Atlas 9000、Orbscan和Pentacam测量近视角膜非球面系数（Q值）的差异和一致性

目的　评价Ａｔｌａｓ９０００、Ｏｒｂｓｃａｎ及Ｐｅｎｔａｃａｍ三种方法测量近视患者角膜非球面系数（Ｑ值）的差异和一致性。方法　横断面比较性研究，随机选取在广西视光中心就诊的成年近视患者４９例（９８眼），分别应用Ａｔｌａｓ９０００、Ｏｒｂｓｃａｎ及Ｐｅｎｔａｃａｍ测量患者的角膜Ｑ值。采用随机区组设计资料的方差分析（Ｔｗｏ-ｗａｙＡＮＯＶＡ）比较不同仪器测量结果的差异，采用Ｐｅａｒｓｏｎ相关系数分析不同仪器测量结果的相关性，采用Ｂｌａｎｄ-Ａｌｔｍａｎ分析评价不同方法测量结果的一致性。结果　Ａｔｌａｓ９０００、Ｏｒｂｓｃａｎ及Ｐｅｎｔａｃａｍ测得的角膜Ｑ值分别为－０．３４２±０．１３５、－０．３０２±０．１８２和－０．３０５±０．１２０，三种方法测得角膜Ｑ值差异有统计学意义（Ｆ＝５．４６５，Ｐ＝０．００５），两两比较表明Ａｔｌａｓ９０００与Ｏｒｂｓｃａｎ、Ｐｅｎｔａｃａｍ的检测结果比较差异均有统计学意义（均为Ｐ＜０．０５），测得负值更大，但Ｏｒｂｓｃａｎ与Ｐｅｎｔａｃａｍ检测结果间比较差异无统计学意义（Ｐ＞０．０５）。Ｐｅａｒｓｏｎ相关分析显示，Ａｔｌａｓ９０００、Ｏｒｂｓｃａｎ与Ｐｅｎｔａｃａｍ测得的角膜Ｑ值之间均有正相关性（均为Ｐ＜０．００１）。Ｂｌａｎｄ-Ａｌｔｍａｎ一致性分析表明Ａｔｌａｓ９０００与Ｐｅｎｔａｃａｍ一致性好。结论　Ａｔｌａｓ９０００、Ｏｒｂｓｃａｎ及Ｐｅｎｔａｃａｍ测量近视患者角膜Ｑ值存在一定差异，但Ａｔｌａｓ９０００与Ｐｅｎｔａｃａｍ的一致性较好，两者可相互参考。

Difference and agreement of myopic corneal asphericity (Q value) measured by Atlas 9000, Orbscan and Pentacam

Objective To evaluate the difference and agreement of myopic corneal asphericity ( Q value ) measured by Atlas 9000 . Orbscan and Pentacam. Methods This was a cross-sectional, comparative study. Forty-rune cases of adult myopia ( 98 eyes) were selected randomly from the Visual Science and Optometry Center of Guangxi,the Q value were measured by Atlas 9000 .Orbscan and Pentacam. The difference of Q value measured by Atlas 9000 . Orbscan and Pentacam were compared by Two-way ANOVA, and the correlation and agreement of Q value were analyzed by Pearson correlation and Bland-Altman analysis. Results Q value measured by Atlas 9000 , Orbscan and Pentacam were - 0. 342 + 0. 135 , - 0. 302 +0. 182 and - 0. 305 + 0. 120 , respectively. There was statistical significant difference in the Q value measured by Atlas 9000 , Orbscan and Pentacam ( F = 5. 465 .P = 0. 005 ) , and there were significant differences between Atlas 9000 and Orbscan , Atlas 9000 and Pentacam ( all P < 0. 05 ) . but no difference between Orbscan and Pentacam (P > 0. 05 ) . Significantly statistical correlation were observed in the Q value measured by Atlas 9000. Orbscan and Pentacam ( all P < 0. 001) . Bland-Altman analysis showed that satisfactory agreement was observed in the Q value measured by Atlas 9000 and Pentacam. Conclusion There are sigruficantly statistical difference in the Q value measured by Atlas 9000 , Orbscan and Pentacam. However , the agreement in the Q value measured by Atlas 9000 and Pentacam is satisfactory.