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经自动板层角膜成形术治疗的沙眼性角膜病变的处理。

Management of trachomatous keratopathy by automated lamellar therapeutic keratoplasty.

机构信息

R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Cornea. 2012 Oct;31(10):1107-10. doi: 10.1097/ICO.0b013e3182181e22.

Abstract

PURPOSE

To evaluate the efficacy of automated lamellar therapeutic keratoplasty (ALTK) for the management of anterior corneal stromal scarring caused by trachoma.

METHODS

Seventeen cases of trachomatous keratopathy that were treated by ALTK were retrospectively evaluated. The main outcome measures were uncorrected visual acuity, best-corrected visual acuity (BCVA), keratometry, pachymetry, time to epithelialization, graft clarity, and complications, if any.

RESULTS

The mean age of the patients was 50.3 ± 14.1 years. Five of the 17 cases had Salzmann nodular degeneration. The mean decimal BCVA was 0.06 ± 0.05 preoperatively, which improved to 0.41 ± 0.16 at 12 months, and 12 eyes (70.6%) had a postoperative BCVA of 6/18 or better. The median epithelialization time was 6 days (range, 1-38 days). Persistent epithelial defect developed in 6 eyes, and 1 eye developed graft infection.

CONCLUSIONS

Anterior stromal corneal scarring caused by trachoma can be effectively treated with ALTK. However, occurrence of persistent epithelial defects may complicate the success of this surgery.

摘要

目的

评估自动板层角膜成形术(ALTK)治疗沙眼引起的前部角膜基质瘢痕的疗效。

方法

回顾性评估了 17 例经 ALTK 治疗的沙眼性角膜病变病例。主要观察指标包括未矫正视力、最佳矫正视力(BCVA)、角膜曲率计、角膜测厚仪、上皮愈合时间、移植物清晰度以及任何并发症。

结果

患者的平均年龄为 50.3±14.1 岁。17 例中有 5 例有 Salzmann 结节变性。术前平均十进制 BCVA 为 0.06±0.05,术后 12 个月时提高至 0.41±0.16,12 只眼(70.6%)术后 BCVA 达到 6/18 或更好。中位上皮愈合时间为 6 天(范围 1-38 天)。6 只眼出现持续性上皮缺损,1 只眼发生移植物感染。

结论

沙眼引起的前部角膜基质瘢痕可以通过 ALTK 有效治疗。然而,持续性上皮缺损的发生可能会使手术的成功复杂化。

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