目的：观察浸润式B超引导下的A超分段式声速测量在致密型白内障眼轴测量中的准确性。

方法：前瞻性研究。选取成都爱尔眼科医院2020-08/2022-08致密型白内障患者86例90眼，男61例59眼，女25例31眼，平均年龄66.49±14.55岁。术前分别采用接触式A超，浸润式B超引导下A超分段式声速测量法与IOL Master 700测量眼轴(AL)、前房深度(ACD)(含角膜厚度)、角膜曲率(K)、晶状体厚度(LT)、中央角膜厚度(CCT)、白到白角膜直径(WTW)。术后1 wk，使用IOL Master 700的无晶状体眼模式复测眼轴长度。分析三种设备测量眼轴的一致性与相关性。

结果：术前接触式A超与浸润式B超引导下A超分段式声速测量眼轴为23.40(22.63，23.89)、23.70(23.04，24.25)mm，术后1 wk IOL Master 700测量眼轴为23.72(23.01，24.27)mm。接触式A超与浸润式B超引导下A超分段式声速测量法、术后IOL Master 700测量眼轴差异均有统计学意义(P=0.018)，而浸润式B超引导下A超分段式声速测量法与术后IOL Master 700测量眼轴差异无统计学意义(P=0.991)。通过Bland-Altman分析，浸润式B超引导下A超分段式声速测量法与IOL Master 700测量眼轴有很好的一致性(P=0.0809)。术前浸润式B超引导下A超分段式声速测量法与术后IOL Master 700眼轴正相关(r_s=0.992， P<0.0001)，术前接触式A超与术后IOL Master 700眼轴正相关(r_s=0.989， P<0.0001)。

结论：对于致密型白内障，浸润式B超引导下A超分段式声速测量比接触式A超更接近术后IOL Master 700眼轴测量数据，具有良好的相关性和一致性。

METHODS: Perspective study. A total of 86 patients(90 eyes)with dense cataract were selected from Chengdu Aier Eye Hospital from August 2020 to August 2022. There were 61 males(59 eyes)males and 25 females(31 eyes)females, with an average age of 66.49±14.55 years. The axial length(AL), anterior chamber depth(ACD)(including corneal thickness), corneal curvature(K), lens thickness(LT), central corneal thickness(CCT), and white-to-white(WTW)were measured preoperatively by contact A-scan, infiltrating B ultrasound guided segmented A-scan, and IOL Master 700, respectively. At 1 wk postoperatively, AL was retested by IOL Master 700 in aphakic mode. Furthermore, the agreements and correlations of AL obtained by the three kinds of devices were analyzed.

RESULTS:The AL measured by contact A-scan and infiltrating B ultrasound guided segmented A-scan were 23.40(22.63, 23.89)mm and 23.70(23.04, 24.25)mm, respectively, and the AL measured by IOL Master 700 at 1 wk postoperatively was 23.72(23.01, 24.27)mm. There were statistical significant difference in AL measured by the three methods(P=0.018), while there were no statistical significant difference in AL measured by infiltrating B ultrasound guided segmented A-scan and IOL Master 700(P=0.991). Bland-Altman analysis showed that there was a good agreement in AL measured by infiltrating B ultrasound guided segmented A-scan and IOL Master 700(P=0.0809). The AL measured by infiltrating B ultrasound guided segmented A-scan and IOL Master 700 was positively correlated(r_s=0.992, P<0.0001), and the AL was positively correlated between preoperative contact A-scan and postoperative IOL Master 700(r_s=0.989, P<0.0001).

CONCLUSION:For dense cataract, infiltrating B ultrasound guided A-scan segment biometric measurement, which has good correlations and agreement, is closer to the AL measured by IOL Master 700 postoperatively than that measured by contact A-scan.