三种方法测量白内障患者前房深度的比较及其影响因素
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Comparison of anterior chamber depth measurements using three methods and the influence factors in age-related cataract patients
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    摘要:

    目的:比较Pentacam、IOL Master和接触式A超对前房深度(ACD)的测量结果,分析三种测量方法的差异性、相关性、一致性和影响因素。方法:选取白内障术前患者250例307眼应用Pentacam、IOL Master和接触式A超进行ACD测量,对三种方法的测量结果进行单因素方差分析、两两比较。将可能的影响因素纳入多重线性回归进行评估,并将重要的影响因素分层,应用独立样本t检验或单因素方差分析进行层间比较。结果:Pentacam、IOL Master和接触式A超测量的ACD均值(2.42±0.45、2.96±0.43、2.58±0.36mm)有差异(F=136.694,P<0.05)。三种方法两两比较均有差异(P<0.05)。将三种方法两两进行Pearson相关分析,每组间均呈线性正相关。将Pentacam的ACD测量值与中央角膜厚度(CCT)相加,所得到的修正值与IOL Master的ACD值无差异(P=0.93)。当Pentacam的ACD测量值小于1.85mm(IOL Master约2.40mm)时,接触式A超的ACD测量值明显升高且波动增大。在众多可能的影响因素中,眼轴、晶状体厚度、年龄对ACD测量的影响最大。ACD与眼轴呈正相关(rPentacam=0.602,rIOL Master=0.603,rA超=0.483),与晶状体厚度呈负相关(rPentacam=-0.382,rIOL Master=-0.350,rA超=-0.582),与年龄呈负相关(rPentacam=-0.328,rIOL Master=-0.414,rA超=-0.265)。将三因素纳入多重线性回归模型,接触式A超的年龄因素由于影响权重过低被剔除。结论:Pentacam和修正了中央角膜厚度的IOL Master测量值可能更接近前房深度真实值。接触式A超测量浅前房时可能会误差增大。眼轴、晶状体厚度和年龄对ACD测量的影响最大,是Pentacam和IOL Master的影响因素,但年龄不是接触式A超的影响因素。

    Abstract:

    AIM: To compare the measurement results of anterior chamber depth(ACD)by Pentacam, IOL Master and Contact Ultrasonic A-scan, and analyze the difference, correlation, consistency and influencing factors of the three measurement methods.METHODS: In this study of 307 eyes of 250 cataract patients with preoperative, ACD estimation was done by Pentacam, IOL Master and Contact Ultrasonic A-scan. The independent sample t-test, Analysis of Variance(ANOVA), Pearson's correlation test and multiple linear regressions were used to analyze the results.RESULTS: The mean of ACD measured by Pentacam(ACDp), IOL Master(ACDi)and A-scan(ACDa)were 2.42±0.45mm, 2.96±0.43mm, 2.58±0.36mm, the difference was statistically significant(F=136.694, P<0.05). The three methods were sequentially compared in pairs, and the differences within the groups were statistically significant(P<0.05). Pearson's correlation test was performed on the three methods in pairs, and there was a linear positive correlation within each group. When the ACDp and the central corneal thickness(CCT)were added, the sum(ACDp2)was no statistically significant compared with the ACDi(P=0.93). When the ACDp was less than 1.85mm(ACDi was about 2.40mm), the ACDa increases significantly and the fluctuation increases. Among the many possible influencing factors, axial length, lens thickness and age have the highest relative importance for ACD measurement.ACD was positively correlated with axial length(rPentacam=0.602, rIOL Master=0.603, rA-scan=0.483), and negatively correlated with the lens thickness(rPentacam= -0.382, rIOL Master= -0.350, rA-scan= -0.582), negatively correlated with age(rPentacam= -0.328, rIOL Master= -0.414, rA-scan= -0.265). Three factors were included in the multiple linear regression model, and the age factor of Contact Ultrasonic A-scan was eliminated due to the low influence weight.CONCLUSION: ACDp2 and ACDi may be closer to the true value of the anterior chamber depth. The Contact Ultrasonic A-scan may increase the measurement error when measuring shallow anterior chamber. Axial length, lens thickness and age have the greatest influence on ACD measurement, which are the influencing factors of Pentacam and IOL Master, but age is not the influencing factor of Contact Ultrasonic A-scan.

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吴怡,唐少华,杨光,等.三种方法测量白内障患者前房深度的比较及其影响因素.国际眼科杂志, 2021,21(4):702-706.

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  • 收稿日期:2020-08-04
  • 最后修改日期:2021-03-10
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  • 在线发布日期: 2021-03-25
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