散瞳对Lenstar测量白内障患者眼球生物结构参数及IOL度数计算的影响

doi:10.3760/cma.j.issn.1674-845X.2014.05.010

科研成果详情

题名	散瞳对Lenstar测量白内障患者眼球生物结构参数及IOL度数计算的影响
其他题名	Effect of cycloplegia on ocular parameters and intraocular lens calculation with Lenstar on patients with cataracts
作者	林华优1,2,3; 黄锦海 1,2,3; 黎远光 1,2,3; 苏彬彬 1,2,3; 吴戈 1,2,3; 宫贤惠1,2,3; 蔡军勇1,2,3; 赵云娥1,2,3
发表日期	2014-05-25
发表期刊	中华眼视光学与视觉科学杂志影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	Lenstar IOLMaster 散瞳生物结构测量白内障人工晶状体度数计算
其他关键词	Lenstar ; IOLMaster ; Cycloplegia ; Biometry ; Cataract ; Intraocular lens power calculation
摘要	目的评估新型光学生物测量仪Lenstar测量白内障患者眼球生物结构参数和IOL度数计算的准确性,并研究散瞳对其测量结果的影响。方法前瞻性临床研究。应用Lenstar和IOLMaster分别对76例(76眼)年龄相关性白内障患者散瞳前后的眼轴长度(AL)、角膜曲率(K1和K2)、前房深度(ACD)及白到白距离(WTW)进行测量,并利用SRK-T、Hollday 1、Hoffer Q和Haigis 4种公式计算IOL度数。同一医生完成所有的测量,2个仪器测量顺序随机。散瞳前2个仪器的测量结果的差异性和一致性及散瞳后2个仪器的测量结果的差异性和一致性分别做配对￡检验和Bland-Altman分析;对散瞳前后2个仪器测量结果及IOL度数的比较采用Pearson相关分析和配对t检验。结果 Lenstar和IOLMaster散瞳前后测量的AL、K1、K2均高度相关(r均>0.90)。2种仪器散瞳后测量的ACD和WTW值[Lenstar:(3.13±0.34)mm和(11.76±0.51)mm;IOLMaster:(3.15±0.34)mm和(12.15±0.47)mm]均大于散瞳前[Lenstar:(3.05±0.35)mm和(11.56±0.55)mm;IOLMaster:(3.03±0.34)mm和(11.85±0.44)mm],且差异具有统计学意义(￡=-3.98、-5.09、-9.00、-6.52,P<0.01)。2种方法测量的WTW的95%LoA散瞳前为-1.20～0.61 mm,散瞳后为-1.09～0.33 mm,一致性较差,其余参数一致性较好。散瞳后Haigis公式依据IOLMaster测量结果计算的IOL度数比散瞳前大(0.08±0.29)D,差异有统计学意义(t=-2.31,P<0.05)。结论Lenstar是一种精确性高的眼球生物参数测量和IOL度数计算工具,可替代IOLMaster行白内障术前检查。散瞳影响ACD和WTW的测量,但对IOL度数的计算影响很小。
其他摘要	Objective To evaluate ocular biometry measurements and intraocular lens (IOL) power calculation with the new optical biometry Lenstar,and to review the effect of cycloplegia on biometric parameters and IOL power calculation on patients with cataracts.Methods In this prospective,comparative,observational study of ocular measurements on 76 cataracts,measurements of axial length (AL),corneal curvature (K1,K2),anterior chamber depth (ACD) and white to white (WTW) were performed by a single operator using the Lenstar and the IOLMaster before and after pupil dilation.The sequence of the measurements pre-and post-cycloplegia between the two devices was randomized.Pre-and post-cycloplegic IOL power were performed with 4 formulas (Sanders-Retzlaff-Kraff/Thoretical,Holloday 1,Hoffer Q and Haigis) using an A constant of 118.0.The refractive target was post-operative emmetropia.Bland-Altman plots were applied to evaluate the agreement and differences between the two devices.The differences between pre-and post-cycloplegic measurements as well as IOL power calculations with the 2 devices were assessed using a paired t test,and their correlation was reviewed by the Pearson coefficient.Results The pre-and post-cycloplegic measurements of AL and K1 and K2 performed with both devices correlated well (Lenstar,r=1.00,0.990,1.00,respectively) and (IOLMaster,r=1.00,0.99,0.99,respectively).ACD and WTW were significantly longer after pupil dilation:Lenstar (3.05±0.35 mm,pre-cycloplegia) vs (3.13±0.34 mm,post-cycloplegia) with ACD (t=-3.98,P＜0.01) and (11.56±0.55 mm,pre-cycloplegia) vs (11.76±0.51 mm,post-cycloplegia) with VCD (t=-5.09,P＜0.01); IOLMaster,(3.03±0.34 mm,pre-cycloplegia)vs (3.15±0.34 mm,post-cycloplegia)with ACD (t=-9.00,P＜0.01)and (11.85±0.44 mm,pre-cycloplegia) vs (12.15±0.47 mm,post-cycloplegia) with WTW (t=-6.52,P＜0.01).All measurements except WTW were closely related.The 95％LoAs in both devices were -1.20～0.61 mm pre-cycloplegia and-1.09～0.33 mm post-cycloplegia.The differences between pre-and post-cycloplegic IOL power were not statistically significant except for the IOLMaster using the Haigis formula (t=2.31,P＜0.05),but the values were not clinically different.Conclusion Lenstar biometry provides precise measurements and correlates well with IOLMaster,thus either can be used for the preoperative examination of cataracts.
资助项目	浙江省医药卫生科技计划项目（2012KYB135）;浙江省教育厅科研项目（Y201223147）;温州市科技局资助项目（Y20110045,Y20120176）
ISSN	1674-845X
卷号	16 期号:05 页码:301-305
DOI	10.3760/cma.j.issn.1674-845X.2014.05.010
页数	5
收录类别	CNKI ; 万方 ; 维普 ; ISTIC
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引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/51841
专题	眼视光学院（生物医学工程学院）、附属眼视光医院眼视光学院（生物医学工程学院）、附属眼视光医院_实验室中心_眼科与视光仪器评估研究所
作者单位	1.温州医科大学附属眼视光医院; 2.温州医科大学眼科和视光仪器评估与应用研究所; 3.温州医科大学眼视光学院
第一作者单位	眼视光学院（生物医学工程学院）、附属眼视光医院; 眼视光学院（生物医学工程学院）、附属眼视光医院_实验室中心_眼科与视光仪器评估研究所
第一作者的第一单位	眼视光学院（生物医学工程学院）、附属眼视光医院
推荐引用方式 GB/T 7714	林华优,黄锦海,黎远光,等. 散瞳对Lenstar测量白内障患者眼球生物结构参数及IOL度数计算的影响[J]. 中华眼视光学与视觉科学杂志,2014,16(05):301-305.
APA	林华优., 黄锦海., 黎远光., 苏彬彬., 吴戈., ... & 赵云娥. (2014). 散瞳对Lenstar测量白内障患者眼球生物结构参数及IOL度数计算的影响. 中华眼视光学与视觉科学杂志, 16(05), 301-305.
MLA	林华优,et al."散瞳对Lenstar测量白内障患者眼球生物结构参数及IOL度数计算的影响".中华眼视光学与视觉科学杂志 16.05(2014):301-305.