Fronterrè A, Portesani G P
Cornea. 1991 Jul;10(4):305-11. doi: 10.1097/00003226-199107000-00005.
We report 100 cases of postkeratoplasty astigmatism, ranging from 4 to 20.5 diopters, treated with the following procedures: relaxing incisions, relaxing incisions with augmentation sutures, and repeated relaxing incisions with augmentation sutures according to the degree of astigmatism. Patients were divided into three study groups (group 1 for preoperative defects ranging from 4 to 10 diopters, group 2, from 10.5 to 15 diopters, and group 3 for defects exceeding 15 diopters). Mean preoperative astigmatism was 7.15 +/- 1.67, 12.56 +/- 1.37, and 17.50 +/- 1.51 diopters in each group, respectively. The net decrease in astigmatism after surgery was 5.53 +/- 1.44, 9.68 +/- 1.80, and 14.87 +/- 1.69 diopters in each group, respectively. Postoperatively, spectacle-corrected visual acuity improved by two Snellen lines in the group 1, five in the group 2, and nine in the group 3. The mean time to achieve stable results after surgery was 2.2 +/- 0.3, 2.7 +/- 0.4, and 4.2 +/- 0.7 months in each group, respectively (two patients in group 2 and all patients in group 3 underwent a two-step procedure). The relaxing incisions procedure, eventually modified by either adding compression sutures or repeating the incisions after 8-10 weeks, offers the possibility of a wide range of corrections for postkeratoplasty astigmatism with acceptable postoperative periods for visual rehabilitation.
我们报告了100例角膜移植术后散光患者，散光度数在4至20.5屈光度之间，采用以下手术方法进行治疗：松解切口、带加固缝线的松解切口，以及根据散光程度重复进行带加固缝线的松解切口。患者被分为三个研究组（第1组术前散光度数为4至10屈光度，第2组为10.5至15屈光度，第3组为超过15屈光度）。每组术前平均散光度数分别为7.15±1.67、12.56±1.37和17.50±1.51屈光度。术后每组散光净减少量分别为5.53±1.44、9.68±1.80和14.87±1.69屈光度。术后，第1组患者经眼镜矫正后的视力提高了两行Snellen视力表，第2组提高了五行，第3组提高了九行。每组术后达到稳定结果的平均时间分别为2.2±0.3、2.7±0.4和4.2±0.7个月（第2组有两名患者和第3组所有患者接受了两步手术）。松解切口手术最终通过添加压迫缝线或在8至10周后重复切口进行改良，为角膜移植术后散光提供了广泛的矫正可能性，且术后视力恢复时间可接受。
