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Descemet 氏膜撕除自动内皮角膜移植术后的角膜高阶像差。

Corneal higher-order aberrations after Descemet's stripping automated endothelial keratoplasty.

机构信息

University of Texas Southwestern Medical Center, Department of Ophthalmology, Dallas, Texas 75390-9057, USA.

出版信息

Ophthalmology. 2010 May;117(5):878-884.e6. doi: 10.1016/j.ophtha.2010.02.001. Epub 2010 Mar 26.

Abstract

PURPOSE

To compare the corneal higher-order aberration (HOA) after Descemet's stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PKP), and in age-matched controls.

DESIGN

Cross-sectional, non-comparative interventional case series.

PARTICIPANTS

Thirty-one eyes of 28 patients who underwent DSAEK, 20 eyes of 16 patients who underwent PKP, and 31 eyes of 31 control patients.

INTERVENTION

The corneal topography and HOAs of the central 4- and 6-mm zones from anterior and posterior corneal surfaces were evaluated postoperatively with the Scheimpflug rotating imaging system (Oculus Gmbh, Wetzlar, Germany).

MAIN OUTCOME MEASURES

Anterior and posterior corneal HOAs.

RESULTS

The mean anterior corneal total HOAs of the central 4 and 6 mm were 0.599+/-0.288 microm and 1.215+/-0.496 microm, respectively, in eyes that underwent DSAEK; 1.730+/-0.826 microm and 3.349+/-1.490 microm, respectively, in eyes that underwent PKP; and 0.439+/-0.163 microm and 0.921+/-0.300 microm, respectively, in controls. Although the mean anterior corneal total HOAs of the central 4 and 6 mm were significantly higher in eyes that underwent PKP than in eyes that underwent DSAEK and in controls (P<0.01), there was no significant difference in anterior corneal total HOAs of the central 4 and 6 mm between eyes that underwent DSAEK and controls. The mean posterior corneal total HOAs of the central 4 and 6 mm were 3.680+/-1.586 microm and 7.142+/-3.011 microm, respectively, in eyes that underwent DSAEK; 2.957+/-1.238 microm and 5.314+/-2.095 microm, respectively, in eyes that underwent PKP; and 0.818+/-0.193 microm and 1.609+/-0.344 microm, respectively, in controls. Although there was no significant difference in posterior corneal total HOAs of the central 4 mm between the DSAEK group and the PKP group, the posterior corneal HOAs of the central 6 mm were significantly higher in the DSAEK group than in the PKP group (P<0.01).

CONCLUSIONS

Although posterior corneal HOAs are significantly higher in eyes that underwent DSAEK, anterior corneal HOAs are not significantly different in eyes that underwent DSAEK than those of age-matched controls.

摘要

目的

比较去表皮内皮角膜移植术(DSAEK)和穿透性角膜移植术(PKP)术后的角膜高阶像差(HOA),并与年龄匹配的对照组进行比较。

设计

横断面、非对照干预病例系列。

参与者

28 例 31 眼接受 DSAEK 治疗,16 例 20 眼接受 PKP 治疗,31 例 31 例对照。

干预措施

术后应用 Scheimpflug 旋转成像系统(Oculus Gmbh,德国威茨拉尔)评估中央前、后角膜表面 4 至 6mm 区的角膜地形图和 HOA。

主要观察指标

前、后角膜 HOA。

结果

DSAEK 组中央 4mm 和 6mm 角膜前总 HOA 分别为 0.599+/-0.288μm 和 1.215+/-0.496μm,PKP 组分别为 1.730+/-0.826μm 和 3.349+/-1.490μm,对照组分别为 0.439+/-0.163μm 和 0.921+/-0.300μm。尽管 PKP 组中央 4mm 和 6mm 角膜前总 HOA 明显高于 DSAEK 组和对照组(P<0.01),但 DSAEK 组与对照组中央 4mm 和 6mm 角膜前总 HOA 无显著性差异。DSAEK 组中央 4mm 和 6mm 角膜后总 HOA 分别为 3.680+/-1.586μm 和 7.142+/-3.011μm,PKP 组分别为 2.957+/-1.238μm 和 5.314+/-2.095μm,对照组分别为 0.818+/-0.193μm 和 1.609+/-0.344μm。尽管 DSAEK 组和 PKP 组中央 4mm 角膜后总 HOA 无显著性差异,但 DSAEK 组中央 6mm 角膜后 HOA 明显高于 PKP 组(P<0.01)。

结论

尽管 DSAEK 术后角膜后 HOA 明显升高,但 DSAEK 术后角膜前 HOA 与年龄匹配的对照组无显著差异。

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