角膜扩张的治疗策略。
Treatment strategies for corneal ectasia.
机构信息
Emory Eye Center & Emory Vision, Atlanta, Georgia, USA.
出版信息
Curr Opin Ophthalmol. 2010 Jul;21(4):255-8. doi: 10.1097/ICU.0b013e32833a8bfe.
PURPOSE OF REVIEW
To review the most recent management strategies for corneal ectasia after keratorefractive surgery.
RECENT FINDINGS
Management options for postoperative ectasia include conservative management with various types of contact lenses such as rigid gas permeable lenses, custom wave front-guided soft contact lenses, hybrid lenses and tandem soft contact lens-rigid gas permeable lenses. Minimally invasive surgical options including corneal ring segment implantation with Intacs, KeraRings or Ferrara rings have shown to have good results in the initial period after insertion. However, there appears to be some evidence that this initial effect may regress with time. Collagen cross-linking is also minimally invasive and has been documented to stop the progression of ectasia and in some cases may cause regression. Recently, techniques combining collagen cross-linking with intracorneal ring segments or with topography-guided excimer laser treatments have shown to have promising results.
SUMMARY
Early management of ectasia is essential to prevent its progression and to preserve visual potential. There are several management options that are available that may be used to reduce the need for corneal transplantation for these patients.
目的综述
回顾角膜屈光手术后角膜扩张的最新治疗策略。
最新发现
术后扩张的治疗选择包括各种类型的接触镜的保守治疗，如硬性透气性角膜接触镜、定制波前引导软接触镜、混合镜和串联软接触镜-硬性透气性角膜接触镜。角膜环段植入术包括 Intacs、KeraRings 或 Ferrara 环等微创手术，在插入后的初始阶段显示出良好的效果。然而，似乎有一些证据表明，这种初始效果可能会随着时间的推移而消退。胶原交联也是一种微创技术，已被证明可以阻止扩张的进展，在某些情况下可能会导致退行。最近，结合胶原交联与角膜内环段或与地形图引导准分子激光治疗的技术显示出有希望的结果。
总结
早期治疗扩张对于防止其进展和保护视力潜能至关重要。有几种治疗选择可以用来减少这些患者对角膜移植的需求。
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