目的：分析Pentacam眼前节分析仪检查参数对早期圆锥角膜的诊断价值。

方法：回顾性对照研究，选取2019-01/2020-01于我院就诊的圆锥角膜患者100例124眼作为研究组，根据Amsler-Krumeich分级法将圆锥角膜患者按照严重程度分为轻度组(51眼)、中度组(43眼)和重度组(30眼)，另外选取30名屈光度<-3.00D且无散光体检正常者右眼作为对照组，比较各组Pentacam眼前节分析仪参数\〖3mm直径范围水平中央曲率(K1)、3mm直径范围垂直中央曲率(K2)、角膜前表面最大屈光力(Kmax)、角膜散光(Cyl)、角膜最薄处的厚度(thinnest local)、角膜表面变异指数(ISV)、垂直不对称指数(IVA)、圆锥角膜指数(KI)、前房容积(ACV)以及前房深度(ACD)\〗情况，通过ROC曲线分析诊断早期圆锥角膜的敏感指标。

结果：研究组患者K1、K2、Kmax、Cyl、ISV、IVA、KI、ACD均明显高于对照组(P<0.05)，thinnest local、ACV均明显低于对照组(P<0.05)； 不同严重程度圆锥角膜患者的K1、K2、Kmax、Cyl、thinnest local、ISV、IVA、KI、ACV、ACD差异均有统计学意义(P<0.05)，中度组和重度组K1、K2、Kmax、Cyl、ISV、IVA、KI、ACD均明显高于轻度组(P<0.05)，thinnest local、ACV均明显低于轻度组(P<0.05)，中度组和重度组K1、K2、Kmax、Cyl、thinnest local、ISV、IVA、KI、ACV、ACD比较有差异P<0.05)； ROC诊断曲线结果显示，Kmax、thinnest local、ISV、IVA、KI是诊断圆锥角膜的敏感指标(AUC>0.85)，其中ISV的诊断价值最高。

结论：Pentacam眼前节分析仪可有效测量圆锥角膜参数，不同严重程度圆锥角膜患者参数存在差异，其中Kmax、thinnest local、ISV、IVA、KI是诊断早期圆锥角膜的敏感指标，Pentacam眼前节分析仪检查参数对早期圆锥角膜具有较高的诊断价值。

METHODS: Retrospective control study. Totally 100 patients(124 eyes)with keratoconus who were treated in the hospital between January 2019 and January 2020 were selected as study group. According to the severity of Amsler-Krumeich classification, patients with keratoconus were divided into mild group(51 eyes), moderate group(43 eyes)and severe group(30 eyes), and another 30 normal people with past history of myopia and astigmatism(30 eyes)were selected as control group. The Pentacam anterior segment analyzer parameters \〖horizontal central curvature of 3mm diameter range(K1), vertical central curvature of 3mm diameter range(K2), maximum refractive power of corneal anterior surface(Kmax), corneal astigmatism(Cyl), corneal thickness at the thinnest(thinnest local), ROC curve was used to analyze the sensitive indicators in the diagnosis of early keratoconus.

RESULTS:The K1, K2, Kmax, Cyl, ISV, IVA, KI and ACD in study group were significantly higher than those in control group(P<0.05)while the thinnest local and ACV were significantly lower than those in control group(P<0.05). There were statistically significant differences in the K1, K2, Kmax, Cyl, thinnest local, ISV, IVA, KI, ACV and ACD among patients with different degrees of keratoconus(P<0.05), and the K1, K2, Kmax, Cyl, ISV, IVA, KI and ACD in moderate group and severe group were significantly higher than those in mild group(P<0.05)while the thinnest local and ACV were significantly lower than those in mild group(P<0.05), and there were significant differences in the parameters between moderate group and severe group(P<0.05). ROC diagnostic curve results showed that Kmax, thinnest local, ISV, IVA and KI were sensitive indicators for diagnosing keratoconus(AUC>0.85), of which ISV had the highest diagnostic value.

CONCLUSION: Pentacam anterior segment analyzer can effectively measure the keratoconus parameters. There are differences in the parameters among patients with different degrees of keratoconus. Kmax, thinnest local, ISV, IVA and KI are sensitive indicators for diagnosing early keratoconus, and Pentacam anterior segment analyzer examination parameters have a higher diagnostic value on early keratoconus.