접촉식과 광학적 방식에 의한 전방깊이 측정값의 비교

• Published in: Daihan angwa haghoi jabji Vol. 54; no. 8; pp. 1219 - 1226
• Main Authors: 박율리, Yu Li Park, 황형빈, Hyung Bin Hwang, 정성근, Sung Kun Chung
• Format: Journal Article
• Language: Korean
• Published: 대한안과학회 15.08.2013
• Subjects: A-scan; Anterior chamber depth; IOL Master; Orbscan II; Pentacam; 안과학; Orbscan II; Pentacam; Anterior chamber depth; A-scan; IOL Master
• ISSN: 0378-6471; 2092-9374

목적: 접촉식인 A-scan (Pacscan 300A, Sonomed Inc., Chicago, IL, USA)과 광학적 방식인 IOL masterⓡ (Carl Zeiss Meditec, Germany), Pentacamⓡ (Oculus, Wetzlar, Germany), 그리고 Orbscan IIⓡ (Orbtek Inc., USA)를 이용하여 전방깊이를 측정한 후 각 검사방법의 재현성 및 일치 정도를 비교하고자 하였다. 대상과 방법: 백내장수술 예정인 환자 94명(188안)에 대해 접촉식 방식인 A scan과 광학적 방식인 IOL masterⓡ, Pentacamⓡ, Orbscan IIⓡ를 이용하여 전방깊이를 측정한 후 비교하였다. 네 기기의 신뢰성을 알아보기 위하여 변동계수, 표준편차, 그룹 내 변동계수를 계산하였고 기기간 전체 평균 차이를 반복측정 분산분석과 Bland-Altman plot를 이용하여 비교하였다. 결과: A-scan, IOL masterⓡ, Pentacamⓡ, Orbscan IIⓡ로 측정한 평균 전방깊이는 각각 2.89 ± 0.49 mm, 3.25 ± 0.45 mm, 3.21 ± 0.46 mm, 3.19 ± 0.47 mm로 측정방식에 따라 유의한 차이가 있었다(p＜0.01). 네 가지 측정 방식의 변이계수는 각각 2.50%, 0.87%, 1.25%, 1.04%로 A scan에 비해 IOL masterⓡ, Pentacamⓡ, Orbscan IIⓡ이 더 재현성이 높았다. 상관계수는 IOL masterⓡ와 A scan은 0.65, IOL masterⓡ와 Pentacamⓡ은 0.91, IOL masterⓡ와 Orbscan IIⓡ은 0.90, A scan과 Pentacamⓡ은 0.69, A scan과 Orbscan IIⓡ는 0.71, Pentacamⓡ과 Orbscan IIⓡ는 0.93이었다. 결론: 전방깊이의 측정방법에서 접촉식 방식인 A-scan보다 광학적 방식인 IOL masterⓡ, Pentacamⓡ, Orbscan IIⓡ을 사용했을 경우 전방깊이가 유의하게 깊게 측정되었다(p＜0.01). 광학적 측정방식들끼리는 상관계수가 높았고, 재현성 또한 높았으며 그 중에서 IOL masterⓡ가 가장 낮은 변이계수를 보였다. <대한안과학회지 2013;54(8):1219-1226> Purpose: To assess the reproducibility and reliability of applanation A-scan ultrasonography (Pacscan 300A, Sonomed Inc., Chicago, IL, USA) and optical measurements with IOL Master® (Carl Zeiss Meditec, Germany), Pentacam® (Oculus, Wetzlar, Germany), and Orbscan II® (Orbtek Inc., Laredo, TX, USA) when measuring anterior chamber depth (ACD). Methods: In this study of 188 eyes of 94 patients, ACD estimation prior to cataract surgery was preformed by the applanation A-scan method and IOL Master®, Pentacam®, and Orbscan II® optical methods. Repeatability from each device was evaluated by coefficient of variation, standard deviation, and intraclass correlation coefficient. RM-ANOVA on Ranks was used to compare the differences in ACD among the devices. The Bland-Altman plot was performed to assess agreement in measurements between the devices. Results: The mean ACD according to the applanation A-scan method and IOL Master®, Pentacam®, and Orbscan II® optical methods were 2.89 ± 0.49 mm, 3.25 ± 0.45 mm, 3.21 ± 0.46 mm, and 3.19 ± 0.47 mm, respectively, and the differences were statistically significant (p < 0.01). The coefficient of variation for the 4 methods was 2.50% in the A-scan, 0.87% in the IOL Master®, 1.25% in the Pentacam®, and 1.04% with Orbscan II®, and reproducibility was higher with the optical principle devices. The correlation coefficient between A-scan and IOL Master® was 0.65, between IOL Master® and Pentacam® 0.91, between IOL Master® and Orbscan II® 0.90, between A-scan and Pentacam® 0.69, between A-scan and Orbscan II® 0.71, and between Pentacam® and Orbscan II® 0.93. Conclusions: Applanation A-scan provided lower measurements for ACD compared with IOL Master®, Pentacam® and Orbscan II®. There was good agreement between results obtained with the latter 3 methods, and reproducibility was high with optical measurements. The coefficient of variation was low for IOL Master®. J Korean Ophthalmol Soc 2013;54(8):1219-1226