Central South University, Aier School of Ophthalmology, Changsha, China.
Lanzhou University First Affiliated Hospital, Gansu, China.
Eur J Ophthalmol. 2024 May;34(3):656-665. doi: 10.1177/11206721231202539. Epub 2023 Sep 18.
To evaluate the viability and precision of measuring the distance from the limbus to extraocular muscle insertion using anterior segment optical coherence tomography (AS-OCT) and panoramic ultrasound biomicroscopy (UBM) before and after strabismus surgery.
We recruited primary strabismus patients and measured the limbus-insertion distance by AS-OCT and UBM preoperatively, 2 weeks, and 1, 3, and 6 months postoperatively. Values were also measured using callipers intraoperatively before and after the planned procedures. Preoperative AS-OCT and UBM values were compared to intraoperative calliper measurements as the gold standard. Postoperative AS-OCT and UBM values were compared to the new postoperative limbus-insertion distance. The limit of agreement deemed clinically acceptable was defined as 1 mm.
A total of 85 horizontal muscles of 40 patients, including 48 lateral rectus muscles and 37 medial rectus muscles, were analysed. Primary muscles could be successfully detected by AS-OCT (95%) and UBM (100%). At 2 weeks and 1, 3, and 6 months postoperatively, the new rectus muscle attachment site detection rate by AS-OCT was 6%, 32%, 80%, and 89%, respectively, and that by UBM was 24%, 60%, 85%, and 93%, respectively. The Bland-Altman plots revealed better consistency in pairs of AS-OCT, UBM, and calliper measurements of primary muscles than postoperative muscles. For primary muscles, 89% of AS-OCT measurements fell within the permissible range of surgical measurements (1 mm), but this dropped to 67% at 6 months postoperatively ( < 0.001). The accuracy of UBM measurements of primary muscles was 81%, and this decreased to 59% at 6 months postoperatively ( = 0.001).
AS-OCT and UBM performed well in terms of imaging primary horizontal rectus muscles, but showed decreased accuracy and reproducibility in postoperative muscle measures.
评估在斜视手术前后使用眼前节光学相干断层扫描（AS-OCT）和全景超声生物显微镜（UBM）测量眼外肌插入处到角膜缘的距离的可行性和准确性。
我们招募了原发性斜视患者，在术前、术后 2 周、1 个月、3 个月和 6 个月使用 AS-OCT 和 UBM 测量角膜缘-插入距离，并在计划手术前后使用卡尺进行术中测量。将术前 AS-OCT 和 UBM 值与术中卡尺测量值作为金标准进行比较。将术后 AS-OCT 和 UBM 值与新的术后角膜缘-插入距离进行比较。认为临床可接受的一致性限为 1 毫米。
共分析了 40 名患者的 85 条水平肌，包括 48 条外直肌和 37 条内直肌。AS-OCT（95%）和 UBM（100%）可成功检测到原发性肌肉。术后 2 周、1 个月、3 个月和 6 个月时，AS-OCT 检测到新直肌附着点的检出率分别为 6%、32%、80%和 89%，UBM 分别为 24%、60%、85%和 93%。Bland-Altman 图显示，原发性肌肉的 AS-OCT、UBM 和卡尺测量结果之间的一致性优于术后肌肉。对于原发性肌肉，89%的 AS-OCT 测量值在手术测量的允许范围内（1 毫米），但术后 6 个月时降至 67%（<0.001）。原发性肌肉 UBM 测量的准确性为 81%，术后 6 个月时降至 59%（=0.001）。
AS-OCT 和 UBM 在成像原发性水平直肌方面表现良好，但在术后肌肉测量中准确性和可重复性降低。
