Pentacam眼前节分析系统在巩膜镜验配初始矢高选择中的应用.

目的：评估Pentacam眼前节分析系统测量的眼前节生物学参数在巩膜镜（SL）验配初始镜片矢高（LSD）选择中的应用价值。方法：回顾性系列病例研究。选取2020 年10 月至2021 年6 月于南京医科大学附属眼科医院验配SL的角膜不规则散光或干眼患者32 例（53 眼）。所有患者均行SL验配前一般眼科检查，采用Pentacam采集角膜前表面平坦曲率（Kf）、陡峭曲率（Ks）、散光量、非球面参数Q值、中央角膜厚度（CCT）、角膜直径、前房深度（ACD）等数据。此外，采用Pentacam自带软件测量受检眼于13.50 mm弦长下的角膜矢高（CSH）。采用Pearson或Spearman相关以及线性回归分析各眼前节生物学参数与最终试戴评估修正后LSD的关系。结果：患者均完成初次SL试戴验配。Pentacam眼前节分析系统Scheimpflug images模式下所测量的13.50 mm弦长下CSH为（3 746±187）μm，试戴修正后LSD为（3 622±206）μm。相关分析结果显示：角膜前表面Kf、Ks、散光量、ACD及Pentacam测量的CSH与试戴修正后的LSD均呈正相关（r=0.36～0.84，均P<0.05）；CCT与试戴修正后LSD呈负相关（r=-0.35，P=0.011）；非球面参数Q值、角膜直径与试戴修正后LSD无相关性。将试戴修正后LSD作为因变量，校正相关因素后的线性回归方程显示Pentacam测量的CSH与试戴修正后LSD高度相关，即试戴修正后LSD=416.996+0.854×CSH（调整R2=0.63，F=89.17，P<0.001）。结论：Pentacam测量的部分眼前节生物学参数与SL试戴修正后的LSD相关，其中CSH可作为LSD选择的重要参考依据。

The Application of Pentacam Anterior Segment Analyzer in the Selection of Initial Sagittal Height in Scleral Lens Fitting

Objective: To evaluate the value of using the Pentacam anterior segment analyzer to measure ocular anterior segment parameters in the selection of initial lens sagittal depth (LSD) for scleral lenses (SL). Methods: Retrospective serial case study. Thirty-two patients (53 eyes) with irregular corneal astigmatism or dry eye disease were enrolled and fitted with SL in the Affiliated Eye Hospital of Nanjing Medical University from October 2020 to June 2021. All patients underwent general ophthalmic examinations before the initial SL fitting evaluation. Pentacam was used to obtain the ocular anterior segment parameters, such as flat keratometry (Kf), steep keratometry (Ks), corneal astigmatism, aspheric factor (Q-value), central corneal thickness (CCT), corneal diameter, and anterior chamber depth (ACD). In addition, the built-in caliper of the Pentacam was used to measure corneal sagittal height (CSH) at a 13.50 mm chord length. A Pearson or Spearman correlation analysis was used to evaluate the relationship between the modified LSD and above-mentioned parameters measured by Pentacam, and a linear regression model was created. Results: All patients completed the first SL fitting evaluation.The CSH measured in the Scheimpflug images of the Pentacam were 3 746±187 μm under a 13.50 mm chord length, and the modified LSD was 3 622±206 μm after fitting. The results of a correlation analysis showed that the modified LSD was positively associated with Kf, Ks, corneal astigmatism, ACD and CSH (r ranged from 0.36 to 0.84, all P<0.05). The modified LSD was negatively correlated with CCT (r=-0.35, P=0.011). However,there was no correlation between the Q-value or corneal diameter and the modified LSD. Defining the modified LSD as a dependent variable, the linear regression model showed that CSH measured by Pentacam was highly correlated with the modified LSD after correcting for the other covariates. The linear regression equation is LSD=416.996+0.854×CSH (adjusted R2=0.63, F=89.17, P<0.001). Conclusions: Some ocular anterior segment parameters measured by Pentacamare correlated with the modified LSD, and CSH can be used as an important reference for the selection of LSD inthe process of SL fitting.