新型角膜内皮镜SP-1P检测中央角膜厚度的临床应用

目的　研究角膜内皮镜SP-1P测量中央角膜厚度（central corneal thickness，CCT）的重复性，以及与A型超声角膜测厚仪（A超）和眼前节光学相干断层扫描仪（anterior segment optical coherence tomography，AS-OCT）检测CCT的一致性。方法　前瞻性临床研究。收集2017年8月至10月在河南省眼科研究所准分子激光治疗中心矫正近视的患者114例（均纳入右眼），年龄为（22.14±4.83）岁，采用角膜内皮镜SP-1P连续测量3次CCT，同时通过AS-OCT和A超分别测量CCT，测量结果采用方差分析进行比较，进一步应用Bland-Altman法对一致性进行分析。结果　角膜内皮镜SP-1P 3次测得的CCT值分别为（521.33±27.90）μm、（521.70±27.83）μm、（521.69±27.69）μm，差异无统计学意义（F=0.728，P=0.395）；Bland-Altman分析结果显示，3次测量间的差值均至少95.6%的点在95％的一致性界限内。A超及AS-OCT测得的CCT值分别为（544.50±30.48）μm和（520.75±28.62）μm，其中角膜内皮镜SP-1P和AS-OCT测得的CCT值均较A超所测CCT值偏低，差异均具有统计学意义（均为P<0.001）；而角膜内皮镜SP-1P和AS-OCT测量结果相比，差异无统计学意义（P=0.162）。结论　角膜内皮镜SP-1P测量CCT具有良好的重复性和稳定性，角膜内皮镜SP-1P和AS-OCT具有同等的准确性及良好的一致性，可以相互替代；但二者测得的CCT值均较A超偏低。

Application of new corneal endoscope SP-1P in the measurement of central corneal thickness

Objective　To investigate the repeatability of a new corneal endoscope SP-1P for central corneal thickness （CCT） measurement and further to analyze the consistency of CCT measured by corneal endoscope SP-1P，type-A ultrasonic corneal thickness gauge （A ultrasound） and anterior segment optical coherence tomography （AS-OCT）.Methods　A retrospective clinical study was performed in Henan eye institute ophthalmic excimer laser treatment center from August to October 2017.A total of 114 patients （all right eyes） aged （22.14±4.83）years old for correction of myopia were included in the current study.The CCT values of individuals were measured three times by corneal endoscope SP-1P，and were also measured by A ultrasound and AS-OCT，respectively.Analysis of variance was used to evaluate the difference，and Bland-Altman method was used to analyze the consistency.Results　The CCT values of three repeated corneal endoscope SP-1P measurements were （521.33±27.90）μm，（521.70±27.83）μm and （521.69±27.69）μm，respectively.The difference was not statistically significant among different measured methods （F=0.728，P=0.395）.The analysis of Bland-Altman showed that at least 95.6% of the differences among the three repeated measurements were within the 95% consistency limit.The CCT values measured by A ultrasound and AS-OCT were （544.50±30.48）μm and （520.75±28.62）μm，respectively.The CCT values measured by AS-OCT and corneal endoscope SP-1P were lower as comparison with measured by A ultrasound，and the differences were statistically significant （all P<0.001），but no statistically difference was obtained between the CCT values measured by AS-OCT and corneal endoscope SP-1P（P=0.162）.Conclusion　By using corneal endoscope SP-1P，the measurement of CCT had a good repeatability and stability.Furthermore，corneal endoscope SP-1P and AS-OCT have a similar accuracy and good consistency，but the CCT values were lower measured by SP-1P and AS-OCT than measured by A-ultrasound.