Jin Haiying, Ou Zhongmin, Guo Haike, Zhao Peiquan
Department of Ophthalmology (H.J., P.Z.), Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China; Department of Physics (Z.O.), Shanghai University, Shanghai, China; and Department of Ophthalmology (H.G.), Aier Eye Hospital, Zhengzhou, China.
Eye Contact Lens. 2018 Sep;44 Suppl 1:S151-S157. doi: 10.1097/ICL.0000000000000364.
To investigate interdevice differences and agreement in the measurement of anterior corneal curvature obtained by different technologies after laser corneal refractive surgery.
The prospective study comprised 109 eyes of 109 consecutive patients who had undergone laser-assisted in situ keratomileusis (LASIK). Preoperative and postoperative corneal parameters were measured by Scheimpflug imaging (Pentacam), Placido-slit-scanning (Orbscan) and auto-keratometry (IOLMaster). Preoperative and postoperative anterior corneal curvatures (K readings) were compared between devices. Interdevice agreement was evaluated by Bland-Altman analysis.
Preoperatively, the difference of K reading for Pentacam-IOLMaster (0.04±0.20 D) was not statistically significant (P=0.059). The differences between Pentacam-Orbscan and Orbscan-IOLMaster were 0.20±0.34 D (P<0.001) and -0.17±0.29 D (P<0.001), respectively. After surgery, no difference was found for Pentacam-Orbscan (-0.05±0.38, P=0.136). The differences between Pentacam-IOLMaster and Orbscan-IOLMaster were 0.13±0.29 D (P<0.001) and 0.19±0.34 D (P<0.001). Preoperative interdevice agreement (95% limit of agreement [LOA]) between Pentacam and Orbscan, Pentacam and IOLMaster, and Orbscan and IOLMaster were 1.31 D, 0.79 D and 1.14 D, respectively. The 95% LOAs decreased to 1.47 D, 1.14 D, and 1.34 D after refractive surgery.
Corneal refractive surgery changed the preoperative and postoperative interdevice differences in corneal curvature measurements and reduced interdevice agreement, indicating that the devices are not interchangeable.
研究激光角膜屈光手术后，不同技术测量角膜前表面曲率时的设备间差异及一致性。
前瞻性研究纳入109例连续接受准分子原位角膜磨镶术（LASIK）患者的109只眼。术前及术后角膜参数采用眼前节分析系统（Pentacam）、角膜地形图仪（Orbscan）及自动角膜曲率计（IOLMaster）测量。比较各设备术前及术后角膜前表面曲率（K值）。采用Bland-Altman分析评估设备间一致性。
术前，Pentacam与IOLMaster的K值差异无统计学意义（0.04±0.20 D，P=0.059）。Pentacam与Orbscan、Orbscan与IOLMaster的差异分别为0.20±0.34 D（P<0.001）和-0.17±0.29 D（P<0.001）。术后，Pentacam与Orbscan无差异（-0.05±0.38，P=0.136）。Pentacam与IOLMaster、Orbscan与IOLMaster的差异分别为0.13±0.29 D（P<0.001）和0.19±0.34 D（P<0.001）。术前，Pentacam与Orbscan、Pentacam与IOLMaster、Orbscan与IOLMaster的设备间一致性（95%一致性界限[LOA]）分别为1.31 D、0.79 D和1.14 D。屈光手术后，95% LOA分别降至1.47 D、1.14 D和1.34 D。
角膜屈光手术改变了术前及术后角膜曲率测量的设备间差异，降低了设备间一致性，提示各设备不可互换。
