目的：比较波前像差仪OPD-Scan Ⅲ、光学相干生物测量仪IOL Master、三维眼前节分析系统Pentacam及自动电脑验光仪KR-8900 四种不同仪器测量角膜曲率、角膜散光的差异性和一致性，指导白内障术前检查应用。

方法：前瞻性临床研究。选取2017-04/06在我院就诊的白内障患者45例86眼，分别应用OPD-Scan Ⅲ与Pentacam、IOL Master、KR-8900测量患者受检眼角膜曲率(K₁、K₂)和散光轴位，并计算出平均角膜曲率(mean keratometry，K_m)、散光矢量J₀和J₄₅，采用配对样本t检验对测量结果的差异进行比较，相关性分析采用线性相关分析，一致性评价采用Bland-Altman分析。

结果：在测量K₁值时，OPD-Scan Ⅲ与IOL Master测量值的差异有统计学意义(P<0.001)； 在测量K₂、K_m值时，OPD-Scan Ⅲ与IOL Master、Pentacam测量值的差异均有统计学意义(P<0.05)； OPD-Scan Ⅲ与另外3种仪器的其他测量值间相比较，差异无统计学意义(P>0.05)。经Pearson相关分析，其结果显示：OPD-Scan Ⅲ与KR-8900、IOL Master及Pentacam测量值间均有一定相关性(r=0.408～0.980，P<0.001)。Bland-Altman散点图中，OPD-Scan Ⅲ与Pentacam及IOL Master在测量角膜曲率时一致性较差，与KR-8900的一致性较好； OPD-Scan Ⅲ与KR-8900、IOL Master、Pentacam在测量角膜散光时一致性较差。

结论：OPD-Scan Ⅲ具有操作简单方便、非接触式等优点。测量角膜曲率时，OPD-Scan Ⅲ与KR-8900一致性较好，可以相互替换，与Pentacam及IOL Master一致性较差； 测量角膜散光时，OPD-Scan Ⅲ与KR-8900、IOL Master及Pentacam一致性较差，使用时需根据4种仪器的原理、适用范围及临床情况加以衡量。

METHODS: In this prospective clinical trial, 45 cataract patients(86 eyes), received treatment at the Department of Ophthalmology in our hospital from April 2017 to June 2017, underwent corneal parameters measurements with four instruments: OPD-Scan Ⅲ, Pentacam, IOL Master, and KR-8900. Measurements included corneal curvature(K₁, K₂, K_m)and astigmatism parameters. The results were assessed using the paired samples t tests, Pearson coefficient, and Bland-Altman plots.

RESULTS: The difference of K₁ value measured by OPD-Scan Ⅲ and IOL Master was significant(P<0.001). Significant differences were also found in K₂ and K_m values between OPD-Scan Ⅲ and Pentacam or IOL Master(P<0.05), while others had noncomparable results(P>0.05). All biometry measurements revealed good liner correlation(r=0.408-0.980, P<0.001). The Bland-Altman showed that the corneal curvature and astigmatism vectors examined by OPD-Scan Ⅲ and all other devices had non-comparable results, except for the comparison of K₁, K₂ and K_m measured by OPD-Scan Ⅲ and KR-8900.

CONCLUSION: OPD-Scan Ⅲ and KR-8900 can be interchangeable for the measurements of corneal curvature, while the others are not directly interchangeable. The astigmatic results obtained from OPD-Scan Ⅲ are not completely interchangeable with KR-8900, IOL Master or Pentacam.