三种仪器测量白内障眼生物学参数的比较

目的:比较最新的IOL Master 700与已广泛应用的IOL Master 500及A型超声测量白内障眼生物学参数的一致性,分析评价IOL Master 700在白内障术前检查中的测量优势。方法:前瞻性研究。随机选取2018-04-05/04-20于我院住院行白内障超声乳化摘除及人工晶状体植入手术的年龄相关性白内障患者共52例100眼(其中4例为单眼),对所有患者分别采用IOL Master 700、IOL Master 500、A型超声波(A超)进行检查,获取眼轴长度(AL)、角膜曲率(Km)、中央前房深度(ACD)、角膜横径(W-W)、瞳孔直径(P)等参数。结果:IOL Master 700、IOL Master 500、A超对AL和ACD的检出率分别为98%、87%、99%和100%、99%、99%;IOL Master 700、IOL Master 500对Km的检出率分别为100%、99%;对W-W及P的检出率均为99%。其中高度近视伴后巩膜葡萄肿且AL≥26mm的24眼,IOL Master 700、IOL Master 500、A超的AL检出率分别为96%、79%、96%。三种设备间测得的AL、ACD有差异(F=11.58,P=0.03;F=12.46,P=0.02),Km、W-W、P的参数无差异(均P>0.05)。三种设备对AL测量的平均差值:IOL Master 700和IOL Master 500为0.05±0.12mm,IOL Master 700和A超为0.16±0.14mm;三种设备对AL≥26mm的AL测量的平均差值:IOL Master 700和IOL Master 500为0.17±0.16mm,IOL Master 700和A超为0.55±0.22mm,IOL Master 500和A超为0.11±0.17mm。Pearson相关性分析显示各设备间在AL测量结果中具有较高的相关性,IOL Master 500与IOL Master 700(r=0.85,P=0.03);IOL Master 500与A超(r=0.69,P=0.02);IOL Master 700与A超(r=0.61,P=0.03);通过Bland-Altman法对各设备的AL数据进行一致性分析,显示结果的一致性较好。结论:三种设备的不同眼部生物测量结果一致性较高。IOL Master 700对AL的检出率高于IOL Master 500;同时在高度近视伴后巩膜葡萄肿的AL测量中,IOL Master 700测量的精确性及可靠性更高。与传统检查设备相比,IOL Master 700更好的穿透力和精准度可以提供更加精确的测量参数。

Comparison of biometric measurement of IOL Master 700, IOL Master 500 and A-Mode ultrasound in cataract patients

AIM:To compare the consistency of IOL Master 700 with IOL Master 500 and A-mode ultrasound for biological measurements,and evaluate the measurements of IOL Master 700 in preoperative examinations of cataract patients.METHODS:In this prospective study,a total of 52 patients(100 eyes)diagnosed as age-related cataract were selected at the Nanjing Medical University Eye Hospital.All the patients were examined in turn by IOL Master 700,IOL Master 500 and A-mode ultrasound.Measurements by these three instruments were compared for axial length(AL),corneal curvature(Km),central anterior chamber depth(ACD),white-to-white(W-W)and pupil diameter(P).The results were analyzed by one-way ANOVA,Pearson correlation and Bland-Altman.RESULTS:The detection rates of AL and ACD with IOL Master 700,IOL Master 500 and A-mode ultrasound were 98%,87%,99%and 100%,99%,99%;respectively.The detection of Km with IOL Master 700 and IOL Master 500 were 100%,99%.The detection of W-W and P were both 99%.Among them,24 eyes had high myopia,posterior scleral grape swelling and axial length≥26mm.The detection of AL with IOL Master 700,IOL Master 500 and A-mode ultrasound were 96%,79%,96%.There was a significant difference in AL and ACD between three instruments(F=11.58,P=0.03;F=12.46,P=0.02).There were no significant differences in Km,W-W and P parameters among three instruments(all P>0.05).The average difference between three instruments for AL measurement:IOL Master 700 and IOL Master 500 was 0.05±0.12mm,IOL Master 700 and A-mode ultrasound was 0.16±0.14mm;The average difference between three instruments for AL measurement in axial length≥26mm:IOL Master 700 and IOL Master 500 was 0.17±0.16mm,IOL Master 700 and A-mode ultrasound was 0.55±0.22mm.The Pearson’s correlation analysis showed that there was a high correlation between the measured results of each equipment.The consistency of AL results using Bland-Altman analysis showed there was good consistency in the range of 95%consistency.CONCLUSION:There was high consistency in ocular biological measurements between three instruments in cataract eyes.However,the detection rate of IOL Master 700 in AL was higher than that of IOL Master 500,and the accuracy of the IOL Master 700 measurement was higher in the AL measurement in high myopia with posterior staphyloma.Compared with traditional examination equipment,IOL Master 700 has better penetration and accuracy to provide more accurate measurement parameters.