摘要背景 兔是建立降眼压手术和药物治疗模型的常用动物,其眼压测量的准确性在数据分析和定量评价中至关重要,目前测量兔眼压精确的方法是前房插管测压法,但为有创测量法.Schi(o)tz眼压计、Perkins眼压计和Rebound眼压计测量均为无创测量法,使用更为简便,但关于这三者测量兔眼压的准确性研究较少. 目的 以前房插管测压法测量值(IMV)为基准作为实际眼压值,探讨Schi(o)tz眼压计、Perkins眼压计和Rebound眼压计测量兔眼压值的准确性,并结合兔眼球生理参数,对Schi(o)tz眼压计读数(STV)、Perkins眼压计读数(PTV)和Rebound眼压计读数(RTV)进行校正.方法 选择健康成年新西兰大耳白兔8只,均取右眼为实验眼,利用Lenstar900和超声生物显微镜(UBM)分别测量其中央角膜厚度(CCT)、角膜曲率(CC)、眼轴长度(AL)、前房深度(ACD)、晶状体厚度(LT)和巩膜厚度(ST).全身麻醉下行右眼玻璃体腔和前房穿刺,玻璃体腔置管连接平衡盐溶液(BSS)以建立眼压梯度,前房插管测压法测量实际眼压,同步同梯度获得STV、PTV和RTV;以IMV为基准,将STV、PTV与RTV结合兔眼球生理参数,获得其多元回归方程对眼压值进行校正. 结果 测得8只眼球的生理参数,CCT为(338.96±21.52)μm,CC为(51.68±1.66)D,AL为(14.63±0.19) mm,ACD为(2.22±0.04)mm,LT为(6.15±0.10)mm,ST为(339.80±47.41) μm.与IMV相比较,Schi(o)tz、Perkins和Rebound眼压计测量值的误差分别为(17.08±11.22)、(25.81±12.43)和(22.50±11.47) mmHg(1 mmHg=0.133 kPa),差异均有统计学意义(t=10.54、14.39、13.59,均P＜0.05).STV、PTV、RTV与IMV的95％一致性界限较大,随着实际眼压的升高,测量误差增大.IMV(实际眼压)与STV的回归方程为:实际眼压=141.015+1.570×STV+0.122×CCT-3.480×CC (R=0.92,P=0.00);与PTV回归方程为:实际眼压=-33.323+1.914×PTV+0.133×CCT(R=0.88,P=0.00);与RTV回归方程为:实际眼压=160.395+1.866× RTV+0.201×CCT+34.554×LT-2.649×CC+0.063×ST(R=0.95,P=0.00).结论 兔眼的生理参数与人眼有诸多差异,临床上常用的3种便携式眼压计测得的兔眼压值与实际眼压差异较大,需要结合兔眼球生理参数进行回归校正,以降低误差.

abstractsBackground Rabbits are commonly used as animal models for the evaluation of drugs and surgery to lower intraocular pressure (IOP).The accuracy of IOP measurement is therefore critical in the analysis of data and subsequent extrapolation to humans.An accurate method to measure rabbit IOP is intracameral manometry,but it is an invasive way.Schi(o)tz,Perkins and Rebound were often used in clinic.However,their accuracy in measuring rabbit IOP in experimental study is unclear.Objective The purpose of this study was to investigate the accuracy of IOP measured by Schi(o)tz tonometer,Perkins tonometer and Rebound tonometer relative to intracameral manometry in New Zealand white rabbits.Methods The central corneal thickness (CCT),corneal curvature (CC),axial length (AL),anterior chamber depth (ACD),lens thickness (LT) and scleral thickness (ST) were respectively measured in 8 eyes of 8 healthy New Zealand white rabbits with lenstar900 and ultrasound biomicroscopy (UBM).The actual IOP was measured with a 24G needle inserted the anterior chamber and connected to a pressure transducer under the general anesthesia,the IOP gradient was set with a 24G needle inserting the vitreous cavity and connecting to a container with balanced salt solution(BSS).Then,comparative measurements at the same pressures were performed with three types of tonometers.The IOP values from Schi(o)tz tonometer,Perkins tonometer and Rebound tonometer were calibrated based on actual IOP from intracameral manometry and eyeball physiological parameters by multiple regression equation.Results The mean of CCT,CC,AL,ACD,LT and ST was (338.96 ±21.52) μm,(51.68±1.66) D,(14.63±0.19) mm,(2.22±0.04) mm,(6.15±0.10) mm and (339.80±47.41) μm.Compared with the intracameral manometry value (IMV),the error range was (17.08± 11.22) mmHg in the Schi(o)tz tonometer value (STV),(25.81±12.43) mmHg in the Perkins tonometer value (PTV) and (22.50±11.47) mmHg in the Rebound tonometer value (RTV),with significant differences between them (t =10.54,14.39,13.59,all at P＜ 0.05).Compared with IMV,the 95％ limits of agreement of three portable tonometer values is larger,and three portable tonometer values had the greater measurement error with elevated IOP gradient.The regression equations was IOP =141.015 + 1.570 × STV + 0.122 × CCT-3.480 × CC between actual IOP and STV (R =0.92,P =0.00),IOP =-33.323+1.914×PTV+0.133×CCT between actual IOP and PTV(R =0.88,P=0.00),IOP=160.395+1.866×RTV+ 0.201×CCT+34.554×LT-2.649×CC+0.063×ST between actual IOP and RTV (R=0.95,P=0.00).Conclusions The physiological parameters of rabbit eyeball are obviously different from human.The STV,PTV and RTV have a great measuring error in comparson with actual IOP,and therefore it is necessary to correct STV,PTV and RTV based on the ocular physiology parameters in experimental study.