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目的探讨Pentacam测量所得的角膜后表面参数对于筛查临床前期圆锥角膜的作用。设计前瞻性病例对照研究。研究对象正常对照组45例73眼,临床期圆锥角膜组14例20眼,临床前期圆锥角膜组43例58眼。方法经TOPOLYZER角膜地形图仪和裂隙灯显微镜检查确诊的临床前期、临床期圆锥角膜组,用Pentacam测量获得角膜后表面参数水平,分别与正常对照组所得的相应参数进行对比。主要指标角膜后表面的高度最大值、高度最小值、高度差、最小矢状曲率、角膜中央3mm平均散光度。结果正常对照组和临床期、临床前期圆锥角膜组间有统计学显著性差异的角膜后表面参数为:角膜后表面的高度最大值(P均<0.001)、高度最小值(P均<0.001)、高度差(P均<0.001)、最小矢状曲率(P<0.001、P=0.014)、角膜中央3mm平均散光度(P<0.001、P=0.008),它们均与圆锥角膜的发展相关,并依照ROC曲线,计算出角膜后表面高度最大值、高度差、角膜中央3 mm平均散光度在区分正常角膜和临床期、临床前期圆锥角膜时的切点、敏感度及特异度。结论Pentacam测量的角膜后表面参数可以有效地筛查临床前期圆锥角膜及确诊临床期圆锥角膜。
Objective To investigate the effect of corneal posterior surface parameters measured by Pentacam on the screening of preclinical keratoconus. Design prospective case-control study. Forty-five eyes (73 eyes), 14 eyes (20 eyes), and 43 eyes (58 eyes) in the pre-clinical keratoconus group were included in the study. Methods The corneal posterior corneal surface parameters were measured by Pentacam and compared with the corresponding parameters of the normal control group. The main indicators of the corneal height of the posterior surface of the maximum, minimum height, height difference, minimum sagittal curvature, central corneal 3mm average astigmatism. Results The posterior corneal surface parameters of normal control group, preclinical keratoconus group and corneal keratoconus group were statistically significant (P <0.001, P <0.001) , Height difference (P <0.001), minimal sagittal curvature (P <0.001, P = 0.014), central corneal 3mm mean astigmatism (P <0.001, P = 0.008), which were all related to the development of keratoconus and According to ROC curve, the maximum value of posterior corneal height, height difference, mean central corneal 3 mm astigmatism were calculated to distinguish between normal cornea, clinical point, preclinical keratoconus, sensitivity and specificity. Conclusions The corneal posterior surface parameters measured by Pentacam can effectively screen the preclinical keratoconus and diagnose the clinical keratoconus.