Abstract：
OBJECTIVE: To evaluate the viability and precision of measuring the distance from the limbus to extraocular muscle insertion using anterior segment optical coherence tomography (AS-OCT) and panoramic ultrasound biomicroscopy (UBM) before and after strabismus surgery.
METHODS: We recruited primary strabismus patients and measured the limbus-insertion distance by AS-OCT and UBM preoperatively, 2 weeks, and 1, 3, and 6 months postoperatively. Values were also measured using callipers intraoperatively before and after the planned procedures. Preoperative AS-OCT and UBM values were compared to intraoperative calliper measurements as the gold standard. Postoperative AS-OCT and UBM values were compared to the new postoperative limbus-insertion distance. The limit of agreement deemed clinically acceptable was defined as 1 mm.
RESULTS: A total of 85 horizontal muscles of 40 patients, including 48 lateral rectus muscles and 37 medial rectus muscles, were analysed. Primary muscles could be successfully detected by AS-OCT (95%) and UBM (100%). At 2 weeks and 1, 3, and 6 months postoperatively, the new rectus muscle attachment site detection rate by AS-OCT was 6%, 32%, 80%, and 89%, respectively, and that by UBM was 24%, 60%, 85%, and 93%, respectively. The Bland-Altman plots revealed better consistency in pairs of AS-OCT, UBM, and calliper measurements of primary muscles than postoperative muscles. For primary muscles, 89% of AS-OCT measurements fell within the permissible range of surgical measurements (1 mm), but this dropped to 67% at 6 months postoperatively (P < 0.001). The accuracy of UBM measurements of primary muscles was 81%, and this decreased to 59% at 6 months postoperatively (P = 0.001).
CONCLUSIONS: AS-OCT and UBM performed well in terms of imaging primary horizontal rectus muscles, but showed decreased accuracy and reproducibility in postoperative muscle measures.
METHODS: We recruited primary strabismus patients and measured the limbus-insertion distance by AS-OCT and UBM preoperatively, 2 weeks, and 1, 3, and 6 months postoperatively. Values were also measured using callipers intraoperatively before and after the planned procedures. Preoperative AS-OCT and UBM values were compared to intraoperative calliper measurements as the gold standard. Postoperative AS-OCT and UBM values were compared to the new postoperative limbus-insertion distance. The limit of agreement deemed clinically acceptable was defined as 1 mm.
RESULTS: A total of 85 horizontal muscles of 40 patients, including 48 lateral rectus muscles and 37 medial rectus muscles, were analysed. Primary muscles could be successfully detected by AS-OCT (95%) and UBM (100%). At 2 weeks and 1, 3, and 6 months postoperatively, the new rectus muscle attachment site detection rate by AS-OCT was 6%, 32%, 80%, and 89%, respectively, and that by UBM was 24%, 60%, 85%, and 93%, respectively. The Bland-Altman plots revealed better consistency in pairs of AS-OCT, UBM, and calliper measurements of primary muscles than postoperative muscles. For primary muscles, 89% of AS-OCT measurements fell within the permissible range of surgical measurements (1 mm), but this dropped to 67% at 6 months postoperatively (P < 0.001). The accuracy of UBM measurements of primary muscles was 81%, and this decreased to 59% at 6 months postoperatively (P = 0.001).
CONCLUSIONS: AS-OCT and UBM performed well in terms of imaging primary horizontal rectus muscles, but showed decreased accuracy and reproducibility in postoperative muscle measures.
摘要：
目的：评估斜视手术前后使用眼前节光学相干断层扫描（AS-OCT）和全景超声生物显微镜（UBM）测量从角膜缘到眼外肌插入距离的可行性和准确性。
方法：我们招募了原发性斜视患者，并在术前通过AS-OCT和UBM测量了角膜缘插入距离，2周,术后1、3和6个月。在计划的程序之前和之后，还在手术中使用卡尺测量了值。将术前AS-OCT和UBM值与术中卡尺测量值作为金标准进行比较。术后AS-OCT和UBM值与新的术后角膜缘插入距离进行比较。认为临床上可接受的协议极限定义为1mm。
结果：40例患者共85条水平肌，包括48块外侧直肌和37块内侧直肌,进行了分析。通过AS-OCT（95％）和UBM（100％）可以成功检测到原发性肌肉。在术后2周和1、3和6个月，AS-OCT对新直肌附着部位的检出率为6%，32%,80%,89%，分别,UBM是24%，60%,85%,93%,分别。Bland-Altman图显示出AS-OCT对的一致性更好，UBM,与术后肌肉相比，主要肌肉的卡尺测量值。对于初级肌肉，89%的AS-OCT测量值在允许的手术测量范围内（1mm），但在术后6个月时下降到67%(P<0.001)。初级肌肉UBM测量的准确度为81%，术后6个月下降到59％（P=0.001）。
结论：AS-OCT和UBM在原发性水平直肌成像方面表现良好，但显示术后肌肉测量的准确性和可重复性下降。
方法：我们招募了原发性斜视患者，并在术前通过AS-OCT和UBM测量了角膜缘插入距离，2周,术后1、3和6个月。在计划的程序之前和之后，还在手术中使用卡尺测量了值。将术前AS-OCT和UBM值与术中卡尺测量值作为金标准进行比较。术后AS-OCT和UBM值与新的术后角膜缘插入距离进行比较。认为临床上可接受的协议极限定义为1mm。
结果：40例患者共85条水平肌，包括48块外侧直肌和37块内侧直肌,进行了分析。通过AS-OCT（95％）和UBM（100％）可以成功检测到原发性肌肉。在术后2周和1、3和6个月，AS-OCT对新直肌附着部位的检出率为6%，32%,80%,89%，分别,UBM是24%，60%,85%,93%,分别。Bland-Altman图显示出AS-OCT对的一致性更好，UBM,与术后肌肉相比，主要肌肉的卡尺测量值。对于初级肌肉，89%的AS-OCT测量值在允许的手术测量范围内（1mm），但在术后6个月时下降到67%(P<0.001)。初级肌肉UBM测量的准确度为81%，术后6个月下降到59％（P=0.001）。
结论：AS-OCT和UBM在原发性水平直肌成像方面表现良好，但显示术后肌肉测量的准确性和可重复性下降。
