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中华眼科医学杂志(电子版)

中华眼科医学杂志(电子版) ›› 2019, Vol. 09 ›› Issue (03) : 153 -159. doi: 10.3877/cma.j.issn.2095-2007.2019.03.005

论著

OPD-Scan Ⅲ型屈光分析仪在评估SBL-3型多焦点人工晶状体中的应用
刘一昀1, 孙彤2, 高玉菲3, 马思翼2, 秦思源2, 唐楚皓2, 鲁恬舒1, 齐虹4,†()   
  1. 1. 100191　北京大学第三医院2019级博士研究生
    2. 100191　北京大学第三医院2015级本科生
    3. 100191　北京大学第三医院2017级博士研究生
    4. 100191　北京大学第三医院眼科　眼部神经损伤的重建保护与康复北京市重点实验室
  • 收稿日期:2019-05-07 出版日期:2019-06-28
  • 通信作者: 齐虹
  • 基金资助:
    国家自然科学基金面上项目(81570813)

The use of OPD-Scan Ⅲ with mesopic/phtopic pupil analysis system in assessment of SBL-3 multifocal intraocular lens

Yiyun Liu1, Tong Sun2, Yufei Gao3, Siyi Ma2, Siyuan Qin2, Chuhao Tang2, Tianshu Lu1, Hong Qi4,†()   

  1. 1. Doctor′s degree 2019, Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
    2. Bachelor′s degree 2015, Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
    3. Doctor′s degree 2017, Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
    4. Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
  • Received:2019-05-07 Published:2019-06-28
  • Corresponding author: Hong Qi
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引用本文：

刘一昀, 孙彤, 高玉菲, 马思翼, 秦思源, 唐楚皓, 鲁恬舒, 齐虹. OPD-Scan Ⅲ型屈光分析仪在评估SBL-3型多焦点人工晶状体中的应用[J]. 中华眼科医学杂志(电子版), 2019, 09(03): 153-159.

Yiyun Liu, Tong Sun, Yufei Gao, Siyi Ma, Siyuan Qin, Chuhao Tang, Tianshu Lu, Hong Qi. The use of OPD-Scan Ⅲ with mesopic/phtopic pupil analysis system in assessment of SBL-3 multifocal intraocular lens[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2019, 09(03): 153-159.

目的

利用OPD-Scan Ⅲ型屈光分析仪评估SBL-3型多焦点人工晶状体的轴位和居中性。

方法

回顾性研究。收集2017年6月至2018年7月在北京大学第三医院眼科行超声乳化白内障吸除联合SBL-3型多焦点人工晶状体植入术的33例(66只眼)患者。分别由两名经验丰富的研究人员利用OPD-Scan Ⅲ型的屈光分析仪检查术后3个月术眼的屈光分布和日-夜瞳孔分析情况，来评估术眼视近区、视远区分布的SBL-3居中性。再利用组内相关系数(ICC)和Bland-Altman法评估该方法的可靠性和一致性。以日-夜瞳孔分析图像中术眼人工晶状体中心与相对于视轴的距离和夹角来代表SBL-3型多焦点人工晶状体的居中性。以屈光分布图中术眼晶状体视近区及视远区间的过渡区对应角度来代表SBL-3型多焦点人工晶状体的轴位。

结果

本研究发现不同研究人员测量的轴位间无统计学意义(Z＝- 0.994，P>0.05)，(ICC＝0.950，P<0.05)；95%一致性界限(LoA)为7.0°。不同研究人员测量SBL-3型多焦点人工晶状体中心与视轴距离的差异无统计学意义(t＝1.659，P>0.05)，(ICC＝0.913，P<0.05)；(Z＝-1.253，P>0.05)，(ICC＝0.607，P<0.05)。95% LoA分别为0.17 mm、348.2°。

结论

利用OPD-Scan Ⅲ型屈光分析仪评估SBL-3型多焦点人工晶状体的轴位及居中性，不同研究人员间表现出有良好的可靠性及一致性，但SBL-3居中性的角度评估可靠性较差。

关键词: 白内障, 多焦点人工晶状体, 区域折射, 居中性, 轴位
Objective

The aim of this study was to evaluate a new method to assess the orientation and centration of SBL-3 intraocular lens using with OPD-Scan Ⅲ.

Methods

The design of the study was retrospective. 33 age-related cataract patients (66 eyes) underwent phacoemulsification and SBL-3 intraocular lens implantation in Department of Ophthalmology, Peking University Third Hospital from June 2017 to July 2018 were included. In this retrospective study, the refraction distribution and mesopic/phtopic pupil analysis system of OPD-Scan Ⅲ were used to assess the distribution of the near segment and the distance segment and centration of SBL-3 intraocular lens with two veterans of operating equipment at 3 months post-operation. Intra-class correlation coefficient (ICC) and Bland-Altman method were used to assess the reliability and consistency of this method. The center of SBL-3 and visual axis were used to assess the centration of SBL-3 intraocular lens. The placement of SBL-3 is defined as the transition zone between the near and distant segment measured by refractive distribution.

Results

In this study, there is no statistically significant difference between two operators (Z=-0.994, P>0.05). And the ICC was 0.950 (P<0.05). Bland-Altman 95% limits of agreement (LoA) were 7.0°. There is no significant difference on the distance and angle between two operators on these factors (t=1.659, P>0.05; Z=-1.253, P>0.05). And the ICC was 0.913 and 0.607 (P<0.05), respectively. Bland-Altman 95% LoA were 0.17 mm and 348.2°, respectively.

Conclusion

This new metheod to assess the orientation and centration distance of SBL-3 intraocular lens using OPD-Scan Ⅲ has shown that there was a good reliability and consistency. The measurement of centration angle had a good consistency but medium reliability.

Key words: Cataract, Multifocal intraocular lens, Segmental refractive, Centration, Orientation
图3 利用日-夜瞳孔测量分析系统进行人工晶状体的定位图　在OPD-Scan Ⅲ的日-夜瞳孔测量分析系统中，将充分散瞳下可见的人工晶状体边缘设定为"夜间瞳孔"，系统便可自动分析确定其中心的位置。白色十字代表视轴；蓝色图案和十字分别代表SBL-3型多焦点人工晶状体及其中心；紫色图案和十字代表瞳孔及其中心；绿色图案和十字代表白到白及其中心
图4 两位研究人员测量SBL-3型多焦点人工晶状体轴位的Bland-Altman分析图
表1 两位研究人员SBL-3型人工晶状体轴位和居中性分析的比较
组别 晶状体轴位(°) 晶状体偏心距(mm) 晶状体偏中心角度(°)
研究人员A 1.6±4.5 0.23±0.11 195.5±102.8
研究人员B 1.8±4.4 0.22±0.11 162.1±104.4
Z/t -0.994a 1.659b -1.253a
P值 >0.05 >0.05 >0.05
图5 两位研究人员测量SBL-3型多焦点人工晶状体中心相对于视轴的距离和夹角的Bland-Altman分析图　图A和图B分别显示两位研究人员测量SBL-3型多焦点人工晶状体中心相对于视轴的距离和视轴二者连线角度的Bland-Altman分析图
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