治疗性角膜接触镜对Tono-pen眼压计测量角膜病变患者眼压的影响

发布时间：2018-07-05 06:10

  本文选题：眼压 + Tono-pen眼压计　； 参考：《中山大学学报(医学科学版)》2014年01期

【摘要】：【目的】比较配戴治疗性角膜接触镜(TCL)前后Tono-pen眼压计测量角膜病变患者眼压测量的差异,分析治疗性角膜接触对Tono-pen眼压计测量值的影响。【方法】连续纳入2012年4月至2012年10月我院就诊的33例(33眼)角膜病变患者,包括大泡性角膜病变11眼、眼化学伤8眼、单疱病毒性角膜炎5眼、继发性青光眼4眼、前部角膜营养不良2眼、穿透性角膜移植术后2眼、复发性胬肉1眼。应用Tono-pen眼压计测量患者未配戴TCL和配戴TCL两种状态下的眼压,每种测量方式各重复测2次。用组内相关系数ICC计算每一种测量方法的重复性,计算重复测量间差异的95%可信限;配对t检验比较两种眼压测量方法的差异,计算差异的可信限95%LoA,并绘制Bland-Altman散点图。【结果】Tono-pen眼压计直接重复测量的ICC为0.986,两次测量的平均差值为(0.42±1.98)mmHg,95%可信限为-4.30~3.46 mmHg,其中90.9%的测量差值≤3 mmHg;配戴治疗性角膜接触镜后重复测量的ICC为0.983,两次测量的平均差值为(0.12±2.19)mmHg,95%可信限为-4.46~4.22 mmHg,90.9%的测量差值≤3 mmHg。配戴治疗性角膜接触镜后Tono-pen眼压测量值平均减小(0.68±3.39)mmHg,差异无统计学意义(P=0.257),两种测量结果的一致性系数ICC为0.959,差值的95%可信限为-7.32~5.96 mmHg,其中70%测量的差值≤3 mmHg;在平均眼压21 mmHg的患者中,82.4%的测量差值≤3 mmHg,在平均眼压≥21 mmHg的患者中,56.3%的测量差值≤3 mmHg。【结论】Tono-pen眼压计测量角膜病变患者的眼压有较好的重复性,配戴治疗性角膜接触镜对测量的重复性和总体的测量均值无影响。但配戴角膜接触镜前后眼压测量值存在一定程度的差异,高眼压者比正常眼压者的差异大,临床应用时应对测量结果进行客观的评价。
[Abstract]:[objective] to compare the difference of intraocular pressure (IOP) measurement between patients with keratopathy before and after wearing a therapeutic contact lens (TCL) with Tono-pen intraocular pressure (IOP). The effect of therapeutic corneal contact on Tono-pen IOP was analyzed. [methods] 33 cases (33 eyes) of keratopathy were included in our hospital from April 2012 to October 2012, including 11 eyes with macular keratopathy and 8 eyes with chemical injury. Herpes simplex keratitis in 5 eyes, secondary glaucoma in 4 eyes, anterior corneal dystrophy in 2 eyes, penetrating keratoplasty in 2 eyes, recurrent pterygium in 1 eye. The intraocular pressure (IOP) was measured with Tono-pen intraocular pressure meter under the condition of non-wearing TCL and TCL. The repeatability of each measurement method was calculated with the intra-group correlation coefficient ICC, and the 95% confidence limit of the difference between repeated measurements was calculated. Calculate the confidence limit of difference 95LoA, and draw Bland-Altman scatter plot. [results] the ICC measured directly by Tono-pen IOP was 0.986.The average difference between the two measurements was (0.42 卤1.98) mm Hg 95% confidence limit was -4.30 mm 3.46 mm Hg, 90.9% measurement difference was 鈮，

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