Agarwal Tushar, Bandivadekar Pooja, Sharma Namrata, Sagar Pradeep, Titiyal Jeewan S
Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Cornea. 2015 Jun;34(6):615-20. doi: 10.1097/ICO.0000000000000432.
To compare the results of microkeratome-assisted sutureless anterior lamellar keratoplasty (SALK) with and without phacoemulsification.
In this retrospective comparative interventional case series, patients with superficial anterior corneal opacity were divided into 2 groups. Eyes in group 1 (n = 6) had associated cataract and underwent SALK with phacoemulsification surgery (SALK triple). Eyes in group 2 (n = 6) did not have cataract and underwent only anterior lamellar keratoplasty. A 200-μm microkeratome head was used for host and donor cut. Fibrin glue was applied at the graft-host junction. Visual acuity, refractive error, topographic changes, and pachymetry were noted.
Mean follow-up was 9 ± 2.7 months. The best spectacle-corrected visual acuity (BSCVA) improved significantly over the preoperative value in both the groups at 1 month, 6 months, and the last follow-up (P = 0.028). The mean gain in BSCVA was 8.8 ± 3.4 lines and 6.8 ± 5.2 lines, respectively, for groups 1 and 2 at the last follow-up, with no statistically significant difference in the BSCVA of both groups at the last follow-up (P = 0.80). There was no statistical difference at the last follow-up between the 2 groups with respect to spherical equivalent (P = 0.6), cylinder (P = 0.81), topographic astigmatism (P = 0.75), and graft thickness (P = 0.81). One patient in group 1 underwent graft rejection, which completely reversed with treatment. No cases of graft dislocation, infection, epithelial ingrowth, vascularization, or recurrence of primary pathology were noted in either group.
SALK triple is an effective surgery for early visual rehabilitation of patients with superficial anterior corneal opacity and concomitant cataract.
比较有晶状体超声乳化和无晶状体超声乳化的微型角膜刀辅助无缝合前板层角膜移植术（SALK）的结果。
在这个回顾性比较干预性病例系列中，将浅层前角膜混浊患者分为2组。第1组（n = 6）的眼睛伴有白内障，并接受了晶状体超声乳化手术的SALK（SALK三联手术）。第2组（n = 6）的眼睛没有白内障，仅接受了前板层角膜移植术。使用200μm的微型角膜刀头进行受体和供体切割。在移植-受体交界处应用纤维蛋白胶。记录视力、屈光不正、地形图变化和角膜厚度测量结果。
平均随访时间为9±2.7个月。在1个月、6个月和最后一次随访时，两组的最佳矫正视力（BSCVA）均较术前值有显著提高（P = 0.028）。在最后一次随访时，第1组和第2组的BSCVA平均提高分别为8.8±3.4行和6.8±5.2行，两组在最后一次随访时的BSCVA无统计学显著差异（P = 0.80）。在最后一次随访时，两组在等效球镜度（P = 0.6）、柱镜度（P = 0.81）、地形图散光（P = 0.75）和移植片厚度（P = 0.81）方面无统计学差异。第1组有1例患者发生移植排斥反应，经治疗后完全逆转。两组均未发现移植片脱位、感染、上皮内生、血管化或原发病变复发的病例。
SALK三联手术是治疗浅层前角膜混浊合并白内障患者早期视力恢复的有效手术。
