【摘要】 目的：讨论ICARE回弹式眼压计的临床性能。方法：对78例156眼同时用ICARE回弹式眼压计和NCT眼压计进行眼压测量，对比分析两种眼压计的测量结果及两者的相关情况;观察ICARE眼压计对特殊病例测量的结果。结果：ICARE眼压计和NCT眼压计测得的眼压均值分别为16.55±8.54mmHg和16.81±7.35mmHg,两者无显著差别。两种眼压计测量值显著相关,相关系数为0.964。ICARE眼压计可较好地完成角膜病变和无固视能力等病例的眼压测量。结论：ICARE眼压计可以在临床上运用，尤其适用于其它眼压计测量困难的病例。
【关键词】 眼压；眼压测量；ICARE回弹式眼压计
Comparison between intraocular pressure measured with ICARE rebound tonometer and NCT tonometer
HeZheng Zhou,WenShan Jiang,ShaoYang Zhang,Ying Yan,YunHui Chen,Wei Du
Department of Ophthalmology, Wuhan General Hospital, Guangzhou Military Command of Chinese PLA, Wuhan 430070, Hubei Province, China
Abstract
AIM: To discuss the clinical performance of ICARE rebound tonometer .
METHODS: IOP measurements were performed on 78 cases (156 eyes) with ICARE rebound tonometer and NCT tonometer respectively. Comparative analysis of two types of tonometer measurement results and the two relevant circumstances; Observing the results of ICARE tonometer measurements in special cases.
RESULTS: The mean IOP of ICARE rebound tonometer and NCT tonometer were 16.55±8.54mmHg and 16.81±7.35mmHg respectively. There was no significant difference between the IOP of the two tonometer. The IOP of ICARE rebound tonometer had a significant correlation with that of NCT tonometer, and the correlation coefficient was 0.964. ICARE rebound tonometer could be useful in measuring the IOP in those special patients with the corneal disease and the patients who failed to stare.
CONCLUSION: ICARE rebound tonometer could be useful in clinical application and especially useful in the IOP measuring in those patients whose IOP could not be measured with other tonometer.
KEYWORDS: intraocular pressure;intraocular pressure measurement;ICARE rebound tonometor
0引言
眼压是青光眼患者功能损害的主要危险因素，也是目前唯一可有效控制的因素[1]。青光眼防盲的关键是早期诊断、早期治疗，眼压测量是青光眼早期诊断和治疗监控的重要手段[2]。目前临床运用的眼压计有十余种，如修氏眼压计、NCT眼压计、哥德曼眼压计、动态轮廓眼压计（DCT）、Proview眼压计、Tonopen眼压笔等;各有优缺点。最新问世的ICARE回弹式眼压计具有测量方便、运用范围广泛等优点[3]，在国外很多医疗单位已投入临床使用。为探讨其临床性能，我们对ICARE眼压计和NCT眼压计的测量结果进行了对比研究，现报告如下。
1对象和方法
1.1对象 选取200808/09在我院就诊的患者共78例156眼。这些患者中有可疑青光眼、青光眼、屈光不正及部分健康体检者。其中男 29例，女 49例；年龄4～74（平均32.5）岁；测得的最高眼压 65mmHg，最低眼压 6mmHg。选用芬兰TIOLATOY公司产TAOLI ICARE眼压计和日本尼德克公司产NT2000型NCT眼压计。两种眼压计测量的顺序自由随机，但两者测量间隔时间<30min；两种眼压计均先测右眼后测左眼。
1.2方法 两种眼压计均测量坐位眼压。两种眼压计都不用表面麻醉药，嘱患者取正确坐位、正前方注视、全身放松后开始测量[4]。ICARE眼压计测量时每次都要更换无菌探针，调节支撑杆长度至测压头距角膜顶点4～8mm，读数复零后开始连续按压测量键，如果连续获得6次成功测量，眼压计就会自动鸣笛，测量结束。眼压计自动分析，舍去最高值和最低值后计算，显示其中4次测量的平均值作为本次测量结果，人工记录测量值。NCT测量按常规方法进行，取连续3次差值<2mmHg的测量值，计算平均值作为本次测量结果，自动显示并打印。特殊病例测量：角膜外伤和角膜病病变各5例5眼，小儿和老年性痴呆各4例8眼，内眼手术中3例3眼，术后次日28例28眼，均由经验丰富的青光眼专家指测预估患眼眼压，再用ICARE眼压计进行测量。
统计学分析：首先剔除两种眼压计测量值相差5mmHg以上的病例（测量80例，剔除2例）。纳入统计病例的测量结果用SPSS 13.0软件包进行配对t检验和线性回归分析。
2结果
2.1 ICARE眼压计与NCT眼压计的测量值 ICARE眼压计与NCT眼压计对78例156眼同时测量的眼压均值分别为16.55±8.54mmHg和16.81±7.35mmHg，两者的差值均数为0.26±2.44mmHg，t=1.342,P=0.181，两者测量值无显著差异；线性回归分析显示两种眼压计眼压测量值的相关系数为0.964，决定系数为0.929，P<0.001,两者有极显著的相关关系。
2.2 ICARE眼压计对特殊病例的测量结果 49例57眼中，37例53眼完成了ICARE眼压计的测量；53眼中，与青光眼专家指测结果相差10mmHg者1眼，5mmHg者5眼，其余47眼两者差值<5mmHg。
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