目的:通过对白内障患者行Phaco+IOL手术前后A超和IOL-Master的眼球生物测定值的动态对比观察,经统计分析其临床意义。方法:连续动态观察本院固定手术(Phaco+IOL术)患者70例84眼。采用A超和IOL-Master分别对术前、术后14d患者眼球生物值测定,包括:眼轴长度、前房深度、晶状体厚度、玻璃体腔深度。并对手术前后患者坐、卧位的眼球生物值进行对比观测,分别对各项生物测定值进行统计学分析。结果:(1)前房深度:术后比术前前房平均加深28.41%,前房深度加深改变与晶状体厚度呈正相关(r=0.396,P=0.002,n=58),进行线性模拟表示:前房加深深度=0.445×晶状体厚度-1.207;(2)A超测定手术前后坐、卧位前房深度的差异无统计学意义(P=0.264,n=57;P=0.663,n=44);(3)A超、IOL-Master术前前房深度测定有显著统计学意义(P<0.01,n=29),A超测得均值为:2.75±0.57mm,Master测得均值为:2.96±0.61mm,差值为:-0.21±0.29mm,两者差值的95%CI为:(-0.32～0.10mm);(4)A超、IOL-Master术后前房深度测定有显著统计学意义(P=0.002,n=41),A超测得均值为:3.46±0.46mm,Master测得均值为:3.79±0.65mm,差值为:-0.33±0.63mm,两者差值的95%CI为:(-0.53～0.14mm);(5)A超测定手术前后前房深度改变与IOL-Master手术前后前房深度改变的差异无统计学意义(P=0.619,n=19)。眼轴:(1)A超测定手术前后眼轴长度无统计学差异(P=0.079,n=58);(2)术前、术后A超坐、卧位测定眼轴长度无统计学意义(P=0.934,n=57;P=0.196,n=44);(3)A超、IOL-Master术前、术后眼轴长度测定均没有统计学意义(P=0.175,n=17;P=0.248,n=31)。结论:Phaco+IOL患者手术前后前房深度改变显著且与晶状体厚度呈正相关,术后比术前前房平均加深28.41%;除前房深度外,常规A超眼球生物测定值与IOL-Master眼球生物测定值相一致。另外,患者的体位对A超测定结果基本无影响。

AIM:To compare the biometry measurements of IOL-Master and A-scan ultrasound in patients with cataract surgery,and analyze its clinical significance.METHODS:Dynamic observation was conducted in 84 eyes of 70 cataract patients by same operator.Measurements were made before and 14 days after the operation by IOL-Master optical instrument(Carl Zeiss)and Ultrascan Digital 2000 contact ultrasound A-scan(Alcon),respectively,which included axial length(AL),anterior chamber depth(ACD),and crystal thickness.Simultaneously,a prospective comparison of measurements was made by A-scan ultrasound in sitting and decubitus position.RESULTS:ACD:(1)Average depth of postoperation increased by 28.41% compared with that before operation.The operational devation of ACDs was correlated with crystal thickness positively(r=0.396,P=0.002,n=58),Linear analog representation showed that the operational devation of ACD=0.445×crystal thickness-1.207(mm);(2)There was no statistical significance of ACDs before and after operation measured by A-scan ultrasound in sitting and decubitus position(P=0.264,n=57;P=0.663,n=44);(3)The preoperation ACD values measured by the IOL-Master was deeper than that measured by A-scan ultrasound(P<0.01,n=29),mean value by A-scan ultrasound:2.75±0.57mm,mean value by the IOL-Master:2.96±0.61mm,difference in values was-0.21±0.29mm,95%CI:(-0.32-0.10mm);(4)The postoperation ACD values given by the IOL-Master was deeper than that by A-scan ultrasound(P=0.002,n=41),mean value by A-scan ultrasound:3.46±0.46mm,mean value by the IOL-Master:3.79±0.65mm,difference in values was-0.33±0.63mm,95%CI:(-0.53-0.14mm);(5)There was no statistical significance of ACD changes before and after operation measured by A-scan ultrasound and IOL-Master respectively(P=0.619,n=19).AL:(1)The ALs before and after operation were not significantly different(P=0.079,n=58);(2)Before and after operation,the difference of AL values measured by A-scan ultrasound in sitting and decubitus position both were not significant(P=0.934,n=57;P=0.196,n=44);(3)Before and after operation,the difference of AL values measured by the IOL-Master and by A-scan ultrasound both were not significant(P=0.175,n=17;P=0.248,n=31).CONCLUSION:The postoperative average depth increased by 28.41% than preoperative,and the operational devation of ACDs was correlated with crystal thickness positively.The biometry measurements of IOL-Master and A-scan ultrasound in patients with cataract surgery was same except ACDs.In addition,different measuring positions have no influence on the result of A-scan ultrasound measure.

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