Lenstar、自动角膜曲率计和角膜地形图仪测量眼前节参数的比较

科研成果详情

题名	Lenstar、自动角膜曲率计和角膜地形图仪测量眼前节参数的比较
其他题名	Comparison of anterior eye segment measurements obtained by Lenstar with those obtained by autokeratometry and corneal topography
作者	黄柳萌
学位类型	硕士
导师	王勤美
答辩日期	2016-06-06
学位授予单位	温州医科大学
学位专业	眼科学
关键词	Lenstar 自动角膜曲率计角膜地形图仪角膜曲率白到白一致性
摘要	目的评估光学低相干反射测量仪（Lenstar）、自动角膜曲率计（Tomey RC-5000）和角膜地形图仪（Topolyzer）在角膜曲率，白到白测量的差异性，并分析其一致性，为Lenstar的临床应用提供依据。方法采用前瞻性研究，纳入健康受试者46例（其中男19例，女27例），平均年龄为23.4±5.4岁，平均等效球镜度为-4.6±2.8 D。由同一位操作者应用Lenstar、Tomey RC-5000和Topolyzer分别对受试者进行3次测量，检查对象均为右眼，测量顺序随机选择，记录每种仪器的平坦K值（Kf）、陡峭K值(Ks)、平均K值(Km)及角膜缘白到白距离（WTW）。3种仪器的上述测量参数比较采用重复测量方差分析（ANOVA）联合Bonferroni法比较仪器间的差异。采用Bland-Altman分析方法比较测量结果的一致性。结果Lenstar、Tomey RC-5000与Topolyzer测得Kf的平均值分别为（43.08±1.31）D、（42.96±1.36）D与（43.02±1.33）D，Km的平均值分别为（43.69±1.34）D、（43.59±1.34）D与（43.63±1.34）D。Lenstar测量的Kf、Km比Tomey RC-5000明显陡峭（两者均P<0.001），但95%—致性区间（LoA）较窄（分别为-0.02至0.46D，-0.16至0.36D），Lenstar及Topolyzer测量Kf及Km之间无显著差异（P=0.092，P=0.281），95% LoA较窄（分别为-0.30至0.42 D，-0.36至0.46D）。对于Ks的测量，3种仪器测得的平均值分别为（44.29±1.45）D、（44.21±1.42）D与（44.25±1.42）D ，Lenstar与Tomey RC-5000，Lenstar与Topolyzer之间均无明显差异。且Lenstar与Tomey RC-5000，Lenstar与Topolyzer具有较好的一致性，95%LoA分别在-0.40至0.56D，-0.56至0.64D之间。3种仪器测得的WTW的平均值分别为（12.09±0.38）mm、（12.00±0.36）mm与（11.78±0.38）mm。但Lenstar与其他两种仪器之间具有很好的一致性，95%LoA范围分别为-0.13至0.74mm和-0.33至0.51mm。结论Lenstar是一种操作简单，非接触性、高准确性的眼前节生物测量仪器。对于角膜曲率，白到白的测量，Lenstar与Tomey RC-5000、 Topolyzer之间具有较好的一致性，因此，在临床工作中，对于角膜曲率，白到白的测量，Lenstar与Tomey RC-5000，Lenstar与Topolyzer可以相互替代使用。关键词：Lenstar；自动角膜曲率计；角膜地形图仪；角膜曲率；白到白；一致性
其他摘要	Purpose: To evaluate the differences and agreements among measurements of keratometry and white-to-white using low optical coherence reflectometry (Lenstar), autokeratometry (Tomey RC-5000) and corneal topography (Topolyzer), and providing references for the clinical application of Lenstar.Methods: Fourty-six healthy subjects (19 males and 27 female),with a mean age of 23.4±5.4 years, were enrolled in this prospective study. The mean spherical equivalent refraction was -4.6±2.8 diopters. The flat keratometry (Kf), steep keratometry (Ks), mean keratometry (Km) and white-to-white (WTW) distance were obtained using Lenstar,Tomey RC-5000 and Topolyzer by the same investigator. Only the right eye of each subject was scanned.The order of measurements taken using the three insturments was randomized for all subjects. Repeated-measures analysis of variance (ANOVA) with Bonferroni correction was applied for multiple comparisons between Lenstar and other devices. The agreements between devices were evaluated by Bland and Altman analysis.Results: The mean Kf obtained by Lenstar, Tomey and Topolyzer were 43.08 ±1.31D,42.96± 1.36 D and 43.02±1.33 D,respectively. The mean Km were 43.69±1.34 D,43.59±1.34 D and 43.63±1.34 D,respectively.The Kf and Km obtained by Lenstar were significantly steeper than Tomey RC-5000 (both p<0.001), but the 95% LoA of the two instruments were narrow (-0.22 to 0.46 D, -0.16 to 0.36 D,respectively). The Kf and Km obstained by Lenstar and Topolyzer were not significantly different,with a narrow 95% LoA(-0.30 to 0.42 D，-0.36 to 0.46D,respectively). The mean Ks obtained by Lenstar, Tomey and Topolyzer were 44.29±1.45 D,44.21±1.42 D and 44.25±1.42 D,respectively. The Ks values provided by Lenstar and Tomey RC-5000, and also Lenstar and Topolyzer were not significantly different(P=0.098 and P=1.000). A good agreement was observed between them with 95% LoA of -0.40 to 0.56 D, and -0.56 to 0.64 D, respectively. As for WTW values,the mean WTW obtained by the three devices were 12.09±0.38mm,12.00±0.36 mm and 11.78±0.38mm,respectively. A good agreement was founded between the WTW obtained by Lenstar and Topolyzer, Tomey RC-5000, with 95% LoA ranging from –0.13 to 0.74 mm and –0.33 to 0.51 mm. Conclusions:The Lenstar is a convenient,non-contact device,and it can provid precise measurements.As far as K and WTW were concerned ,a good agreement was found between the Lenstar,Tomey RC-5000 and Topolyzer.The K and WTW measurements obtained by Lenstar and Tomey RC-5000, Topolyzer can be used interchangeably in clinical practice.Key words：Lenstar;autokeratometry;corneal topography;keratometry;white-to-white; agreement
语种	中文
学号	902020024
发布年限	2019-06-06
毕业论文分类号	0R77
原始专题	眼视光学院
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全文文件名	0902020024黄柳萌2016眼科学.pdf\|0902020024黄柳萌2016眼科学.pdf
文献类型	学位论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/114153
专题	温州医科大学
作者单位	溫州医科大学眼视光学院
推荐引用方式 GB/T 7714	黄柳萌. Lenstar、自动角膜曲率计和角膜地形图仪测量眼前节参数的比较[D]. 温州医科大学,2016.