From Dr. Rajendra Prasad Centre for Ophthalmic Sciences (Vajpayee, Maharana, Sharma, Agarwal), All India Institute of Medical Sciences, New Delhi, India; the Centre for Eye Research Australia (Vajpayee, Jhanji), University of Melbourne, Australia; the Department of Ophthalmology and Visual Sciences (Jhanji), Chinese University of Hong Kong, Hong Kong.
From Dr. Rajendra Prasad Centre for Ophthalmic Sciences (Vajpayee, Maharana, Sharma, Agarwal), All India Institute of Medical Sciences, New Delhi, India; the Centre for Eye Research Australia (Vajpayee, Jhanji), University of Melbourne, Australia; the Department of Ophthalmology and Visual Sciences (Jhanji), Chinese University of Hong Kong, Hong Kong.
J Cataract Refract Surg. 2014 Feb;40(2):276-82. doi: 10.1016/j.jcrs.2013.07.047. Epub 2013 Dec 15.
To evaluate the outcomes of a new surgical technique, diamond knife-assisted deep anterior lamellar keratoplasty (DALK), and compare its visual and refractive results with big-bubble DALK in cases of keratoconus.
Tertiary eyecare hospital.
Comparative case series.
The visual and surgical outcomes of diamond knife-assisted DALK were compared with those of successful big-bubble DALK.
Diamond knife-assisted DALK was performed in 19 eyes and big-bubble DALK, in 11 eyes. All surgeries were completed successfully. No intraoperative or postoperative complications occurred with diamond knife-assisted DALK. Six months after diamond knife-assisted DALK, the mean corrected distance visual acuity (CDVA) improved significantly from 1.87 logMAR ± 0.22 (SD) to 0.23 ± 0.06 logMAR, the mean keratometry improved from 65.99 ± 8.86 diopters (D) to 45.13 ± 1.16 D, and the mean keratometric cylinder improved from 7.99 ± 3.81 D to 2.87 ± 0.59 D (all P=.005). Postoperatively, the mean refractive astigmatism was 2.55 ± 0.49 D and the mean spherical equivalent was -1.97 ± 0.56 D. The mean logMAR CDVA (P = .06), postoperative keratometry (P=.64), refractive cylinder (P=.63), and endothelial cell loss (P=.11) were comparable between diamond knife-assisted DALK and big-bubble DALK.
Diamond knife-assisted DALK was effective and predictable as a surgical technique for management of keratoconus cases. This technique has the potential to offer visual and refractive outcomes comparable to those of big-bubble DALK.
No author has a financial or proprietary interest in any material or method mentioned.
评估一种新的手术技术——钻石刀辅助深层前板层角膜移植术（DALK）的结果，并将其在圆锥角膜病例中的视觉和屈光结果与大泡 DALK 进行比较。
三级眼科医院。
对比病例系列。
比较钻石刀辅助 DALK 与成功的大泡 DALK 的视觉和手术结果。
19 只眼行钻石刀辅助 DALK，11 只眼行大泡 DALK。所有手术均顺利完成。钻石刀辅助 DALK 无术中或术后并发症。DALK 术后 6 个月，平均矫正远视力（CDVA）从 1.87 logMAR±0.22（SD）显著提高至 0.23±0.06 logMAR，平均角膜曲率从 65.99±8.86 屈光度（D）降至 45.13±1.16 D，平均角膜散光从 7.99±3.81 D 降至 2.87±0.59 D（均 P=.005）。术后平均屈光性散光为 2.55±0.49 D，平均等效球镜为-1.97±0.56 D。平均 logMAR CDVA（P=.06）、术后角膜曲率（P=.64）、屈光散光（P=.63）和内皮细胞丢失（P=.11）在钻石刀辅助 DALK 和大泡 DALK 之间无显著差异。
钻石刀辅助 DALK 是治疗圆锥角膜病例的有效且可预测的手术技术。该技术有可能提供与大泡 DALK 相当的视觉和屈光结果。
无作者在任何材料或方法上存在财务或所有权利益。
