两种非接触眼压计临床应用效果及其关联因素的临床研究

目的探讨两种非接触眼压计测量的眼压(IOP)值之间的关联性及一致性,及其与中央角膜厚度(CCT)、陡峭角膜曲率(Ks)和平坦角膜曲率(Kf)的关联性。 方法横断面研究。收集2018年3月至2018年4月在首都医科大学附属北京同仁医院眼科屈光中心招募的71例(142只眼)健康志愿者的眼科资料,依次使用CanonTX20型非接触气动眼压计测量IOP,VX120型多参数测量系统测量IOP、校正IOP及CCT,角膜地形图测量Ks、Kf。采用Wilcoxon秩和检验分析两种非接触眼压计测量的IOP值之间的关联性及一致性。应用Spearman相关分析分析非接触眼压计测量的IOP值与CCT、Ks和Kf的相关性;应用Bland-Altman以及95%的一致性界限(LoA)分析两种非接触眼压测量计的一致性。 结果CanonTX20、VX120测量的IOP和校正后的VX120测量的IOP分别为(15.7±2.5)mmHg(1 mmHg＝0.133 kPa)、(16.7±3.4)mmHg、(16.8±3.3)mmHg,其不同性别间的差异无统计学意义(Z＝0.295,0.366,0.131;P>0.05)。VX120测量的IOP值比CanonTX20测量的IOP值高(1.007±2.651)mmHg,两者之间差异有统计学意义(t＝-4.527,P<0.05)。CanonTX20、VX120测量的IOP分别与VX120、Lenstar LS900测量的CCT有相关性(r＝0.177,0.167,0.221,0.178;P<0.05)。校正后的VX120测量的IOP和VX120、Lenstar LS900测量的CCT无相关性(r＝0.026,-0.001,0.026;P>0.05)。三种方式测量的IOP与Ks及Kf的相关性均无统计学意义(r＝0.158,0.158;P>0.05)。通过Bland-Altman以及95%LoA分析显示两者的95%LoA为±5.2 mmHg。年龄和IOP之间无明显的线性趋势。 结论CanonTX20测量的IOP值和VX120测量的IOP值一致性较差,说明不可相互替代;CCT与CanonTX20及VX120测量的IOP值均存在相关性,但CCT与校正后的VX120测量的IOP值无相关性;Ks和Kf与IOP值均无相关性。

Comparisons on the correlation and agreement between two non-contact tonometers

ObjectiveThe aim of this study was to explore the correlation and the agreement between the intraocular pressure (IOP) measured by two different non-contact tonometers in healthy eyes and evaluate the impact of central corneal thickness (CCT) and corneal curvature (Ks, Kf) on the IOP measurements. MethodsIn the cross-sectional study, the case data of 71 patients (142 eyes) who were examined in Beijing Tongren Eye Center of Capital Medical University were collected from March 2018 to April 2018. IOP was measured sequentially with the Canon TX20 (Canon Inc., Janpan), VX120 (Luneau Technology USA), including CCT corrected IOP . CCT was measured using VX120. Ks and Kf were measured using Corneal Topographer. The relationships between different parameters and the measured IOP with each device were evaluated by Wilcoxon test with Spearman correlation analysis. Bland-Altman plot and 95% limit of agreement (LoA) of IOPs was analyzed. ResultsThe IOP measured by CanonTX20, VX120 and IOP measured by VX120 after correction were (15.7±2.5) mmHg (1 mmHg=0.133 kPa), (16.7±3.4) mmHg, (16.8±3.3) mmHg, respectively; and IOP among of them were not shown the statistically on the gender (Z=0.295, 0.366, 0.131; P>0.05). There was a positive correlation between IOP measured by CanonTX20 , VX120 and CCT measured by VX120, Lenstar LS900(r=0.177, 0.167, 0.221, 0.178; P<0.05). There was not shown a correlation between corrected IOP measured by VX120 and CCT measured by VX120, Lenstar LS900 (r=0.026, r=-0.001; P>0.05). The correlation coefficients of IOP measured by three methods, Ks and Kf were not statistically significant (r=0.158, 0.158; P>0.05). The IOP measured by CanonTX20 was (1.007±2.651) mmHg higher than that measured by CanonTX20 (t=-4.527, P<0.05). Blander-Altman plot and 95% consistency threshold analysis showed that 95% LoA of them was ± 5.2 mmHg. Additionally, there was no obvious linear trend between age and IOP. ConclusionThe IOP measured by CanonTX20 and VX120 were shown a bad consistency, which suggesting they cannot be used interchangeably to measure IOP in clinical practice. There was a correlation between CCT and IOP measured by CanonTX20, VX120, but there was no correlation between corrected IOP measured by VX120 and CCT. The correlations between Ks, Kf and IOP were not found.