摘要目的 评估角膜后弹力层剥除自动角膜刀取材内皮移植术(DSAEK)后ICare眼压计(RBT)及Goldmann眼压计(GAT)测量值的一致性及角膜厚度对眼压测量的影响.方法 分别对34例(37只眼)DSAEK术后患者使用GAT、RBT测量角膜中央部眼压及分别距鼻、颞侧角巩膜缘1 mm处的眼压,并使用前节相干光断层成像(OCT)测量中央角膜及周边角膜的厚度.使用配对t检验比较各组眼压均值；通过Pearson分析评估各种眼压测量方法间的相关性及角膜厚度对眼压测量值的影响；使用Bland-Ahman法分析不同眼压测量方法的一致性.结果 GAT眼压值为(16.2±4.7)mm Hg(1 mm Hg=0.133 kPa),RBT在角膜中央、鼻侧及颞侧的测量值依次为(16.0±5.3)、(17.4±5.0)和(17.1 ±5.0)mm Hg.角膜中央GAT与RBT测量值差异无统计学意义(t=0.77,P=0.446),RBT在鼻侧及颞侧测量值均高于中央部测量值(=3.24,3.17;P =0.003).RBT周边与中央的测量值间均分别呈正相关(r =0.869,0.911；P＜0.05).中央部GAT及RBT测量值均分别与中央角膜厚度(r =0.335,0.396)及植片厚度(r=0.330,0.356)呈正相关(P＜0.05)；周边部RBT测量值与周边角膜厚度呈正相关(r =0.339,0.351；P ＜0.05).Bland-Altman法分析结果显示各种测量方法有较好一致性.结论 DSAEK术后RBT与GAT测量值均受到角膜厚度影响,呈正相关.在DSAEK术后,RBT与GAT两种眼压计的测量值之间、RBT周边眼压测量值与中央的测量值之间,都有着显著的相关性和较好的一致性.

abstractsObjective To evaluate the influence of corneal thickness (CT) on the intraocular pressure (IOP) measurements,the agreement of IOP readings with ICare rebound tonometer (RBT) and Goldmann applanation tonometer(GAT),and the agreement of central and peripheral IOP values obtained by RBT.Methods Thirty-seven eyes of 34 patients after Descemet's stripping with automated endothelium keratoplasty (DSAEK) underwent CT measurement using anterior segment OCT(AS-OCT) followed by IOP evaluation with the GAT at corneal center and with the RBT at corneal center and at 1 mm from the limbus in the nasal and temporal directions.The mean IOP measurement by the RBT and measurement by the GAT were analysed by paired t test.Pearson correlation analysis were performed to assess the correlations between the measurement and the influence of CT on IOP values.Agreement between the tonometers was calculated using the Bland-Ahman method.Results IOP obtained by GAT was (16.2 ± 4.7) mm Hg (1 mm Hg =0.133 kPa),and IOP obtained from central cornea,nasal cornea and temporal cornea by RBT were (16.0 ± 5.3)mm Hg,(17.4 ± 5.0) mm Hg and (17.1 ± 5.0)mm Hg,respectively.There was no statistical difference between the IOP on central cornea obtained by GAT and RBT(t =0.77,P =0.446),IOP on the peripheral cornea were higher than on central cornea by RBT(t =3.24,3.17,P =0.003),and they were positively correlated(r =0.869,0.911,P ＜ 0.05).The IOP readings showed positive relationship to CT values.Bland-Altman scatter plots showed reasonable inter-method agreement between each technique of IOP measurements.Conclusions After DSAEK,the IOP readings obtained by RBT or GAT show positive relationship to CT values.There are reasonable agreements between each technique of IOP measurements.Considering the special advantages,RBT is an effective method to observe the IOP changes after DSAEK.