使用不同眼压计比较翼状胬肉术后绷带镜对眼压的影响

Comparative measurement of intraocular pressure by Rebound and non-contact tonometry in patients wearing bandage contact lenses after pterygium excision

摘要:

目的：利用回弹式眼压计(RT)及非接触式眼压计(NCT)测量并比较翼状胬肉术后配戴治疗用绷带镜时与裸眼眼压的差异。

方法：选取2019-04/06在开封市中心医院开封眼病医院手术治疗的翼状胬肉患者(鼻侧原发性翼状胬肉小于4mm且术后配戴治疗用绷带镜)50例50眼。于术后14d用RT及NCT分别在戴镜状态、裸眼状态测量患者眼压，比较并分析翼状胬肉术后治疗用绷带镜对眼压测量的影响。

结果：RT在戴镜状态、裸眼状态测得的眼压分别为18.20±3.19、15.17±3.80mmHg，相差3.04±1.79mmHg，且前后两次测量具有良好的相关性(r=0.884，P<0.001)； NCT在戴镜状态、裸眼状态测得的眼压分别为15.74±3.23、13.19±3.89mmHg，相差2.55±1.88mmHg，且具有良好的相关性(r=0.876，P<0.001)； 在戴镜状态及裸眼状态，两种设备测量所得眼压分别相差2.46±1.45、1.98±1.67mmHg，RT测量结果均显著高于NCT测量结果(P<0.001)。

结论：翼状胬肉术后应用RT、NCT测量配戴治疗用绷带镜状态与裸眼状态的眼压一致性均较好，但在配戴治疗用绷带镜时两种眼压计均有高估患者眼压风险，且应用RT在戴镜状态及裸眼状态眼压高估较NCT更明显。

Abstract:

AIM: To compare the measurement of intraocular pressure(IOP)through a bandage contact lens with the “native” measurement by rebound tonometry and non-contact tonometry in patients after pterygium excision.

METHODS: Fifty consecutive patients(50 eyes)undergone pterygium excision(unilateral nasal, primary pterygium, horizontal length <4mm), and conjunctival autografting were included in this prospective study. IOP measurements were obtained by Rebound tonometry and non-contact tonometry in random order with(lens measurement)and without(native measurement)a bandage contact lens half a month after operation. We compared the mean values(validity parameter)and standard deviation(precision parameter)of the two individual measurements in each case using the paired t-test 14d after surgery.

RESULTS: With the rebound tonometry we detected statistically significant higher values in the contact lens measurements(18.20±3.19 vs 15.17±3.80mmHg in the native measurements; P<0.001), a good correlation with r=0.884 and mean difference was 3.04±1.79mmHg; With the non-contact tonometry we detected statistically significant higher values in the contact lens measurements(15.74±3.23 vs 13.19±3.89mmHg in the native measurements; P<0.001), a good correlation with r=0.876 and mean difference was 2.55±1.88mmHg. In the contact lens measurements and native measurements, we detected statistically significant higher values by Rebound tonometry than that by non-contact tonometry(P<0.001), and mean difference was 2.46±1.45mmHg, 1.98±1.67mmHg.

CONCLUSION: The use of rebound tonometry and non-contact tonometry shows good consistency between lens measurement and native measurement. However, it should be noted that the average of the measurements over contact lens by rebound tonometry and non-contact tonometry were found to be higher than that in native measurement, and the average of the measurements with and without lens by rebound tonometer was found to be higher than what was measured by non-contact tonometry.