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圆锥角膜穿透性角膜移植术后移植物生物力学特性。

Graft biomechanical properties after penetrating keratoplasty in keratoconus.

机构信息

Ophthalmic Research Center, Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Cornea. 2012 Aug;31(8):855-8. doi: 10.1097/ICO.0b013e31823f8ce4.

Abstract

PURPOSE

To measure corneal graft biomechanical properties after penetrating keratoplasty (PKP) in a group of keratoconic eyes using the ocular response analyzer (ORA) and to evaluate the relationship between donor size, donor-recipient disparity and central graft thickness (CGT), and ORA parameters.

METHODS

This cross-sectional study was conducted on 34 eyes of 34 keratoconus patients who had undergone PKP. Corneal hysteresis (CH), corneal resistance factor (CRF), and cornea-compensated intraocular pressure were measured at least 6 months after complete suture removal. Two groups of donor-recipient disparity (0.25 vs. 0.50 mm) were compared using the independent t test. Multivariate regression analysis was used to investigate the correlation of donor trephine size and CGT with ORA parameters. Factors influencing intraocular pressure measured with the Goldmann applanation tonometer (IOP GAT) after PKP were determined using multiple regression analysis.

RESULTS

Mean patient age and follow-up period were 29.6 ± 6.2 years and 82.4 ± 59.6 months, respectively. Mean CGT, CH, and CRF were 564.7 ± 36.9 μm, 10.1 ± 2.1 mm Hg, and 10.0 ± 2.3 mm Hg, respectively. CH and CRF had a significant positive correlation with donor trephine size and CGT. Significantly greater values of CH and CRF were observed in the 0.5-mm disparity group compared with the 0.25-mm disparity group. Among the studied parameters, only CH, CRF, and cornea-compensated intraocular pressure had a significant positive correlation with IOP GAT.

CONCLUSION

Graft biomechanics seem to be closer to normal values with larger grafts and greater donor-recipient disparity. These metrics had a significant correlation with IOP GAT after PKP.

摘要

目的

使用眼反应分析仪(ORA)测量一组圆锥角膜眼穿透性角膜移植术后(PKP)的角膜移植物生物力学特性,并评估供体大小、供体-受体差异和中央移植物厚度(CGT)与 ORA 参数之间的关系。

方法

本横断面研究纳入了 34 名接受 PKP 的圆锥角膜患者的 34 只眼。在完全拆除缝线后至少 6 个月测量角膜滞后(CH)、角膜阻力因子(CRF)和角膜补偿眼压。使用独立 t 检验比较两组供体-受体差异(0.25 与 0.50mm)。使用多元回归分析研究供体环钻大小和 CGT 与 ORA 参数的相关性。使用多元回归分析确定影响 PKP 后 Goldmann 压平眼压计(IOP GAT)测量的眼压的因素。

结果

患者平均年龄和随访时间分别为 29.6±6.2 岁和 82.4±59.6 个月。平均 CGT、CH 和 CRF 分别为 564.7±36.9μm、10.1±2.1mmHg 和 10.0±2.3mmHg。CH 和 CRF 与供体环钻大小和 CGT 呈显著正相关。0.5mm 差异组的 CH 和 CRF 值明显大于 0.25mm 差异组。在所研究的参数中,只有 CH、CRF 和角膜补偿眼压与 IOP GAT 呈显著正相关。

结论

较大的移植物和较大的供体-受体差异使移植物的生物力学特性似乎更接近正常。这些指标与 PKP 后 IOP GAT 有显著相关性。

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