Farid Marjan, Steinert Roger F, Gaster Ronald N, Chamberlain Winston, Lin Amy
Department of Ophthalmology, The Gavin Herbert Eye Institute, University of California-Irvine, CA 92697, USA.
Ophthalmology. 2009 Sep;116(9):1638-43. doi: 10.1016/j.ophtha.2009.05.003. Epub 2009 Jul 31.
To evaluate visual outcomes and astigmatism in patients who underwent penetrating keratoplasty (PK) with 2 different incision techniques.
Retrospective comparison of a consecutive surgical series.
Fifty-seven consecutive patients who underwent PK at the University of California, Irvine, academic referral practice.
A comparison of 49 eyes of 43 patients that underwent femtosecond laser zig-zag incision pattern PK versus 17 eyes of 14 patients that underwent conventional Barron suction trephination PK performed contemporaneously. All PKs were closed with an identical, 24-bite running nylon suture technique.
Topographically determined astigmatism, best spectacle-corrected visual acuity (BSCVA), and recovery of full visual potential.
The postoperative follow-up ranged from 1 to 12 months. There was a significant difference in average astigmatism between the groups at postoperative month 1 (P = 0.013) and 3 (P = 0.018). By month 3, the average astigmatism was 3 diopters (D) in the zig-zag group and 4.46 D in the conventional group. Of the patients with normal macular and optic nerve function (n(ZZ) = 32; n(con) = 14), a significant difference in BSCVA was seen at month 1 (P = 0.0003) and month 3 (P = 0.006) with 81% of the zig-zag group versus 45% of the conventional group achieving BSCVA of > or =20/40 by month 3 (P = 0.03).
The femtosecond laser generated zig-zag-shaped incision results in a more rapid recovery of BSCVA and induces less astigmatism compared with conventional blade trephination PK.
FINANCIAL DISCLOSURE(S): Proprietary commercial disclosure may be found after the references.
评估采用两种不同切口技术进行穿透性角膜移植术（PK）患者的视力结果和散光情况。
连续手术系列的回顾性比较。
加利福尼亚大学欧文分校学术转诊机构连续57例行PK的患者。
同期比较43例患者的49眼接受飞秒激光锯齿状切口模式PK与14例患者的17眼接受传统巴伦抽吸环钻PK。所有PK均采用相同的24针连续尼龙缝合技术闭合。
地形图测定的散光、最佳眼镜矫正视力（BSCVA）以及完全视觉潜能的恢复情况。
术后随访时间为1至12个月。两组在术后第1个月（P = 0.013）和第3个月（P = 0.018）的平均散光存在显著差异。到第3个月时，锯齿状组的平均散光为3屈光度（D），传统组为4.46 D。在黄斑和视神经功能正常的患者中（锯齿状组n = 32；传统组n = 14），第1个月（P = 0.0003）和第3个月（P = 0.006）时BSCVA存在显著差异，到第3个月时，锯齿状组81%的患者与传统组45%的患者BSCVA达到≥20/40（P = 0.03）。
与传统刀片环钻PK相比，飞秒激光产生的锯齿状切口可使BSCVA恢复更快且散光更小。
专有商业披露可在参考文献之后找到。
