目的：基于Scheimpflug成像系统评估健康眼角膜变化测量的可靠性，以及正常人群测量值的分布情况。

方法：前瞻性非随机对照研究。纳入27名健康受试者(54眼)，分为正视组(13眼)，近视组(17眼)，远视组(4眼)，散光组(20眼)。所有病例接受了完整的眼科检查，使用Pentacam AXL系统分析不同调节刺激下(+2.00、0.00、-3.00 D)角膜检测参数变化。该研究分为2个阶段：重复性分析和健康人群不同调节刺激下角膜参数变化的特征。

结果：在重复性分析中，在三种调节刺激下高度不对称指数(IHA)表现出最大的变异性，其余参数结果良好。正视组中，最大角膜曲率(Kmax)位置有显著差异(P<0.05)； 而散光组中Kmax、最小角膜厚度(MCT)、角膜球面像差、总像差、低阶像差均有显著差异(P<0.05)。近视组Kmax的水平位置在2.00 D和-3.00 D时的位移存在显著差异(P=0.033)，正视组Kmax的矢量大小变化也存在显著差异(P<0.05)。MCT在不同调节刺激下无显著差异(P≥0.109)。

结论：在不同调节刺激下，Kmax和MCT在健康角膜中的位置会发生显著变化，而这些调节相关角膜变化在屈光不正人群中有不同的趋势。Scheimpflug成像系统测量结果具有一致性。

METHODS: Prospective, non-randomized, comparative study including 27 healthy subjects(54 eyes), including emmetropia(13 eyes), myopia(17 eyes), hyperopia(4 eyes)and astigmatism(20 eyes)groups. In all cases, a complete eye examination was performed, including the analysis of corneal changes with different accommodative stimuli(+2.00, 0.00 and -3.00 D)using the Pentacam AXL system. The investigation was structured in 2 phases: repeatability analysis and characterization of accommodation-related corneal changes in healthy populations.

RESULTS: In the repeatability analysis, the index of height asymmetry(IHA)showed the greatest variability with the three accommodative stimuli, being the results for the rest of parameters acceptable. The group of emmetropes showed significant differences with accommodative changes in the position of maximum keratometry(Kmax; P<0.05), whereas in the astigmatism group, significant changes were not only observed in the position of Kmax, but also in minimum corneal thickness(MCT), corneal spherical aberration, and total and low order aberration root mean square(all P<0.05). Likewise, a significant difference was found in the displacement of the X position of Kmax with +2.00 D and -3.00 D in the myopia group(P=0.033)as well as in changes with +2.00 D and -3.00 D in the magnitude of the position vector of Kmax in the emmetropia group(P<0.05). No significant changes were found between accommodative stimuli in the displacement of coordinates of MCT(P≥0.109).

CONCLUSION: The position of Kmax and MCT in healthy corneas can change significantly when presenting different accommodative stimuli using the accommodation mode of the Pentacam system, with different trends in these accommodation-related corneal changes between refractive errors. Likewise, the consistency of the measurements obtained with Scheimpflug has been confirmed.