该文报道一例30岁的男性患者因“双眼自幼视力不佳，强光下视物模糊加重4年余”就诊，经过眼部检查评估，诊断为双眼瞳孔残膜、双眼屈光不正。患者接受一期双眼瞳孔残膜切除、二期双眼行有晶状体眼后房型环曲面人工晶状体(toric implantable collamer lens,TICL)植入手术，术后视力恢复良好。文章回顾了该例患者的诊治过程，为临床屈光不正同时伴有瞳孔残膜患者的诊治提供参考。
A 30-year-old male patient presented at our institution with a history of poor vision in both eyes since childhood, exacerbated by blurriness under bright light for over four years. Following a comprehensive ophthalmic examination, the patient was diagnosed with bilateral pupillary membrane remnants and refractive errors. The patient underwent a two-stage surgical intervention, starting with the removal of the pupillary membrane remnants, followed by the implantation of toric implantable collamer lenses (TICL) in the posterior chamber of the lensless eyes. Postoperative outcomes were favorable, with significant improvement in visual acuity. This article reviews the therapeutic journey of the patient, offering insights into the diagnosis and management of individuals with concurrent refractive anomalies and pupillary membrane remnants, thereby contributing to the clinical discourse on the subject.
目的：比较四种不同原理的仪器在暗室中对年龄相关性白内障患者Kappa角测量的一致性。方法：对年龄相关性白内障术前60例(60只眼)，暗室中适应10 min后，分别应用iTrace视觉分析仪、Pentacam HR、Lenstar900、IOLMaster700测量瞳孔直径和Kappa角。四种仪器间所测量的数据比较采用单因素方差分析检验和Kruskal-Wallis非参数检验，一致性比较采用Bland-Altman分析。结果：iTrace、Pentacam HR、Lenstar900、IOLMaster700测量瞳孔直径分别为(4.64±0.71) mm，(2.96±0.47) mm，(4.86±0.76) mm，(4.66±0.92) mm；Kappa角大小分别为(0.227±0.121) mm，(0.161±0.09) mm，(0.2±0.124) mm，(0.203±0.104) mm；大于0.5 mm的Kappa角比例分比为3.33%、3.33%、1.67%、1.67%；Pentacam和iTrace的Kappa角测量结果有统计学意义(P=0.001)，Pentacam和Lenstar900、IOLMaster700的Kappa角测量结果差异无统计学意义(P=0.044，0.036)，其他三种仪器之间Kappa角测量结果差异均无统计学意义(P=0.181，0.245，0.860)； 60例被检测者对iTrace、PentacamHR、Lenstar900、IOLMaster700四种仪器测量过程中光强度主观评分结果显示60例(100%)被检测者认为Pentacam HR在测量过程中有明显的不适感，40例(66.67%)被检测者认为IOLMaster700检测过程中舒适感最好，结果差异有统计学意义(χ2=191.236，P<0.001)。结论：Pentacam HR与iTrace、Lenstar900和IOLMaster700三种仪器在暗室中Kappa角的测量结果一致性稍差，临床上需谨慎替换使用。
Objective: To compare the consistency of Kappa Angle measurements in patients with age-related cataracts using four instruments of different principles in a dark room. Methods: Sixty cases (60 eyes) of age-related cataract were adapted in the darkroom for 10 minutes. The pupil size and angle Kappa were measured by iTrace, Pentacam HR, Lenstar900 and IOLMaster700. One-way ANOVA test and Kruskal-Wallis nonparametric test were used to compare the measured data among the four instruments, and Bland-Altman analysis was used for consistency comparison. Results: The measured pupil diameters of iTrace, Pentacam HR, Lenstar900 and IOLmaster700 were 4.64±0.71 mm, 2.96±0.47 mm, 4.86±0.76 mm and 4.66±0.92 mm. The Angle Kappa sizes were 0.227±0.121 mm, 0.161± 0.09 mm, 0.2±0.124 mm, 0.203±0.104 mm. The proportion of angle Kappa larger than 0.5 mm was 3.33%, 3.33%, 1.67% and 1.67%. The measurement results of angle Kappa between Pentacam and iTrace were statistically significant (P=0.001). There was no significant difference in the measurement results of angle Kappa between Pentacam and Lenstar900, Pentacam HR and IOL-Master700 (P=0.044, 0.036). There was no significant difference in the results of angle Kappa measurement among the other three instruments. The subjective score of light intensity in the process of measurement of iTrace, Pentacam HR, Lenstar900 and IOLMaster700 showed that during the process of measurement, 60 cases (100%) experienced obvious discomfort caused by the light intensity in Pentacam HR, while 40 cases (66.67%) felt comfort in IOLMaster700. The differences among the subjective score of light intensity of four instruments were statistically significant (P<0.001). Conclusion: The consistency of the measurement results of Kappa angle between Pentacam HR and iTrace, Lenstar900, IOLMaster700 in the darkroom is relatively poor, so it is necessary to be careful to replace them in clinic.
目的：比较四种不同原理的仪器在暗室中对年龄相关性白内障患者Kappa角测量的一致性。方法：对年龄相关性白内障术前60例(60只眼)，暗室中适应10 min后，分别应用iTrace视觉分析仪、Pentacam HR、Lenstar900、IOLMaster700测量瞳孔直径和Kappa角。四种仪器间所测量的数据比较采用单因素方差分析检验和Kruskal-Wallis非参数检验，一致性比较采用Bland-Altman分析。结果：iTrace、Pentacam HR、Lenstar900、IOLMaster700测量瞳孔直径分别为(4.64±0.71) mm，(2.96±0.47) mm，(4.86±0.76) mm，(4.66±0.92) mm；Kappa角大小分别为(0.227±0.121) mm，(0.161±0.09) mm，(0.2±0.124) mm，(0.203±0.104) mm；大于0.5 mm的Kappa角比例分比为3.33%、3.33%、1.67%、1.67%；Pentacam和iTrace的Kappa角测量结果有统计学意义(P=0.001)，Pentacam和Lenstar900、IOLMaster700的Kappa角测量结果差异无统计学意义(P=0.044，0.036)，其他三种仪器之间Kappa角测量结果差异均无统计学意义(P=0.181，0.245，0.860)； 60例被检测者对iTrace、Pentacam HR、Lenstar900、IOLMaster700四种仪器测量过程中光强度主观评分结果显示60例(100%)被检测者认为Pentacam HR在测量过程中有明显的不适感，40例(66.67%)被检测者认为IOLMaster700检测过程中舒适感最好，结果差异有统计学意义(χ2=191.236，P<0.001)。结论：Pentacam HR与iTrace、Lenstar900和IOLMaster700三种仪器在暗室中Kappa角的测量结果一致性稍差，临床上需谨慎替换使用。
Objective: To compare the consistency of Kappa Angle measurements in patients with age-related cataracts using four instruments of different principles in a dark room. Methods: Sixty cases (60 eyes) of age-related cataract were adapted in the darkroom for 10 minutes. The pupil size and angle Kappa were measured by iTrace, Pentacam HR, Lenstar900 and IOLMaster700. One-way ANOVA test and Kruskal-Wallis nonparametric test were used to compare the measured data among the four instruments, and Bland-Altman analysis was used for consistency comparison. Results: The measured pupil diameters of iTrace, Pentacam HR, Lenstar900 and IOLmaster700 were 4.64±0.71 mm, 2.96±0.47 mm, 4.86±0.76 mm and 4.66±0.92 mm. The Angle Kappa sizes were 0.227±0.121 mm, 0.161± 0.09 mm, 0.2±0.124 mm, 0.203±0.104 mm. The proportion of angle Kappa larger than 0.5 mm was 3.33%, 3.33%, 1.67% and 1.67%. The measurement results of angle Kappa between Pentacam and iTrace were statistically significant (P=0.001). There was no significant difference in the measurement results of angle Kappa between Pentacam and Lenstar900, Pentacam HR and IOL-Master700 (P=0.044, 0.036). There was no significant difference in the results of angle Kappa measurement among the other three instruments. The subjective score of light intensity in the process of measurement of iTrace, Pentacam HR, Lenstar900 and IOLMaster700 showed that during the process of measurement, 60 cases (100%) experienced obvious discomfort caused by the light intensity in Pentacam HR, while 40 cases (66.67%) felt comfort in IOLMaster700. The differences among the subjective score of light intensity of four instruments were statistically significant (P<0.001). Conclusion: The consistency of the measurement results of Kappa angle between Pentacam HR and iTrace, Lenstar900, IOLMaster700 in the darkroom is relatively poor, so it is necessary to be careful to replace them in clinic.
