Sy Mary Ellen, Kovoor Timmy A, Tannan Anjali, Choi Daniel, Deng Sophie X, Danesh Jennifer, Hamilton D Rex
From the American Eye Center (Sy), Makati, Manila, Philippines; Houston Eye Associates (Kovoor), Houston, Texas, Jules Stein Eye Institute (Tannan, Deng, Hamilton), David Geffen School of Medicine (Danesh), University of California Los Angeles, Los Angeles, and the Department of Ophthalmology (Choi), Stanford School of Medicine, Stanford, California, USA.
From the American Eye Center (Sy), Makati, Manila, Philippines; Houston Eye Associates (Kovoor), Houston, Texas, Jules Stein Eye Institute (Tannan, Deng, Hamilton), David Geffen School of Medicine (Danesh), University of California Los Angeles, Los Angeles, and the Department of Ophthalmology (Choi), Stanford School of Medicine, Stanford, California, USA.
J Cataract Refract Surg. 2015 May;41(5):1050-6. doi: 10.1016/j.jcrs.2014.10.028. Epub 2015 Apr 29.
To determine the safety, efficacy, and predictability of combined astigmatic keratotomy (AK) and conductive keratoplasty (CK) for treating high corneal astigmatism.
University of California-Los Angeles, Los Angeles, California, USA.
Retrospective case series.
From January 1, 2004, to December 31, 2009, AK and CK were performed in eyes with corneal astigmatism of 5.0 diopters (D) or more after keratoplasty or trauma. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical equivalent (SE), defocus equivalent, mean astigmatism, efficacy index, and complications were evaluated.
In 11 eyes of 11 patients, the mean UDVA improved from 1.54 logMAR ± 0.50 (SD) preoperatively to 0.69 ± 0.62 logMAR 3 months postoperatively (P < .001) and the mean CDVA from 0.55 ± 0.62 logMAR to 0.12 ± 0.11 logMAR (P = .028). The mean SE and mean defocus equivalent decreased from -1.25 ± 5.06 D to 3.13 ± 3.06 D (P = .15) and from 7.98 ± 4.41 D to 6.97 ± 3.73 D (P = .45), respectively; these changes were not statistically significant. The mean absolute astigmatism decreased from 10.25 ± 4.71 D to 4.31 ± 2.34 D (P < .001). The mean absolute orthogonal and mean oblique astigmatism showed a statistically significant decrease. The efficacy index was 0.82. One case of wound gape after AK required suturing. No infectious keratitis, corneal perforation, or graft rejection occurred.
Results indicate that combined AK and CK is safe and effective for correcting high corneal astigmatism after surgery or trauma.
确定散光性角膜切开术（AK）联合传导性角膜成形术（CK）治疗高度角膜散光的安全性、有效性及可预测性。
美国加利福尼亚州洛杉矶市加利福尼亚大学洛杉矶分校。
回顾性病例系列。
2004年1月1日至2009年12月31日，对角膜移植或外伤后角膜散光5.0屈光度（D）及以上的眼睛进行AK和CK手术。评估未矫正（UDVA）和矫正（CDVA）远视力、球镜等效度（SE）、散焦等效度、平均散光、疗效指数及并发症。
11例患者的11只眼中，平均UDVA从术前的1.54 logMAR±0.50（标准差）提高到术后3个月的0.69±0.62 logMAR（P<.001），平均CDVA从0.55±0.62 logMAR提高到0.12±0.11 logMAR（P=.028）。平均SE和平均散焦等效度分别从-1.25±5.06 D降至3.13±3.06 D（P=.15）和从7.98±4.41 D降至6.97±3.73 D（P=.45）；这些变化无统计学意义。平均绝对散光从10.25±4.71 D降至4.31±2.34 D（P<.001）。平均绝对正交散光和平均斜向散光有统计学意义的降低。疗效指数为0.82。1例AK术后伤口裂开需要缝合。未发生感染性角膜炎、角膜穿孔或移植排斥反应。
结果表明，AK联合CK用于矫正手术或外伤后的高度角膜散光是安全有效的。
