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角膜裂伤修复术后角膜缘楔形切除术治疗高度不规则角膜散光的长期疗效

Long-term outcomes of wedge resection at the limbus for high irregular corneal astigmatism after repaired corneal laceration.

作者信息

Du Jun, Zheng Guang-Ying, Wen Cheng-Lin, Zhang Xiao-Fang, Zhu Yu

机构信息

Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.

Department of Ophthalmology, People's Hospital of Zhengzhou, Zhengzhou 450053, Henan Province, China.

出版信息

Int J Ophthalmol. 2016 Jun 18;9(6):843-7. doi: 10.18240/ijo.2016.06.09. eCollection 2016.

Abstract

AIM

To evaluate the clinical value of wedge resection at corneal limbus in patients with traumatic corneal scarring and high irregular astigmatism.

METHODS

Patients with traumatic corneal astigmatism received wedge resection at least 6mo after suture removal from corneal wound. The uncorrected distance visual acuities (UCVA) and best corrected distance visual acuities (BCVA), pre- and post-operation astigmatism, spherical equivalent (SE), safety and complications were evaluated.

RESULTS

Ten eyes (10 patients) were enrolled in this study. Mean follow-up time after wedge resection was 37.8±15.4mo (range, 20-61mo). The mean UCVA improved from +1.07±0.55 logMAR to +0.43±0.22 logMAR (P=0.000) and the mean BCVA from +0.50±0.30 logMAR to +0.15±0.17 logMAR (P=0.000). The mean astigmatism power measured by retinoscopy was -2.03±2.27 D postoperatively and -2.83±4.52 D preoperatively (P=0.310). The mean SE was -0.74±1.61 D postoperatively and -0.64±1.89 D preoperatively (P=0.601). Two cases developed mild pannus near the sutures. No corneal perforation, infectious keratitis or wound gape occurred.

CONCLUSION

Corneal-scleral limbal wedge resection with compression suture is a safe, effective treatment for poor patients with high irregular corneal astigmatism after corneal-scleral penetrating injury. Retinoscopy can prove particularly useful for high irregular corneal astigmatism when other measurements are not amenable.

摘要

目的

评估角膜缘楔形切除术治疗外伤性角膜瘢痕合并高度不规则散光患者的临床价值。

方法

外伤性角膜散光患者在角膜伤口缝线拆除后至少6个月接受楔形切除术。评估术前、术后的裸眼远视力(UCVA)、最佳矫正远视力(BCVA)、散光、等效球镜度(SE)、安全性及并发症情况。

结果

本研究纳入10例患者的10只眼。楔形切除术后平均随访时间为37.8±15.4个月(范围20 - 61个月)。平均UCVA从+1.07±0.55 logMAR提高至+0.43±0.22 logMAR(P = 0.000),平均BCVA从+0.50±0.30 logMAR提高至+0.15±0.17 logMAR(P = 0.000)。术后检影法测量的平均散光度数为-2.03±2.27 D,术前为-2.83±4.52 D(P = 0.310)。术后平均SE为-0.74±1.61 D,术前为-0.64±1.89 D(P = 0.601)。2例在缝线附近出现轻度血管翳。未发生角膜穿孔、感染性角膜炎或伤口裂开。

结论

角膜巩膜缘楔形切除术联合加压缝线是治疗角膜巩膜穿透伤后高度不规则角膜散光患者的一种安全、有效的方法。当其他测量方法不适用时,检影法对于高度不规则角膜散光可能特别有用。

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