摘要
背景 近视屈光手术的开展需要我们对患者眼前节的数据进行精确测量和评估.目前临床上有多种仪器和方法可以对患者的眼前节进行生物学测量,但是哪种方法更为精确和方便,仍需进一步探讨.目的 比较眼前节光学相干断层扫描（AS-OCT）、OrbscanⅡ、超声生物测厚仪对近视患者眼前节参数的测量结果.方法 回顾性分析2011年11月至2012年5月于浙江大学医学院附属第二医院眼科中心就诊的拟行角膜屈光手术的近视患者70例140眼,受检者等效球镜度为-0.75 ～-10.25 D.分别用AS-OCT、OrbscanⅡ和超声角膜测厚仪测量角膜中央厚度（CCT）,用AS-OCT测量前房深度（ACD）和前房角间距（ATA）,用OrbscanⅡ测量ACD和角膜白到白距离（WTW）,对3种测量仪器的测量结果进行比较. 结果 AS-OCT、超声角膜测厚仪和OrbscanⅡ测量的平均CCT值分别为（516.57±30.25）、（523.68±31.87）和（514.69±38.40） μm,3种测量仪器间测量结果的总体比较差异无统计学意义（F=2.775,P=0.063）.根据超声角膜测厚仪所测的CCT结果将受检者分为＜500μm组、500 ～ 569 μm组和≥570 μm组,＜500 μm组受检者以超声角膜测厚仪测量的CCT值最高,OrbscanⅡ测量值最低,用3种方法测量的CCT值差异有统计学意义（F=22.236,P=0.000）;AS-OCT和超声角膜测厚仪的测量值间差异无统计学意义（P＞0.05）.500～569 μm组受检者用3种仪器测量的CCT值总体比较差异无统计学意义（F=3.011,P=0.051）.≥570 μm组受检者用超声角膜测厚仪测量的CCT最高,AS-OCT测量值最低,3种仪器的测量值总体比较差异有统计学意义（F=4.133,P=0.021）,超声角膜测厚仪与Orbscan Ⅱ测量的CCT值差异无统计学意义（P＞0.05）.AS-OCT和OrbscanⅡ测量的ACD值分别为（3.83±0.21）mm和（3.75±0.21）mm,二者差异有统计学意义（t=-8.520,P=0.000）;AS-OCT测量的ATA为（12.43±0.74） mm,OrbscanⅡ测量的WTW为（11.42±0.33） mm,两种方法间测量的差异有统计学意义（t=-18.088,P=0.000）.结论 AS-OCT、超声角膜测厚仪、OrbscanⅡ均可作为角膜屈光手术前测量CCT的方法,3种方法可互为参考.AS-OCT、OrbscanⅡ还可以测量ACD、ATA、WTW,因测量方法及原理不同,结果亦有差异.
Background It is essential to measure and assess the parameters of ocular anterior segment for refractive surgery in myopic eyes.Some different imaging devices can be used for biometric measurement of ocular anterior segment,but which is more accurate and convenient is still under investigation.Objective This study was to compare the anterior segment parameters in myopic eyes measured by anterior segment optical coherence tomography （AS-OCT）,Orbscan topography and ultrasonic pachymetry （US）.Methods One hundred and forty eyes of 70 myopic subjects with the diopter of-0.75 to-10.25 D,who intended to receive corneal refractive surgery in the Second Affiliated Hospital of Zhejiang University School of Medicine from November 2011 to May 2012,were retrospectively analyzed.Central corneal thickness （CCT） was measured using AS-OCT,Orbscan Ⅱ and US,respectively,and anterior chamber depth （ACD） was measured by AS-OCT and Orbscan Ⅱ,and the angle to angle （ATA） distance and corneal white-to-white corneal distance （WTW） were measured by AS-OCT and Orbscan Ⅱ,respectively.The parameters from different apparatuses were statistically compared.Results The mean CCT were （516.57±30.25） μm in AS-OCT,（523.68±31.87） μm in US and （514.69±38.40） μm in Orbscan Ⅱ,without significant difference among them （F =2.775,P =0.063）.Then the patients were divided into three groups based on the US measurement of CCT （＜500 μm group,500-569 μm group,and ≥ 570 μm group）.In the ＜500 μm group,there was a significant difference in the CCT among the three methods （F =22.236,P =0.000）,significant differences were found between AS-OCT and Orbscan Ⅱ,or Orbscan Ⅱ and US（both at P＜0.05）.In the 500-569 μm group,there was no significant difference in the CCT among the three methods （F =3.011,P =0.051）.In the ≥ 570 μm group,there was a significant difference in the CCT among the three methods （F =4.133,P =0.021）,a significant difference was found between AS-OCT and US（P＜0.05）,but there was no significant difference between AS-OCT and Orbscan Ⅱ （P＞0.05）.The ACD values measured by AS-OCT was （3.83±0.21） mm,which was higher than （3.75 ± 0.21） mm by Orbscan Ⅱ,with a significant difference between them （t =-8.520,P =0.000）.In addition,the ATA value by AS-OCT （12.43 mm±0.74 mm） was higher than the WTW value （11.42 mm±0.33 mm） by OrbscanⅡ,with a significant difference between them（t=-18.088,P=0.000）.Conclusions AS-OCT,US and Orbscan Ⅱ can offer accurate CCT value,and they can provide references to one another before refractive surgery.However,the ACD,ATA and WTW values by AS-OCT and Orbscan]Ⅱ have large differences.
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2014年第12期1097-1101,共5页
Chinese Journal Of Experimental Ophthalmology
基金
浙江省重点创新团队项目（2009R50039）
