Feizi Sepehr, Javadi Mohammad Ali, Javadi Fatemeh, Jafarinasab Mohammad Reza
Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Ophthalmic Vis Res. 2015 Apr-Jun;10(2):112-7. doi: 10.4103/2008-322X.163768.
To compare the clinical outcomes of deep anterior lamellar keratoplasty (DALK) for keratoconus in patients with vernal keratoconjunctivitis (VKC) versus those without VKC.
In this retrospective comparative study, records of 262 eyes with keratoconus (Group 1) and 28 keratoconic eyes with VKC (Group 2) that had undergone DALK were compiled. Reviewed parameters included length of follow-up, best-corrected visual acuity (BCVA), refractive error, complications and cumulative graft survival.
Mean duration of follow-up was 38.6 ± 20.2 and 34.4 ± 20.9 months in groups 1 and 2, respectively (P = 0.21). Mean post-operative BCVA was 0.19 ± 0.11 and 0.20 ± 0.15 logMAR, in groups 1 and 2 (P = 0.79). BCVA≥20/40 was achieved in 91.6 and 88.5% of eyes in groups 1 and 2, respectively (P = 0.48). Epithelial problems were encountered in 31.3 and 42.9% of operated eyes, respectively (P = 0.16). Vascularization of suture tracts and stitch abscesses were encountered more frequently in the eyes with VKC (P = 0.01 and <0.001, respectively). At the 33-month follow-up examination, rejection-free graft survival rates were 56.0% in group 1 and 33.3% in group 2, with mean durations of 41.0 and 32.1 months, respectively (P = 0.15). Graft survival rates were 98.1% in group 1 and 95.0% in group 2, with mean durations of 88.6 and 88.4 months, respectively (P = 0.74).
Clinical outcomes of DALK in keratoconic eyes with VKC were comparable to those in eyes with keratoconus alone. However, complications such as suture tract vascularization and stitch abscesses were more common when VKC coexisted, necessitating closer monitoring.
比较春季角结膜炎（VKC）患者与非VKC患者圆锥角膜行深前板层角膜移植术（DALK）的临床结果。
在这项回顾性比较研究中，收集了262只圆锥角膜眼（第1组）和28只合并VKC的圆锥角膜眼（第2组）行DALK的记录。回顾的参数包括随访时间、最佳矫正视力（BCVA）、屈光不正、并发症和移植片累积存活率。
第1组和第2组的平均随访时间分别为38.6±20.2个月和34.4±20.9个月（P = 0.21）。第1组和第2组术后平均BCVA分别为0.19±0.11和0.20±0.15 logMAR（P = 0.79）。第1组和第2组分别有91.6%和88.5%的患眼达到BCVA≥20/40（P = 0.48）。手术眼分别有31.3%和42.9%出现上皮问题（P = 0.16）。VKC患者的缝线通道血管化和缝线脓肿更常见（分别为P = 0.01和<0.001）。在33个月的随访检查中，第1组无排斥反应的移植片存活率为56.0%，第2组为33.3%，平均持续时间分别为41.0个月和32.1个月（P = 0.15）。第1组和第2组的移植片存活率分别为98.1%和95.0%，平均持续时间分别为88.6个月和88.4个月（P = 0.74）。
合并VKC的圆锥角膜眼行DALK的临床结果与单纯圆锥角膜眼相似。然而，当合并VKC时，缝线通道血管化和缝线脓肿等并发症更常见，需要密切监测。
