三种不同眼压计眼压测量值的比较

目的:比较分析Icare回弹式眼压计、GAT和DCT的眼压测量结果,探讨Icare回弹式眼压计的临床性能。方法:78例152眼分别用Icare,GAT,DCT3种眼压计进行眼压测量,然后根据测得的眼压高低分为高眼压、中眼压、低眼压3个组,对比分析3种眼压计的测量结果。结果:在全部受测者中Icare,GAT,DCT测得的眼压均值分别为19.16±5.03mmHg,18.41±4.52mmHg和17.23±3.69mmHg,每两种眼压计相比均有显著差别,但是彼此之间密切相关。高、中、低3个眼压组两种眼压计之间的差值均随着眼压的增高而增大。结论:使用Icare测量的眼压值准确可信,Icare,GAT和DCT的眼压值彼此之间具有良好的相关性。     

Tono pen眼压计与Goldmann眼压计对玻璃体切割术后患者眼压测量的比较

目的比较Tono-pen眼压计与Goldmann眼压计对玻璃体切割术后患者眼压的测量结果,评价Tono-pen眼压计作为玻璃体切割术后患者眼压测量方法的可行性。方法选取经睫状体平坦部行单纯玻璃体切割及玻璃体切割合并硅油填充术的患者各60例60只眼，分别在手术后第3天用Goldmann眼压计和Tono-pen眼压计测量眼压，比较两种眼压测量值的差异。结果120只眼中，Goldmann眼压计所测量眼压的平均值为（19.72±4.62）mm Hg（1 mm Hg=0133 kPa）；Tono-pen眼压计所测眼压的平均值为（19.69±4.60）mm Hg。经统计学检验，Tono-pen眼压计与Goldmann眼压计的测量结果差异无统计学意义(P＞0.05)。对于8~29 mm Hg 间的眼压测量，Tono-pen眼压计与Goldmann眼压计的测量结果有高度相关性。结论对于经睫状体平坦部行单纯玻璃体切割术和合并硅油填充术的患者眼压在8~29 mm Hg 时Tono-pen眼压计可以作为一种准确测量玻璃体切割术后患者眼压的简单方法。(中华眼底病杂志,2005,21:303-305)     

玻璃体切割术后眼压的测量

玻璃体切割(简称玻切)是眼科手术中的一大飞跃。它使许多眼病的治疗获得丁突破性进展.但玻切术后眼压常常会异常升高或降低,带来一系列严重的并发疵,若及早发现眼压变化,采取相应措施,可减少并发症的发生,因此玻切术后眼压测量是术后一项重要观察项目.玻切术后为了平覆和防止视网膜脱寓常将惰性气体注入玻璃体腔,即进行气一液体交换(gas—fluid exchange)。气体在眼内聚积,会影响眼压测量的准确性。国外学者对各种型号眼压计在气一液体交换的眼上测量眼压的准确性已作了探讨。我们对这些探讨作一回顾,以供实际工作中选     

ICARE回弹式眼压计与NCT眼压计测量结果的比较

目的:讨论ICARE回弹式眼压计的临床性能。方法:对78例156眼同时用ICARE回弹式眼压计和NCT眼压计进行眼压测量,对比分析两种眼压计的测量结果及两者的相关情况;观察ICARE眼压计对特殊病例测量的结果。结果:ICARE眼压计和NCT眼压计测得的眼压均值分别为16.55±8.54mmHg和16.81±7.35mmHg,两者无显著差别。两种眼压计测量值显著相关,相关系数为0.964。ICARE眼压计可较好地完成角膜病变和无固视能力等病例的眼压测量。结论:ICARE眼压计可以在临床上运用,尤其适用于其它眼压计测量困难的病例。     

玻璃体切割术中动态眼压测量

目的：直接测量玻璃体切除手术中眼内压（IOP）的动态变化．确定灌注管通路上一次性压力感受器间接测量术中动态眼内压方法的准确性。 方法：本研究是包含10位玻切患者的实验临床型研究。在导管传感器的近压力感受器末端安装固定铆．将其固定于附加睫状体平坦部切口．并置入玻璃体直接测量眼压。一次性的血压传感器被安置于灌注管道通路上并间接测量眼内压。在玻璃体切除手术的气液交换和气体灌注等不同步骤中，内置压力传感器和惹注管道通路上一次性血压感受器同时记录眼内压。 结果：玻切术中直接眼内压变化范围0-120mmHg。在液体灌注过程中．根据灌注管道通路上的压力感受器计算的间接眼内压．与前者高度一致。 结论：闭合式玻切手术可引起眼内压的巨大波动。液体灌注过程中插入式压力传感器可准确测量眼内压。     

Diaton眼压计与非接触式眼压计测量眼压的比较

目的比较Diaton眼压计（DT）与非接触式眼压计（NCT）测量眼压的差异。方法分别使用DT和NCT测量患者眼压,对测量值进行统计学分析,多元相关分析研究眼压测量值与年龄、角膜曲率、等效球镜度、中央角膜厚度之间的相关性。结果 DT与NCT的平均眼压测量值分别为（13.81±3.27）mmHg和（15.80±3.48）mmHg,差异有统计学意义（P〈0.05）,二者测量值的相关系数r=0.438,P〈0.05,两种眼压计的测量差值随中央角膜厚度增加而升高;将所有患者依照中央角膜厚度分为3组,NCT测量值在3组间有显著差异,而NCT测量值在3组间无差异;NCT测量值与年龄和中央角膜厚度呈正相关,而DT测量值与年龄、角膜曲率、等效球镜度、中央角膜厚度均不相关。结论 Diaton眼压计测量值不受年龄和中央角膜厚度影响,与非接触式眼压计测量值呈正相关,可应用于临床普查和诊断。     

iCare回弹式眼压计与Goldmann压平眼压计测量结果的比较

目的对比iCare回弹式眼压计（RBT）与Goldmann压平眼压计（GAT）测量眼压的一致性,评价RBT测量眼压的准确性及安全性。方法研究为诊断性试验评价。分别用2种眼压计测量角膜正常的患者52例104眼,其中男28例,女24例;年龄19～76岁,以GAT眼压值作为基准分为5组：≤10mmHg、11～20mmHg、21～30mmHg、31～40mmHg、≥41mmHg组。评估2种测量方法的眼压值差值及其与眼压的关系。对RBT眼压值随GAT眼压值变化的关系进行评价。结果 RBT测得的眼压读数为（17.20±9.13）mmHg,GAT测得的眼压读数为（17.13±8.94）mmHg,二者差异无统计学意义（t=0.260,P=0.795）。60.58%的患者2种方法测得的眼压差值在1mmHg以内。5个组中,GAT眼压与RBT眼压的绝对差值随着眼压读数的增高而加大,最大值在≥41mmHg组,二者的最大绝对差值〈4mmHg。RBT眼压读数随着GAT眼压读数的改变而变化,二者的变化呈现良好的相关性（r=0.917,P〈0.01）,但与GAT测量法比较,RBT测得的眼压值均稍高。当GAT眼压值〉21mmHg时,RBT测量的敏感度和特异度分别为95.5%和98.8%。RBT测量后25%的患者主诉有异物感和眼干。结论 iCareRBT测量眼压具有良好的耐受性和安全性,与GAT测量眼压具有较好的相关性,适用于临床。     

Icare回弹式眼压计与Goldmann压平眼压计眼压测量结果的比较

背景Icare回弹式眼压计作为一种新式眼压计,有必要对它的临床应用价值进行评估。目的通过比较分析Icare回弹式眼压计和Goldmann压平眼压计（GAT）的眼压测量结果,探讨Icare的临床价值。方法可疑青光眼、青光眼、屈光不正及部分健康体检者78例共152眼同时接受Icare、GAT眼压测量,受检眼先行Icare测量,然后再进行GAT测量,2次测量间隔3～5min。对比分析两种眼压计的测量结果。结果使用Icare和GAT测得的眼压均值分别为（19．16±5．03）mmHg和（18．41±4．52）mmHg,96眼（63．2％）两者的眼压差值≤1mmHg,二者的测量值差异虽有统计学意义,但二者的变化呈明显正相关（r=0．940,P〈0．01）。当Icare眼压测量值〈16mmHg时,Icare的眼压测量值低于GAT,而当Icare眼压测量值≥16mmHg时恰好相反;CCT偏薄、正常以及偏厚的情况下,Icare的眼压测量值均高于GAT的眼压测量值。Icare、GAT的眼压测量值和CCT间呈正相关（r=0．341,P〈0．01;r=0．333,P〈0．01）。结论与GAT眼压计比较,Icare回弹式眼压计易操作,测量结果可靠,临床实用性更强。     

后部玻璃体切割术后早期高眼压

后部玻璃体切割术后早期高眼压是玻璃体视网膜手术常见的并发症之一。严重的眼压升高可导致患者视力严重损害,其发生机制及危险因素是多方面的。本文就导致后部玻璃体切割术后早期高眼压的各种因素进行综述。     

两种眼压计对环扎术后眼压测量的比较

目的弄清非接触式眼压计（Ｎｏｎ－ＣｏｎｔａｃｔＴｏｎｏｍｅｔｅｒ，ＮＣＴ）和Ｓｃｈｉｔｚ眼压计对环扎术后的眼压测量有何差异。方法用ＮＣＴ和Ｓｃｈｉｔｚ眼压计对５７只视网膜脱离环扎加压术后的眼进行眼压测量。患者健眼亦５７只作对照组。结果手术组的ＮＣＴ值为１．９０２±０．６６４ｋＰａ；Ｓｃｈｉｔｚ值为０．９４３±０．４６４ｋＰａ；对照组ＮＣＴ值为２．３８１±０．６２０ｋＰａ；Ｓｃｈｉｔｚ值为１．９４２±０．４５０ｋＰａ；手术组的（ＮＣＴ－Ｓｃｈｉｔｚ）值为０．９５８±０．４３５ｋＰａ（Ｐ＜０．００１）；对照组（ＮＣＴ－Ｓｃｈｉｔｚ）值为０．４３９±０．４９１ｋＰａ（Ｐ＜０．００１）。结论在环扎加压术后的眼压测量中ＮＣＴ比Ｓｃｈｉｔｚ眼压计准确。     

超声生物显微镜和房角镜判断窄房角结果一致性分析

目的 评价超声生物显微镜(UBM)和裂隙灯显微房角镜(房角镜)对原发性闭角型青光眼房角检查结果 的一致性.方法 采用双盲法随机对一组原发性闭角型青光眼患者的前房角分别进行UBM和房角镜检查,收集房角镜下Scheie分级为NⅢ和NⅣ的患眼共102只眼(55例),将其房角镜检查结果 与UBM检查结果 进行等级相关统计学分析,并建立UBM和房角镜检查结果 的判别分析.结果 两者的检查结果 在上方、鼻侧、下方及颞侧四个方位的检查结果 中,鼻侧检查结果 的一致性最好(r8=.694,P＜0.01),其次为上方(r8=0.545,P＜0.01),颞侧(r8=0.426,P＜0.01),下方的检查结果 一致性最差(r8=0.357,P＜0.01).建立房角镜与UBM两者的判别分析结果 显示,鼻侧、上方、颞侧及下方的回代判别总判别符合率分别为86.3%、81.4%、74.5%及52.9%,交互验证符合率分别86.3%、81.4%、74.5%及52.9%.结论 在窄房角的情况下,UBM和房角镜检查的结果 在不同方位一致性程度不同.

Abstract：

Objective To assess the consistency of results between ultrasound biomcrioscopy (UBIM) and gonioscopy for narrow angle on primary angle-closure glaucoma. Methods UBM and gonioscopy were applied to exam anterior chamber angle on primary angle-closure glaucoma by randomized double-blind method. 102 eyes (55 cases) with Scheie classification NⅢ and NⅣ, were collected and compared the results of UBM. The data were analyzed by Spearman correlation test and discriminant analysis. Results The results of UBM and gonioscopy on narrow anterior chamber angel were well consistency with nasal (rs=0.694, P ＜0.01), followed by the superior (rs=.545, P ＜0.01), temporal (rs=0.426, P ＜0.01), respectively, but consistency were not good with inferior (rs=0.357, P ＜0.01), gonioscopy and UBM discriminant analysis showed that nasal, superior, temporal and inferior the generation of discriminant total different compliance rates were 86.3%, 81.4%, 74.5% and 52.9%, consistent with validation were 86.3%, 81.4%, 74.5% and 52.g%. Conclusions The consistency of results be tween UBM and gonioscopy for narrow anterior chamber angles are different in different direction.     

Effects of corneal thickness on intraocular pressure measured with three different tonometers

Purpose: To compare intraocular pressure (IOP) measured by a Goldmann applanation tonometer (GAT), a noncontact tonometer (NCT), and a portable noncontact tonometer (PNCT) in eyes of healthy volunteers, and to determine if a significant correlation exists between the IOP and the central corneal thickness (CCT). Methods: A total of 144 healthy participants were randomly assigned to one of two groups; in the first group, IOP was measured first with the NCT and then with the GAT. In the second group, IOP was measured first with the PNCT and then with the GAT. Subsequently, the CCT of all subjects was measured with an ultrasonic pachymeter. Results: The IOPs determined by the GAT and NCT and were strongly correlated, as were those determined by the GAT and PNCT, in both groups. However, a Bland-Altman plot showed that the correlations between the GAT and NCT and between the GAT and the PNCT measurements were not significant. With all three instruments, the IOP readings varied with the CCT. The mean IOPs obtained with the GAT increased by 0.23 mmHg with each 10-μm increase in CCT (0.23 mmHg/10 μm). The comparable value for the NCT was 0.29 mmHg/10 μm, and that for the PNCT was 0.31 mmHg/10 μm. Conclusions: For measurements of IOP in normal eyes, the GAT is the tonometer least affected by the CCT, compared with the PNCT and NCT. A PNCT is more likely to be affected by variations in CCT than the GAT.     

中央角膜厚度对3种眼压计眼压测量值的影响

目的比较分析不同中央角膜厚度(central corneal thickness,CCT)下Icare回弹式眼压计、Goldmann压平式眼压计(Goldmann applanation tonometer,GAT)和动态轮廓眼压计(dynamic contour tonometry,DCT)的眼压测量结果,探讨CCT对3种眼压计测量值的影响。方法 对78例患者152眼分别用Icare、GAT、DCT3种眼压计进行眼压测量,并进行CCT的测量,对比不同CCT下3种眼压计的测量结果,分析眼压测量值与CCT的关系。结果 在全部受测者中Icare、GAT、DCT测得的眼压均值分别为(19.16±5.03)mmHg(1 kPa=7.5 mmHg)、(18.41±4.52)mmHg和(17.23±3.69)mmHg,三者之间有显著差异(F=7.256,P=0.001)。Icare和GAT的眼压测量值均与CCT显著相关(r=0.341,P<0.001;r=0.333,P<0.001),CCT每改变10μm,Icare的眼压值改变0.47 mmHg,GAT的眼压值改变0.41 mmHg;而DCT的眼压测量值与CCT无显著相关(r=0.032,P=0.699)。结论 Icare、GAT的眼压测量值均明显受CCT的影响,而Icare受CCT影响的程度较GAT的稍大,DCT的眼压测量值基本不受CCT的影响。     

Comparison of intraocular pressure measurements with different contact tonometers in young healthy persons

AIM: To analyze the correlation of Goldmann applanation tonometer (GAT), I-Care tonometer and Tono-Pen tonometer results in young healthy persons, and to investigate the influence of central corneal thickness (CCT) on intraocular pressure (IOP) measurements recorded with these tonometers. METHODS: We conducted a pilot clinical study in 78 eyes of 78 subjects aged 22-28 years old (44 women and 34 men; mean age 23.8±1.19y). IOP was measured using GAT, I-Care and Tono-Pen tonometers, followed by measurements of CCT. Statistical analysis was performed using SPSS 20.0. RESULTS: The mean IOPs and standard deviation (±SD) for GAT, I-Care and Tono-Pen were 15.62±2.281 mm Hg, 16.29±2.726 mm Hg and 16.32±2.393 mm Hg, respectively. The mean CCT was 555.15±29.648 μm. Clear positive correlations between GAT and I-Care, GAT and Tono-Pen, and I-Care and Tono-Pen tonometers were found (r=0.867, P<0.001; r=0.861, P<0.001; r=0.915, P<0.001, respectively). In comparison between devices, Bland–Altman analysis showed a significant mean difference (MD) in the measurements by GAT and I-Care of ?0.679 mm Hg and by GAT and Tono-Pen of ?0.705 mm Hg ( P<0.001), but there was no significant difference between I-Care and Tono-Pen ( P>0.05). Both non-gold standard tonometers were affected by CCT; that is, both I-Care and Tono-Pen tonometer values were significantly higher with higher CCT means (>555 μm; MD=?1.282, P<0.001; MD=?0.949, P<0.001, respectively) compared with GAT. CONCLUSION: Both I-Care and Tono-Pen tonometers overestimated IOP compared with the GAT values. Either the I-Care or Tono-Pen tonometer could be used instead of GAT because there was no significant difference between their results. Higher CCT values (>555 μm) were associated with overestimated IOP values.     

硅油注入后高眼压的治疗策略

目的 回顾性分析轻重硅油注入术后1个月高眼压的发生及其治疗策略.方法 玻切+轻/重硅油注入术后1个月发生高眼压共46例(46眼).对两种硅油注入术后1个月高眼压的发生率进行分析对比,且对高眼压的处理方式进行对比.结果用x2检验进行分析.结果 轻硅油注入术后取油的时机一般在3个月(68.8％)左右,取出后高眼压可以降至正常范围;重硅油在2个月左右取油(64.3％),取出后高眼压可以降至正常范围.二者没有统计学差异.但重硅油注入术后因高眼压行抗青光眼手术的比例较轻硅油者高,差异有统计学意义.结论 轻重硅油注入术后1个月高眼压的发生率没有统计学差异,但重硅油引起的高眼压最终行抗青光眼手术的比例较轻硅油者高.     

Impact of corneal parameters on intraocular pressure measurements in different tonometry methods

AIM: To evaluate the impact of central corneal thickness (CCT) and corneal curvature on intraocular pressure (IOP) measurements performed by three different tonometers. METHODS: IOP in 132 healthy eyes of 66 participants was measured using three different tonometry techniques: Goldmann applanation tonometer (GAT), Pascal dynamic contour tonometer (DCT), and ICare rebound tonometer (RT). CCT and corneal curvature were assessed. RESULTS: In healthy eyes, DCT presents significantly higher values of IOP than GAT (17.34±3.69 and 15.27±4.06 mm Hg, P<0.0001). RT measurements are significantly lower than GAT (13.56±4.33 mm Hg, P<0.0001). Compared with GAT, DCT presented on average 2.51 mm Hg higher values in eyes with CCT<600 μm and 0.99 mm Hg higher results in eyes with CCT≥600 μm. The RT results were lower on average by 1.61 and 1.95 mm Hg than those obtained by GAT, respectively. Positive correlations between CCT in eyes with CCT<600 μm were detected for all IOP measurement techniques, whereas a similar relationship was not observed in eyes with thicker corneas. A correlation between IOP values and keratometry in the group with CCT<600 μm was not detected with any of the tonometry methods. In thicker corneas, a positive correlation was found for GAT and mean keratometry values (R=0.369, P=0.005). CONCLUSION: The same method should always be chosen for routine IOP control, and measurements obtained by different methods cannot be compared. All analysed tonometry methods are dependent on CCT; thus, CCT should be taken into consideration for both diagnostics and monitoring.     

ICare回弹式眼压计与NCT测量结果的比较

目的：比较ICare回弹式眼压计（ICareRBT）和非接触眼压计（NCT）测量值的一致性,评价ICareRBT的测量精确性。方法：对113例222眼（右眼111眼,左眼111眼）随机使用NCT和ICare回弹式眼压计测量眼压,对两种眼压计所测眼压值的差异采用配对t检验分析法,对ICare所测眼压值随NCT所测值变化的关系分析采用线性回归分析法,对ICare与NCT眼压测量值的一致性采用Bland-Altman分析法。结果：使用ICareRBT和NCT测得的眼压均值分别为18.46±8.50mmHg和17.09±8.32mmHg,二者差值为1.36±1.52mmHg,两种测量方法Pearson相关因子r为0.984。Bland-Altman分析证实ICareRBT与NCT眼压测量值具有良好的一致性。所有受试者对ICareRBT的测量无不适反应。结论：ICareRBT与NCT测量值间具有高度的相关性,可以作为可靠的筛查工具,并可以在临床广泛应用。