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用于圆锥角膜的费拉拉角膜内环片

Ferrara intracorneal ring segments for keratoconus.

作者信息

Kwitko Sérgio, Severo Nórton Souto

机构信息

Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Avenida Nilo Peçanha, 7241-401 Porto Alegre-RS, Brazil.

出版信息

J Cataract Refract Surg. 2004 Apr;30(4):812-20. doi: 10.1016/j.jcrs.2003.12.005.

Abstract

PURPOSE

To assess the outcome of Ferrara intracorneal ring segments for keratoconus.

SETTING

Private practice and university hospital, Porto Alegre, Brazil.

METHODS

In this retrospective noncomparative interventional case series, 51 keratoconus eyes of 47 patients that had Ferrara intracorneal ring segment implantation were reviewed. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), central corneal curvature, corneal astigmatism, surface regularity index, surface asymmetry index, and complications were analyzed.

RESULTS

At a mean follow-up of 13.0 months +/- 8.7 (SD), the BSCVA improved in 86.4% of eyes, was unchanged in 1.9%, and worsened in 11.7%. The UCVA improved in 86.4% of eyes, was unchanged in 7.8%, and worsened in 5.8%. The mean spherical equivalent (SE) was reduced from -6.08 +/- 5.01 diopters (D) to -4.55 +/- 5.71 D and the mean refractive astigmatism, from -3.82 +/- 2.13 D to -2.16 +/- 2.07 D. The mean central corneal curvature was reduced from 48.76 +/- 3.97 D to 43.17 +/- 4.79 D. Eyes with central keratoconus had statistically significantly better results than eyes with inferior keratoconus in topographic astigmatism, SE, and refraction cylinder. Penetrating keratoplasty was avoided in 38 eyes (74.5%) during the follow-up. Intracorneal ring segment decentration occurred in 2 eyes (3.9%), segment extrusion in 10 eyes (19.6%), bacterial keratitis in 1 eye (1.9%) with segment extrusion, and a disciform keratitis in 1 eye (1.9%).

CONCLUSION

Implantation of Ferrara intracorneal ring segments in patients with keratoconus was a safe and reversible procedure that led to stable results and avoided or delayed PKP in many cases.

摘要

目的

评估费拉拉角膜内环植入术治疗圆锥角膜的效果。

地点

巴西阿雷格里港的私人诊所和大学医院。

方法

在这个回顾性非对照干预性病例系列中,对47例患者的51只接受费拉拉角膜内环植入术的圆锥角膜眼进行了评估。分析了未矫正视力(UCVA)、最佳矫正视力(BSCVA)、中央角膜曲率、角膜散光、表面规则性指数、表面不对称指数及并发症。

结果

平均随访13.0个月±8.7(标准差),86.4%的患眼BSCVA提高,1.9%无变化,11.7%下降。86.4%的患眼UCVA提高,7.8%无变化,5.8%下降。平均等效球镜度(SE)从-6.08±5.01屈光度(D)降至-4.55±5.71D,平均屈光性散光从-3.82±2.13D降至-2.16±2.07D。平均中央角膜曲率从48.76±3.97D降至43.17±4.79D。在地形图散光、SE和屈光柱镜方面,中央圆锥角膜患眼的结果在统计学上显著优于下方圆锥角膜患眼。随访期间,38只眼(74.5%)避免了穿透性角膜移植术。2只眼(3.9%)发生角膜内环偏心,10只眼(19.6%)发生节段性挤出,1只发生节段性挤出的眼(1.9%)发生细菌性角膜炎,1只眼(1.9%)发生盘状角膜炎。

结论

圆锥角膜患者植入费拉拉角膜内环是一种安全且可逆的手术,能取得稳定的效果,在许多情况下可避免或推迟穿透性角膜移植术。

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