Cao K W, Liu L N, Sun Y L, Zhang T, Bai J, Liu T
Department of Ophthalmology, Army Medical Center of PLA, Chongqing 400042, China.
Chongqing Vision Institute, Chongqing 400042, China.
Zhonghua Yan Ke Za Zhi. 2020 Oct 11;56(10):761-767. doi: 10.3760/cma.j.cn112142-20200220-00093.
To investigate the effect of corneal diameter on Belin/Ambrósio enhanced ectasia display (BAD). Retrospective case series study. The subjects were 6 744 myopic patients, including 3 341 males and 3 403 females, who had undergone corneal refractive surgery or had completed preoperative examination but had not undergone corneal refractive surgery at the Army Medical Center and Chongqing Vision Institute in Chongqing from June 2017 to June 2019. Age was (23.74±5.73) years old. No patients had keratoconus. One eye of each patient was randomly included, and the patients were divided into groups according to the corneal diameter measured by Pentacam. Group A included 630 patients (630 eyes) with corneal diameter ≤ 11.1 mm. In group B, there were 4 063 patients (4 063 eyes) with corneal diameter of 11.2 to 11.8 mm. In group C, there were 2 051 patients (2 051 eyes) with corneal diameter ≥11.9 mm. Preoperative BAD parameters of deviation of front elevation difference map (Df), deviation of back elevation difference map (Db), deviation of average pachymetric progression index (Dp), deviation of minimum thickness (Dt), deviation of Ambrósio's relational thickness maximum (Da) and overall deviation value (Do) were measured by Pentacam. One-way analysis of variance was used for preoperative BAD parameters comparison between groups. The distribution of normal, suspicious and pathological results of Df, Db, Dp, Dt, Da and Do in each group was tested by chi-square test. In groups A, B and C, Df was 0.73±1.14, 0.48±1.02, and 0.11±0.91, Db was 1.09±1.07, 0.23±0.83, and-0.34±0.62, Dp was 1.57±0.91, 1.14±0.86, and 0.68±0.75, Dt was -0.11±0.84, -0.2±0.82, and 0.03±0.78, Da was 0.78±0.61, 0.64±0.64, and 0.48±0.64, and Do was 1.65±0.64, 1.24±0.60, and 0.86±0.55, respectively. The BAD parameters of Df (=129.549), Db (=829.491), Dp (=344.373), Dt (=7.249), Da (=68.637) and Do (=524.877) were all significantly different between groups (<0.01). The proportion of suspicious and pathological BAD parameters [Df (χ²=161.8), Db (χ²=611.75), Dp (χ²=478.84), Da (χ²=44.636), and Do (χ²=553.11)] suggested the distribution in each group was significantly different (<0.01). Corneal diameter had a significant influence on BAD. Compared with eyes with large corneas, the false positive rate of BAD was higher in eyes with small corneas..
探讨角膜直径对Belin/Ambrósio增强型扩张显示(BAD)的影响。回顾性病例系列研究。研究对象为6744例近视患者,其中男性3341例,女性3403例,于2017年6月至2019年6月在重庆陆军军医大学医学中心和重庆视觉研究所接受了角膜屈光手术或完成了术前检查但未接受角膜屈光手术。年龄为(23.74±5.73)岁。所有患者均无圆锥角膜。随机纳入每位患者的一只眼,并根据Pentacam测量的角膜直径将患者分为几组。A组包括630例患者(630只眼),角膜直径≤11.1mm。B组有4063例患者(4063只眼),角膜直径为11.2至11.8mm。C组有2051例患者(2051只眼),角膜直径≥11.9mm。使用Pentacam测量术前BAD参数,包括前表面高度差图偏差(Df)、后表面高度差图偏差(Db)、平均角膜厚度进展指数偏差(Dp)、最小厚度偏差(Dt)、Ambrósio相关厚度最大值偏差(Da)和总体偏差值(Do)。采用单因素方差分析对各组术前BAD参数进行比较。通过卡方检验检测每组中Df、Db、Dp、Dt、Da和Do的正常、可疑和病理结果分布。在A、B和C组中,Df分别为0.73±1.14、0.48±1.02和0.11±0.91,Db分别为1.09±1.07、0.23±0.83和 - 0.34±0.62,Dp分别为1.57±0.91、1.14±0.86和0.68±0.75,Dt分别为 - 0.11±0.84、 - 0.2±0.82和0.03±0.78,Da分别为0.78±0.61、0.64±0.64和0.48±0.64,Do分别为1.65±0.64、1.24±0.60和0.86±0.55。Df(=129.549)、Db(=829.491)、Dp(=344.373)、Dt(=7.249)、Da(=68.637)和Do(=524.877)的BAD参数在各组之间均有显著差异(P<0.01)。可疑和病理BAD参数的比例[Df(χ²=161.8)、Db(χ²=611.75)、Dp(χ²=478.84)、Da(χ²=44.636)和Do(χ²=553.11)]表明各组分布有显著差异(P<0.01)。角膜直径对BAD有显著影响。与大角膜眼相比,小角膜眼BAD的假阳性率更高。