Dr Lütfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.
Am J Ophthalmol. 2010 Aug;150(2):185-192.e1. doi: 10.1016/j.ajo.2010.03.020. Epub 2010 Jun 8.
To determine the visual and refractive outcomes of 210-degree arc length intrastromal corneal ring segment (ICRS) implantation in eyes with pellucid marginal corneal degeneration (PMCD).
Retrospective, consecutive case series.
Sixteen consecutive eyes of 10 patients who underwent a single 210-degree ICRS implantation by femtosecond laser for the management of PMCD and completed at least 1 year follow-up were included. A complete ophthalmic examination was performed preoperatively and postoperatively, including uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest spherical and cylindrical refractions, spherical equivalent, and keratometric readings.
The mean follow-up period was 30.7 months (range 12 to 36 months). No intraoperative complication was observed. White deposits around the segments were noted in 2 of 16 eyes (12.5%) at the first postoperative year. The mean UCVA showed significant improvement, from 1.69 +/- 1.02 logarithm of the minimal angle of resolution (logMAR) preoperatively to 0.64 +/- 0.43 logMAR at the 36th month (n = 11, P < .001). The mean preoperative BSCVA was 0.88 +/- 0.68 logMAR; after 36 months, this improved to 0.35 +/- 0.34 (P < .001). At the 36th month, UCVA was improved in all eyes (n = 11, range: gain of 1 to 6 lines), whereas BSCVA was improved in 9 eyes (81.8%, range: gain of 2 to 7 lines) and remained unchanged in 2 eyes (18.1%); UCVA was 20/40 or better in 3 eyes (27%) and BSCVA was 20/40 or better in 8 eyes (72.7%). There was a significant reduction in the spherical equivalent refractive error, from -4.40 +/- 1.85 diopters (D) preoperatively to -1.86 +/- 0.60 D (P < .001), and the mean maximum keratometric power decreased from 49.70 +/- 4.32 D to 46.08 +/- 2.84 D (P < .001) after 36 months. The mean cylindrical refraction decreased from -4.39 +/- 1.86 D preoperatively to -2.38 +/- 1.35 D at 36 months (P < .001).
A single 210-degree arc length ICRS implantation using a femtosecond laser for patients with PMCD provides good visual and refractive outcomes.
确定 210 度角长度的角膜基质环段（ICRS）在透明边缘性角膜变性（PMCD）眼中的视力和屈光结果。
回顾性连续病例系列。
纳入 10 例患者的 16 只眼，这些患者因 PMCD 接受了单次 210 度 ICRS 植入，并接受了飞秒激光治疗，至少随访 1 年。术前和术后进行全面眼科检查，包括未矫正视力（UCVA）、最佳矫正视力（BSCVA）、明显的球镜和柱镜屈光度、等效球镜和角膜曲率读数。
平均随访时间为 30.7 个月（范围 12 至 36 个月）。术中未观察到并发症。术后 1 年内，2 只眼（12.5%）可见角膜段周围有白色沉积物。平均 UCVA 显著提高，从术前的 1.69 +/- 1.02 最小角分辨率对数（logMAR）提高到术后 36 个月的 0.64 +/- 0.43 logMAR（n = 11，P <.001）。术前平均 BSCVA 为 0.88 +/- 0.68 logMAR；术后 36 个月，这一数值提高到 0.35 +/- 0.34（P <.001）。术后 36 个月，11 只眼的 UCVA 均有改善（n = 11，提高 1 至 6 行），9 只眼（81.8%，提高 2 至 7 行）的 BSCVA 有所改善，2 只眼（18.1%）不变；3 只眼（27%）的 UCVA 达到 20/40 或更好，8 只眼（72.7%）的 BSCVA 达到 20/40 或更好。等效球镜屈光误差显著降低，从术前的-4.40 +/- 1.85 屈光度（D）降至-1.86 +/- 0.60 D（P <.001），术后 36 个月平均最大角膜曲率从 49.70 +/- 4.32 D 降至 46.08 +/- 2.84 D（P <.001）。术前平均柱镜屈光度为-4.39 +/- 1.86 D，术后 36 个月降至-2.38 +/- 1.35 D（P <.001）。
飞秒激光治疗透明边缘性角膜变性患者的 210 度角长度 ICRS 植入术可获得良好的视力和屈光效果。
