Hoffart Louis, Touzeau Olivier, Borderie Vincent, Laroche Laurent
Service d'Ophtalmologie, Hopital d'Adultes de la Timone, Marseille, France.
J Cataract Refract Surg. 2007 May;33(5):862-8. doi: 10.1016/j.jcrs.2007.01.031.
To report the results of correction of post-keratoplasty astigmatism by arcuate keratotomy performed with the Hanna arcitome (Moria).
Service 5, Hôpital des 15-20, Paris VI University, Paris, France.
Forty eyes operated on for post-keratoplasty astigmatism using the Hanna arcitome were retrospectively studied. Paired symmetrical arcuate keratotomies were performed on the graft button. Mean follow-up was 10.8 months +/- 11.2 (SD). Outcome measures included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and subjective refraction. For statistical analysis, visual acuity data were transformed into logMAR units. The refractive data were analyzed using the Alpins method.
By a mean of 10.8 +/- 11.2 months after surgery, the UCVA had improved a mean of 0.28 +/- 0.46 lines, which was significant (P = .013). The BSCVA remained stable. The mean subjective cylinder was 8.84 +/- 3.00 diopters (D) preoperatively and 4.88 +/- 2.50 D postoperatively (P<.001). The changes in postoperative subjective cylinder values correlated with preoperative cylinder values (r(s) = 0.584; P<.0001). The subjective axis was modified by 20 degrees or less in 27 eyes (67.5%). The mean surgically induced astigmatism was 8.07 +/- 3.83 D and the mean correction index, 0.96 +/- 0.46. One microperforation occurred and required suturing. Incisions were off center in 1 case, and 2 patients had an allograft rejection after the procedure.
Arcuate keratotomy performed with the Hanna arcitome was effective in reducing post-keratoplasty astigmatism. The device enabled safer, easier arcuate incisions than with manual techniques. However, predictability and efficacy could be improved by a more accurate nomogram.
报告使用汉纳弧形角膜切开刀（莫里亚公司）行弧形角膜切开术矫正角膜移植术后散光的结果。
法国巴黎第六大学附属15 - 20医院第五科室。
对40例行角膜移植术后散光矫正术且使用汉纳弧形角膜切开刀的患眼进行回顾性研究。在植片上进行成对对称的弧形角膜切开术。平均随访时间为10.8个月±11.2（标准差）。观察指标包括未矫正视力（UCVA）、最佳眼镜矫正视力（BSCVA）和主观验光。为进行统计分析，视力数据转换为最小分辨角对数（logMAR）单位。屈光数据采用阿尔平斯方法进行分析。
术后平均10.8±11.2个月时，UCVA平均提高了0.28±0.46行，差异有统计学意义（P = 0.013）。BSCVA保持稳定。术前平均主观柱镜度数为8.84±3.00屈光度（D），术后为4.88±2.50 D（P<0.001）。术后主观柱镜度数的变化与术前柱镜度数相关（斯皮尔曼相关系数r(s)=0.584；P<0.0001）。27只眼（67.5%）的主观轴改变20度或更小。手术诱导的平均散光为8.07±3.83 D，平均矫正指数为0.96±0.46。发生1例微小穿孔并需要缝合。1例切口偏心，2例患者术后发生同种异体移植排斥反应。
使用汉纳弧形角膜切开刀行弧形角膜切开术在降低角膜移植术后散光方面有效。该设备使弧形切口比手工技术更安全、更容易。然而，通过更精确的列线图可提高可预测性和疗效。
