Corvis ST与常用眼压计及角膜测厚仪在测量眼压及角膜厚度中的应用

目的：比较可视化角膜生物力学分析仪（Corvis ST）与三维眼前节分析仪（Pentacam）、非接触式眼 压计（NCT）、A型超声角膜测厚仪（A超）、光学生物眼科测量仪（Lenstar）在测量眼压及中央角膜 厚度的差异。方法：前瞻性研究。纳入2020年8—12月佛山市第二人民医院屈光术前近视患者110 例，将Corvis ST 眼压（IOP）及校正眼压（BIOP）、NCT眼压与Pentacam对NCT的校正眼压纳入眼压 指标；将Corvis ST的中央角膜厚度、Pentacam的最薄点中央角膜厚度、Lenstar的角膜厚度、A超的 角膜厚度纳入角膜厚度指标。眼压与角膜厚度的差异对比采用单因素方差分析法，相关性分析采 用Pearson方法，一致性检验采用Bland-Altman。结果：眼压：Corvis ST分别与NCT、Pentacam所测 量的眼压值在组间比较差异无统计学意义，其中Corvis ST分别与NCT、Pentacam测量的眼压值比 较差异有统计学意义（P=0.019; P=0.03）。IOP与NCT眼压、Pentacam校正眼压呈正相关性（r=0.76, P ＜0.001; r=0.65, P＜0.001），BIOP与NCT眼压、Pentacam校正眼压呈正相关性（r=0.66, P＜0.001; r=0.69, P＜0.001），IOP与BIOP呈高度正相关性（r=0.92, P＜0.001）。IOP与NCT眼压、Pentacam校 正眼压、BIOP的95%一致性界限与最大差值绝对值分别为（-2.8~4.3 mmHg, 3.8 mmHg）、（-3.1~4.5 mmHg, 4.1 mmHg）、（-1.46~1.97 mmHg, 1.9 mmHg），BIOP与NCT眼压、Pentacam校正眼压的95%一 致性界限与最大差值绝对值分别为（-3.6~4.6 mmHg, 4.2 mmHg）、（-3.0~3.9 mmHg, 3.4 mmHg）。中 央角膜厚度：Corvis ST与A超、Lenstar、Pentacam所测量的中央角膜厚度值在组间比较差异有统计 学意义（F=2.67, P=0.046），其中Corvis ST与A超的差异有统计学意义（P=0.017）。Corvis ST与A超、 Lenstar、Pentacam所测量的中央角膜厚度值存在着高度正相关性（r=0.96, P＜0.001; r=0.98, P＜0.001; r=0.98, P＜0.001）。Corvis ST与A超、Lenstar、Pentacam对中央角膜厚度的测量值的95%一致性界限 与最大差值绝对值分别为（-5.9~24.3 μm, 23 μm）、（-6.4~18.7 μm, 18 μm）、（-10.7~12 μm, 11 μm）。结 论：Corvis ST的眼压测量值与NCT、Pentacam不可相互替代，并且Corvis ST的BIOP更接近真实眼压； Corvis ST的CCT测量值与A超、Lenstar不可相互替代，与Pentacam可相互替代。

Observation and Study of Corvis ST,Common Tonometer and Corneal Pachymeter in Measuring Intraocular Pressure and Corneal Thickness

Objective: To compare the difference, correlation and consistency of intraocular pressure and central corneal thickness measured by visual corneal biomechanical analyzer (Corvis ST), three-dimensional anterior segment analyzer (Pentacam), non-contact tonometer (NCT), A ultrasound pachymetry(A-ultrasound) and optical biological ophthalmic measuring instrument (Lenstar). Methods: In this prospective study, 110 patients with myopia before refractive surgery in Foshan Second People's Hospital from August to December 2020 were included. Corvis ST intraocular pressure (IOP) and Biomechanical intraocular pressure (BIOP), NCT intraocular pressure and Pentacam corrected intraocular pressure for NCT were included in the intraocular pressure index; the central corneal thickness of Corvis ST, the central corneal thickness of the thinnest point of Pentacam, corneal thickness of Lenstar and corneal thickness of A-ultrasound were included in the corneal thickness index. The difference between intraocular pressure and corneal thickness were compared by One-way ANOVA, Pearson method was used for correlation analysis, and Bland-Altman was used for consistency test. Results: IOP: There was no significant difference in intraocular pressure measured by Corvis ST, NCT and Pentacam between the groups, among them, the difference of intraocular pressure measured by Corvis ST, NCT and Pentacam was statistically significant(P=0.019; P=0.03). IOP was positively correlated with intraocular pressure of NCT and corrected intraocular pressure of Pentacam(r=0.76, P<0.001; r=0.65, P<0.001), BIOP was positively correlated with intraocular pressure of NCT and corrected intraocular pressure of Pentacam (r=0.66, P<0.001; r=0.69, P<0.001), IOP was highly positively correlated with BIOP (r=0.92, P<0.001); the absolute value of 95% consistency limit and maximum difference between IOP and NCT intraocular pressure, Pentacam corrected intraocular pressure and BIOP were (-2.8-4.3 mmHg, 3.8 mmHg), (-3.1-4.5 mmHg, 4.1 mmHg), (-1.46-1.97 mmHg, 1.9 mmHg), the absolute value of 95% consistency limit and maximum difference between BIOP and NCT intraocular pressure and Pentacam corrected intraocular pressure were (-3.6- 4.6 mmHg, 4.2 mmHg), (-3.0-3.9 mmHg, 3.4 mmHg). Central corneal thickness: There was significant difference between Corvis ST and A-ultrasound, Lenstar and Pentacam (F=2.67, P=0.046), and there was significant difference between Corvis ST and A-ultrasound (P=0.017); There was a high positive correlation between Corvis ST and central corneal thickness measured by A-ultrasound, Lenstar and Pentacam (r=0.96, P<0.001; r=0.98, P<0.001, r=0.98, P<0.001). The 95% consistency limit and the absolute value of the maximum difference of the central corneal thickness measured by Corvis ST, A-ultrasound, Lenstar and Pentacam were(-5.9~24.3 μm, 23 μm), (-6.4~18.7 μm, 18 μm), (-10.7~12 μm, 11 μm). Conclusions: The intraocular pressure measured by Corvis ST can not be replaced by NCT and Pentacam, and the BIOP of Corvis ST is closer to the real intraocular pressure; the CCT measured value of Corvis ST can not be replaced with A-ultrasound and Lenstar, and it can be replaced with Pentacam