目的

探讨OPD-scanⅢ与iTrace测量有晶状体眼人工晶状体（ICL）植入术后患者全眼和眼内高阶像差的一致性。

方法

收集2023年6月至2023年12月就诊于首都医科大学附属北京同仁医院眼视光科门诊并行ICL手术的近视眼患者96例（96只眼）。其中，男性46例（46只眼），女性50例（50只眼）。年龄20～49岁，平均年龄（28.3±6.2）岁。分别应用OPD-scanⅢ和iTrace测量暗环境下瞳孔大小为4 mm时的全眼高阶像差、全眼球差、全眼慧差、全眼三叶草差、眼内高阶像差、眼内球差及眼内三叶草差的均方根。经检验，患者全眼高阶像差、全眼球差、全眼慧差、全眼三叶草差、眼内高阶像差、眼内球差及眼内三叶草差符合正态分布，以±s表示。两种设备测量指标的一致性采用Bland-Altman检验分析。两种设备测量结果的比较采用配对样本t检验。

结果

Bland-Altman分析结果显示OPDscanⅢ和iTrace测量全眼高阶像差、全眼球差、全眼慧差、全眼三叶草差、眼内高阶像差、眼内球差及眼内三叶草差均方根差值的平均值（95%一致性界限区间）分别为0.03（-0.13～0.19）μm、0.01（-0.05～0.07）μm、-0.01（-0.11～0.08）μm、0.06（-0.08～0.21）μm、0.03（-0.15～0.21）μm、0.02（-0.05～0.10）μm、-0.00（-0.15～0.15）μm及0.04（-0.11～0.20）μm，分别占5.2%（5/96）、3.1%（3/96）、3.1%（3/96）、7.3%（7/96）、3.1%（3/96）、4.2%（4/96）、6.3%（6/96）及3.1%（3/96）个点位于95%一致性界限区间之外。OPD-scanⅢ和iTrace测量的全眼高阶像差、全眼球差、全眼慧差、全眼三叶草差、眼内高阶像差、眼内球差及眼内三叶草差的均方根分别为（0.231±0.080）μm和（0.199±0.078）μm、（0.042±0.033）μm和（0.034±0.024）μm、（0.067±0.040）μm和（0.080±0.046）μm、（0.191±0.086）μm和（0.131±0.071）μm、（0.202±0.069）μm和（0.171±0.073）μm、（0.074±0.037）μm和（0.049±0.036）μm及（0.131±0.071）μm和（0.086±0.053）μm，其差异具有统计学意义（t＝3.603，2.400，-2.621，7.603，3.207，6.040，6.216；P＜0.05）。OPD-scanⅢ和iTrace测量眼内慧差的均方根分别为（0.081±0.057）μm和（0.083±0.051）μm，其差异无统计学意义（t＝-0.263，P＞0.05）。

结论

尽管OPD-scanⅢ和iTrace测量的全眼高阶像差、全眼球差、全眼慧差、全眼三叶草差、眼内高阶像差、眼内球差、眼内慧差及眼内三叶草差一致性较好，但配对检验结果显示两设备检测的全眼高阶像差、全眼球差、全眼慧差、全眼三叶草差、眼内高阶像差、眼内球差及眼内三叶草差均存在差异仅眼内慧差无差异。鉴于普通患者对较小的差异视觉感觉并不明显，而有高精度视觉需求和夜间较好视觉需求的患者则会感觉明显。笔者建议对于有高精度视觉需求和夜间较好视觉需求的患者，OPD-scanⅢ和iTrace测量的全眼高阶像差、全眼球差、全眼慧差、全眼三叶草差、眼内高阶像差、眼内球差、眼内慧差及眼内三叶草差数据中除眼内慧差可以通用外，其他指标的测量数据不建议互换使用。

Objective

To compare the differences and consistency in total ocular and internal higherorder aberrations（HOAs）measured by OPD-scanⅢand iTrace in patients after ICL surgery.

Methods

A total of 96 patients with myopia who underwent ICL surgery at the Department of Ophthalmology and Optometry of Beijing Tongren Hospital affiliated with Capital Medical University from June 2023 to December 2023 were collected.Among them，there were46 male patients（46 eyes）and 50 female patients（50 eyes）with an average age of（28.3±6.2）years（ranging from 20 to 49 years）.OPD-scanⅢand iTrace were used to measure the root mean square values of HOAs，ocular aberrations，ocular coma，ocular trefoil，intraocular HOAs，intraocular spherical aberrations，and intraocular trefoil in the whole eye when the pupil size was 4 mm in a dark environment.After testing，the patient's age，equivalent refractive power，high-order aberration of the whole eye，total ocular aberration，total ocular aberration，total ocular trefoil aberration，intraocular high-order aberration，intraocular spherical aberration，and intraocular trefoil aberration were found to be normally distributed，as indicated by±s.The differences in measurement indicators between the two devices were analyzed using a paired sample t test.The consistency of the measurement indicators between the two devices was analyzed using the Bland-Altman test.

Results

Bland-Altman analysis showed that the mean differences（95% limits of agreement）in RMSvalues between OPD-scanⅢand iTrace for total ocular HOAs，total ocular spherical aberration，total ocular coma，total ocular trefoil，internal HOAs，internal spherical aberration，internal coma，and internal trefoil were 0.03（-0.13～0.19）μm，0.01（-0.05～0.07）μm，-0.01（-0.11～0.08）μm，0.06（-0.08～0.21）μm，0.03（-0.15～0.21）μm，0.02（-0.05～0.10）μm，-0.00（-0.15～0.15）μm，and 0.04（-0.11～0.20）μm，respectively.The percentages of points outside the 95% limits of agreement were 5.2% （5/96），3.1% （3/96），3.1% （3/96），7.3% （7/96），3.1% （3/96），4.2% （4/96），6.3% （6/96），and 3.1% （3/96），respectively.The root mean square values of total ocular HOAs，total ocular spherical aberration，total ocular coma，total ocular trefoil，internal HOAs，internal spherical aberration，and internal trefoil measured by OPD-scanⅢand iTrace were（0.231±0.080）μm and（0.199±0.078）μm，（0.042±0.033）μm and（0.034±0.024）μm，（0.067±0.040）μm and（0.080±0.046）μm，（0.191±0.086）μm and（0.131±0.071）μm，（0.202±0.069）μm and（0.171±0.073）μm，（0.074±0.037）μm and（0.049±0.036）μm，and（0.131±0.071）μm and（0.086±0.053）μm，respectively.The differences were statistically significant（t＝3.603，2.400，-2.621，7.603，3.207，6.040，6.216；P＜0.05）.The root mean square values of internal coma measured by OPD-scanⅢand iTrace were（0.081±0.057）μm and（0.083±0.051）μm，respectively，with no statistically significant difference（t＝-0.263，P＞0.05）.

Conclusions

Although the consistency between OPD-scanⅢand iTrace in measuring overall HOAs，overall spherical aberrations，overall coma，overall trefoil aberrations，intraocular HOAs，intraocular spherical aberrations，intraocular coma，and intraocular trefoil aberrations is relatively good，paired test results indicate that，except for intraocular coma，significant differences exist in the measurements of overall HOAs，overall spherical aberrations，overall coma，overall trefoil aberrations，intraocular HOAs，intraocular spherical aberrations，and intraocular trefoil aberrations between the two devices.Given that ordinary patients may not notice minor differences in visual perception，while patients with high-precision visual needs and better night vision needs may perceive these differences more distinctly，it is recommended that，for patients with high-precision visual needs and better night vision needs，except for intraocular coma，the measurement data of overall HOAs，overall spherical aberrations，overall coma，overall trefoil aberrations，intraocular HOAs，intraocular spherical aberrations，intraocular coma，and intraocular trefoil aberrations from OPD ｜scanⅢ and iTrace should not be interchangeably used.