使用回归模型研究穿透性角膜移植术后拆线后角膜屈光力和散光的自发性长期变化。

Spontaneous long-term changes of corneal power and astigmatism after suture removal after penetrating keratoplasty using a regression model.

作者信息

Langenbucher Achim, Naumann Gottfried O H, Seitz Berthold

机构信息

Augenklinik mit Poliklinik der Universität Erlangen-Nürnberg, Germany.

出版信息

Am J Ophthalmol. 2005 Jul;140(1):29-34. doi: 10.1016/j.ajo.2005.01.038.

DOI:10.1016/j.ajo.2005.01.038

PMID:16038649

Abstract

PURPOSE

To assess the diagnosis-based spontaneous long-term changes in corneal power and refraction with a regression model in the all-sutures-out time period following non-mechanical penetrating keratoplasty (PK).

DESIGN

Retrospective non-randomized clinical trial.

METHODS

setting: Clinical practice. study population: 147 eyes [47 Fuchs dystrophy (FD); 100 keratoconus (KC)] were studied after suture removal in this retrospective longitudinal study. main outcome measures: Zeiss keratometry [equivalent power (KEQ) and astigmatism (KAST)], corneal topography analysis [equivalent power (TEQ) and astigmatism (TAST)], and subjective refractometry [spherical equivalent (SEQ) and refractive cylinder (RAST)] were assessed in at least three up to 16 ophthalmologic examinations in the all-sutures-out time period. observation procedure: The time course of each target variable was analyzed in a longitudinal manner (time interval > or = 12 months) separately for each patient with a linear regression model.

RESULTS

Post-keratoplasty follow-up ranged from 31 months to 10.3 years. In the linear regression model, the annual change in FD/KC showed an increase/a decrease in KEQ (0.29 +/- 0.50/-0.63 +/- 0.46 diopters, P = .02) and an increase/a decrease in TEQ (0.37 +/- 0.54/-0.69 +/- 0.49 diopters, P = .04) corresponding to a decrease/an increase in SEQ (-0.31 +/- 0.47/0.63 +/- 0.43 diopters, P = .02). KAST/TAST/RAST showed a minimal annual decrease (-0.06 +/- 0.41/-0.05 +/- 0.45/-0.06 +/- 0.41 diopters) in FD but an increase in KC (0.46 +/- 0.41/0.51 +/- 0.43/0.46 +/- 0.38 diopters) (P = .05/0.06/0.12).

CONCLUSIONS

In the follow-up after post-keratoplasty suture removal, patients with FD/KC tend to develop a spontaneous myopic shift (steepening of the cornea)/hyperopic shift (flattening of the cornea). In contrast with those with FD, patients with KC should be counseled on the fact that astigmatism may increase again over time after suture removal.

摘要

目的

采用回归模型评估非机械穿透性角膜移植术（PK）后缝线全部拆除时间段内基于诊断的角膜屈光力和屈光度的自发性长期变化。

设计

回顾性非随机临床试验。

方法

设置：临床实践。研究人群：在这项回顾性纵向研究中，对147只眼[47例富克斯营养不良（FD）；100例圆锥角膜（KC）]在缝线拆除后进行了研究。主要观察指标：在缝线全部拆除时间段内，至少进行3次至16次眼科检查，评估蔡司角膜曲率计[等效屈光力（KEQ）和散光（KAST）]、角膜地形图分析[等效屈光力（TEQ）和散光（TAST）]以及主观验光[等效球镜度（SEQ）和屈光柱镜度（RAST）]。观察程序：采用线性回归模型，对每位患者的每个目标变量的时间进程进行纵向分析（时间间隔≥12个月）。

结果

角膜移植术后随访时间为31个月至10.3年。在线性回归模型中，FD/KC的年变化显示KEQ增加/减少（0.29±0.50/-0.63±0.46屈光度，P = 0.02），TEQ增加/减少（0.37±0.54/-0.69±0.49屈光度，P = 0.04），对应SEQ减少/增加（-0.31±0.47/0.63±0.43屈光度，P = 0.02）。KAST/TAST/RAST在FD中显示每年有最小程度的下降（-0.06±0.41/-0.05±0.45/-0.06±0.41屈光度），但在KC中增加（0.46±0.41/0.51±0.43/0.46±0.38屈光度）（P = 0.05/0.06/0.12）。