Eye Center, Second Affiliated Hospital, Zhejiang University, Hangzhou, China.
J Refract Surg. 2010 Jan;26(1):33-42. doi: 10.3928/1081597X-20101215-05. Epub 2010 Jan 11.
To assess the efficacy, safety, and predictability of conductive keratoplasty for the treatment of corneal trauma/incision-induced hyperopic or compound astigmatism.
Thirteen eyes with corneal trauma/incision-induced astigmatism underwent conductive keratoplasty in this prospective study. The main outcome measures included distance uncorrected visual acuity (UCVA), near UCVA, best spectacle-corrected visual acuity (BSCVA), manifest refraction cylinder, keratometric astigmatism, manifest refraction spherical equivalent (MRSE), contrast sensitivity, glare sensitivity, intraocular pressure, tear break-up time, endothelial cell count, and pachymetry. Patients were followed 1 week and 1, 3, and 6 months postoperatively.
Mean logMAR scores for distance UCVA, near UCVA, and BSCVA significantly improved from 0.87+/-0.31, 1.32+/-0.41, and 0.18+/-0.18, respectively, to 0.32+/-0.21, 0.59+/-0.21, and 0.08+/-0.11 (P<or=.05), respectively, 6 months after conductive keratoplasty. Mean manifest refraction cylinder, keratometric astigmatism, and MRSE significantly reduced from 4.12+/-2.86 diopters (D), 4.15+/-2.40 D, and 0.73+/-2.56 D, respectively, to 1.46+/-1.35 D, 1.66+/-1.44 D, and -0.52+/-0.99 D (P<or=.05), respectively, at 6 months postoperatively. Contrast sensitivity and glare sensitivity showed significant improvement at spatial frequencies of 1, 1.6, 2.5, 4, and 6.3 cycles per degree (P<or=.05). Surgically induced astigmatism calculated by vector analysis highly correlated to target induced astigmatism (P<or=.05). No severe complications occurred postoperatively.
This study suggests that conductive keratoplasty is an effective and safe treatment for hyperopic or compound astigmatism after corneal trauma or incision.
评估传导性角膜成形术治疗角膜外伤/切口引起的远视或复合性散光的疗效、安全性和可预测性。
在这项前瞻性研究中，13 只眼因角膜外伤/切口引起的散光接受了传导性角膜成形术。主要的观察指标包括远距未矫正视力（UCVA）、近距 UCVA、最佳矫正视力（BSCVA）、显微微镜下屈光度柱、角膜曲率散光、显微微镜下等效球镜（MRSE）、对比敏感度、眩光敏感度、眼压、泪膜破裂时间、内皮细胞计数和角膜厚度。患者在术后 1 周、1、3 和 6 个月进行随访。
术后 6 个月，远距 UCVA、近距 UCVA 和 BSCVA 的平均 logMAR 评分分别从 0.87+/-0.31、1.32+/-0.41 和 0.18+/-0.18 显著改善至 0.32+/-0.21、0.59+/-0.21 和 0.08+/-0.11（P<0.05）。平均显微微镜下屈光度柱、角膜曲率散光和 MRSE 分别从 4.12+/-2.86 屈光度（D）、4.15+/-2.40 D 和 0.73+/-2.56 D 显著降低至 1.46+/-1.35 D、1.66+/-1.44 D 和-0.52+/-0.99 D（P<0.05）。在空间频率为 1、1.6、2.5、4 和 6.3 周/度时，对比敏感度和眩光敏感度均显著提高（P<0.05）。矢量分析计算的手术诱导散光与目标诱导散光高度相关（P<0.05）。术后无严重并发症发生。
本研究表明，传导性角膜成形术是治疗角膜外伤或切口后远视或复合性散光的一种有效且安全的方法。
