准分子激光角膜切削术对扫频源生物测量仪和Scheimpflug 眼前节断层扫描仪测量前节变量的一致性的影响。
Effect of photorefractive keratectomy on agreement of anterior segment variables obtained by a swept-source biometer vs a Scheimpflug-based tomographer.
机构信息
From the Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences (R. Salouti, Kamalipour, Masihpour, Nowroozzadeh), Salouti Cornea Research Center, Salouti Eye Clinic (R. Salouti, Zamani, Ghoreyshi, K. Salouti), Health Policy Research Center, Shiraz University of Medical Sciences (Ghoreyshi), Shiraz, Iran.
出版信息
J Cataract Refract Surg. 2020 Sep;46(9):1229-1235. doi: 10.1097/j.jcrs.0000000000000252.
PURPOSE
To evaluate agreement of anterior segment variables between Pentacam-AXL and IOLMaster 700 before vs after photorefractive keratectomy (PRK).
SETTING
Salouti Eye Clinic, Shiraz, Iran.
DESIGN
Prospective cohort with interdevice agreement analysis.
METHODS
This study included healthy PRK candidates who were assessed with both devices preoperatively and 6 months after PRK. Only data from the right eye of each patient was analyzed. Pentacam-AXL average keratometry (AvgK) and zonal keratometry in the central 2.5 mm zone (zonal-K2.5) were each compared with mean keratometry (Km) from the IOLMaster 700. Other main outcome measures included vector analysis of corneal astigmatism (J0 and J45), central corneal thickness (CCT), anterior chamber depth (ACD), and white-to-white (WTW) distance. Axial length (AL) measurements by the same devices on a new cohort of 40 patients who had undergone PRK were also assessed. A paired t test was used to assess the interdevice measurement differences, and Bland-Altman analysis was used to calculate the 95% limits of agreement (LoA).
RESULTS
This study included 97 patients. Preoperative vs post-PRK 95% LoAs between Pentacam-AXL and IOLMaster 700 were as follows: AvgK/Km (-0.42, 0.08 diopter [D]) vs (-0.49, 0.18 D); zonal-K2.5/Km (-0.40, 0.32 D) vs (-0.57, 0.74 D); J0 (-0.33, 0.18 D) vs (-0.28, 0.35 D); J45 (-0.28, 0.23 D) vs (-0.24, 0.27 D); pupil pachymetry/CCT (-18, 12 μm) vs (-2.6, 19.6 μm); apical pachymetry/CCT (-17.4, 12.8 μm) vs (-1.7, 20.9 μm); ACD (-0.03, 0.13 mm) vs (-0.03, 0.13 mm); WTW (-0.68, 0.23 mm) vs (-0.63, 0.14 mm); and AL (-0.07, 0.01 mm) vs (-0.07, 0.03 mm), respectively.
CONCLUSIONS
PRK showed a negative impact on interdevice agreement for CCT and corneal power measurements, whereas it did not have a significant effect on the agreement of devices for ACD, WTW, AL, and the J45 astigmatism vectoral component. For IOL power measurement in post-PRK eyes, the 2 devices could be regarded as interchangeable for measuring AL and ACD but not for keratometry readings.
目的
评估准分子激光角膜表面切削术（PRK）前后 Pentacam-AXL 和 IOLMaster 700 在前节变量方面的一致性。
地点
伊朗设拉子 Salouti 眼科诊所。
设计
前瞻性队列研究，分析设备间的一致性。
方法
本研究纳入了接受 PRK 的健康 PRK 候选者，这些患者在术前和 PRK 后 6 个月分别使用这两种设备进行了评估。每个患者的右眼数据都进行了分析。Pentacam-AXL 的平均角膜曲率（AvgK）和中央 2.5mm 区域的角膜曲率（zonal-K2.5）分别与 IOLMaster 700 的平均角膜曲率（Km）进行比较。其他主要观察指标包括角膜散光的向量分析（J0 和 J45）、中央角膜厚度（CCT）、前房深度（ACD）和瞳孔中心距（WTW）。还评估了接受 PRK 的新队列中 40 名患者的相同设备的眼轴（AL）测量值。采用配对 t 检验评估设备间的测量差异，采用 Bland-Altman 分析计算 95%一致性界限（LoA）。
结果
本研究纳入了 97 名患者。PRK 前后，Pentacam-AXL 和 IOLMaster 700 之间的 95%LoA 如下：AvgK/Km（-0.42，0.08 屈光度[D]）vs（-0.49，0.18 D）；zonal-K2.5/Km（-0.40，0.32 D）vs（-0.57，0.74 D）；J0（-0.33，0.18 D）vs（-0.28，0.35 D）；J45（-0.28，0.23 D）vs（-0.24，0.27 D）；瞳孔厚度/CCT（-18，12μm）vs（-2.6，19.6μm）；顶点厚度/CCT（-17.4，12.8μm）vs（-1.7，20.9μm）；ACD（-0.03，0.13mm）vs（-0.03，0.13mm）；WTW（-0.68，0.23mm）vs（-0.63，0.14mm）；AL（-0.07，0.01mm）vs（-0.07，0.03mm）。
结论
PRK 对 CCT 和角膜屈光力测量的设备间一致性有负面影响，而对 ACD、WTW、AL 和 J45 散光矢量成分的设备一致性没有显著影响。对于 PRK 后的眼内 IOL 屈光力测量，这两种设备可用于测量 AL 和 ACD，但不用于测量角膜曲率。
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