Kim Eric J, Ganga Arjun, Rana Viren K, Tanzer Joshua R, Ronquillo Yasmyne C, Moshirfar Majid
Warren Alpert Medical School at Brown University, Providence, RI, USA.
Hoopes Vision Research Center, Draper, UT, USA.
Clin Ophthalmol. 2022 Aug 25;16:2823-2835. doi: 10.2147/OPTH.S381644. eCollection 2022.
The insertion-limbus distances of the extraocular muscles are clinically relevant in the preoperative planning of strabismus surgeries, especially in reoperations when information regarding insertion sites is not accessible to the surgeon. In this systematic review, we assess the reliability of time-domain anterior segment optical coherence tomography (TD AS-OCT) in determining insertion-limbus distances preoperatively by investigating prior studies that compare preoperative TD AS-OCT measurements of the insertion-limbus distances to those of calipers, which are assumed to be the gold standard.
Systematically reviewing EMBASE, PubMed, Google Scholar, Science Direct, and Web of Science, 2 members screened for studies that compared preoperative TD AS-OCT measurements to those of intraoperative calipers, the gold standard. To assess the risk of bias for individual studies, the reviewers utilized the ROBINS-I tool, a Cochrane's collaboration tool used to assess bias in studies that are not randomized. For the meta-analysis, parallel forms reliability was examined and estimated as the Pearson product-moment correlation between TD AS-OCT measurements and surgical caliper measurements.
Six out of the seven eligible studies provided measures of reliability that were >0.7. These six records were eligible for meta-analysis. There was no evidence of a difference between means of TD AS-OCT and caliper measurements ( = 6.81, 95% CI [6.41, 7.22]; = 6.73, 95% CI [6.18, 7.29]; = 0.08, 95% CI [-0.44, 0.61]). Reliability was estimated to be good ( = 0.91) though the lower limit was slightly below the recommended minimum acceptable level of 0.70 (95% CI [0.65, >0.99]).
In the setting of primary surgeries, TD AS-OCT has an acceptable reliability. However, there is insufficient data to conclude whether TD AS-OCT has an acceptable reliability in the setting of reoperations.
眼外肌附着点至角膜缘的距离在斜视手术的术前规划中具有临床相关性，尤其是在再次手术时，手术医生无法获取有关附着点位置的信息。在本系统评价中，我们通过调查先前的研究来评估时域眼前节光学相干断层扫描（TD AS-OCT）术前测定附着点至角膜缘距离的可靠性，这些研究将术前TD AS-OCT测量的附着点至角膜缘距离与卡尺测量值进行了比较，卡尺测量被认为是金标准。
系统检索EMBASE、PubMed、谷歌学术、科学Direct和科学网，两名研究人员筛选比较术前TD AS-OCT测量值与术中卡尺测量值（金标准）的研究。为评估单个研究的偏倚风险，评价人员使用了ROBINS-I工具，这是一种Cochrane协作工具，用于评估非随机研究中的偏倚。对于荟萃分析，检验并估计了平行形式的可靠性，即TD AS-OCT测量值与手术卡尺测量值之间的Pearson积矩相关性。
七项符合条件的研究中有六项提供的可靠性测量值>0.7。这六项记录符合荟萃分析的条件。没有证据表明TD AS-OCT测量值与卡尺测量值的均值存在差异（ = 6.81，95%CI [6.41, 7.22]； = 6.73，95%CI [6.18, 7.29]； = 0.08，95%CI [-0.44, 0.61]）。尽管下限略低于推荐的最低可接受水平0.70（95%CI [0.65, >0.99]），但可靠性估计良好（ = 0.91）。
在初次手术中，TD AS-OCT具有可接受的可靠性。然而，尚无足够数据得出TD AS-OCT在再次手术中是否具有可接受可靠性的结论。
