摘要目的 对比观察硅油填充眼眼轴长度(AL)浸润式B型超声引导下分段声速测量与光学激光生物测量仪(Lenstar LS900)测量结果,探讨浸润式B型超声引导下分段声速测量对于硅油填充眼AL测量的准确性.方法 前瞻性研究.拟行硅油取出、白内障摘除及人工晶状体植入手术的35例患者38只眼纳入研究.所有患眼均合并不同程度的白内障.手术前采用MD-2300S型眼科A型和(或)B型超声行浸润式B型超声引导下分段声速测量法测量患眼AL.AL为角膜厚度、前房深度、晶状体厚度、硅油泡的表观长度、硅油泡下水层厚度的总和.同时采用LenstarLS900测量患眼AL.所有患眼均顺利完成硅油取出、白内障摘除及人工晶状体植入手术,随诊至手术后3个月均未见并发症发生.手术后3个月,重复应用Lenstar LS900测量患眼AL.对比观察两种测量方法测得AL数据的差异及一致性.结果 38只眼中,手术前经Lenstar LS900测得AL31只眼;因晶状体混浊、AL超过LenstarLS900测量范围未能测得AL7只眼.31只眼的平均AL为(24.12±1.70)nm.手术后3个月经Lenstar LS900测得AL36只眼;AL超过Lenstar LS900测量范围未能测得AL 2只眼.36只眼的平均AL为(24.45±1.89)mm.患眼手术前后AL差值为(0.02±0.07)mm,差异无统计学意义(t=1.752,P＞0.05).手术前所有患眼均经浸润式B型超声引导下分段声速测量法测得AL.患眼平均AL为(24.87±2.52)mm.与手术前Lenstar LS900测得AL比较,两者差值为(-0.00±0.09)mm,差异无统计学意义(t=-0.205,P＞0.05);与手术后3个月Lenstar LS900测得AL比较,两者差值为(-0.02±0.11)mm,差异无统计学意义(t=-1.280,P＞0.05).两种测量方法测量硅油填充眼的AL具有良好的一致性((d)=-0.003,95％可信区间为-0.19～0.18,P＜0.05).结论 浸润式B型超声引导下分段声速测量与Lenstar LS900测量对硅油填充眼AL测量结果一致性良好;浸润式B型超声引导下分段声速测量可对硅油填充眼AL进行准确测量.

abstractsObjective To evaluate the accuracy of the biometry using immersion B scan and partial coherence interferometry (Lenstar LS900) for the axial length (AL) of silicone oil-filled eyes respectively.Methods Thirty-five silicone oil-filled eyes (38 patients) were included in the study.All of these eyes underwent silicone oil removal,cataract extraction and intraocular lenses implantation.The AL of all the silicone oil-filled eyes was measured with A/B-scan ultrasound and Lenstar LS900 before operation and with Lenstar LS900 after operation.The measured distance was compared respectively.The method of immersion B-scan guided with respective sonic velocity.AL was the sum of corneal thickness,anterior chamber depth,lens thickness,the apparent length of oil bubble (velocity values 996 m/s),the depth of the water layer beneath the oil bubble.Results Thirty-one eyes were measured with Lenstar LS900 before silicone oil removal,and the mean AL was (24.12± 1.70) mm,7 eyes failed to get the results before the operation;36 eyes were measured with Lenstar LS900 after silicone oil removal,and the mean AL was (24.45±1.89) mm.All eyes were measured with B-scan before silicone oil removal,and the mean AL was (24.87±2.52) mm.The difference (31 eyes) of AL measurement before silicone oil removal by two methods was (-0.00±0.09) mm;the difference (31 eyes) between pre-and post-surgical AL measurement with Lenstar LS900 was (0.02±0.07) mm;the difference (36 eyes) between pre-surgical AL measured with B-scan and post-surgical AL measured with Lenstar LS900 was (-0.02±0.11) mm.All the differences were not statistically significant (t=-0.205,1.752,-1.280;P＞ 0.05).The consistency of the results measured by two methods was well in Bland-Ahamn analysis.Conclusions Measurement results of AL between immersion B-scan guided with respective sonic velocity and Lenstar LS900 are high repeatability on silicone oil-filled eyes.The AL of silicone oil-filled eyes can be measured reliably by immersion B-scan guided with respective sonic velocity.