1, K2, astigmatism, axis, J0 and J45 measurement difference between OPD-Scan Ⅲ and Pentacam were -0.52-0.50 D, -0.39-0.59 D, -0.37-0.48 D, -17.29°-20.38°, -0.12-0.24 D and -0.22-0.28 D, respectively.
ConclusionsOPD-Scan Ⅲ has high credibility in measuring corneal refractive power and astigmatism degree, but its 95% LOA of astigmatism axis is too large to be accepted clinically.
李盼盼,袁幽,黄黎黎,等. OPD-Scan Ⅲ测量角膜屈光力和散光的可重复性及其与Pentacam检测结果的一致性[J]. 中华实验眼科杂志,2021,39(03)：238-242.
DOI:10.3760/cma.j.cn115989-20190323-00134版权归中华医学会所有。
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