对唐氏综合征患者进行局部麻醉下的角膜交联手术。
Performing corneal crosslinking under local anaesthesia in patients with Down syndrome.
作者信息
Soeters Nienke, Bennen Esmée, Wisse Robert P L
机构信息
Utrecht Cornea Research Group, Department of Ophthalmology, University Medical Center Utrecht, HP E03.136, Heidelberglaan 100, 3508 GX, Utrecht, The Netherlands.
出版信息
Int Ophthalmol. 2018 Jun;38(3):917-922. doi: 10.1007/s10792-017-0535-1. Epub 2017 Apr 19.
PURPOSE
To report on the ability to perform corneal crosslinking (CXL) under local anaesthesia for the treatment of keratoconus in patients with Down syndrome.
METHODS
Nine eyes of seven patients with both keratoconus and Down syndrome were scheduled for an epithelium-off CXL procedure under local anaesthesia. Exclusion criteria were a corneal thickness under 400 µm and the presence of corneal scars. A standardized clinical decision tool was used to estimate patient cooperation and the likelihood for a successful procedure under local rather than general anaesthesia.
RESULTS
In seven eyes, the CXL was completed successfully. The treatment was aborted in two eyes due to insufficient corneal thickness (<400 µm) prior to ultraviolet-A irradiation, even after employing hypoosmolar riboflavin. No adverse events occurred post-operatively, except for one case of delayed epithelial healing (23 days).
CONCLUSIONS
With a proper patient selection, CXL under local anaesthesia can be achieved in patients with Down syndrome.
目的
报告在局部麻醉下进行角膜交联（CXL）治疗唐氏综合征患者圆锥角膜的能力。
方法
7例同时患有圆锥角膜和唐氏综合征的患者的9只眼计划在局部麻醉下进行去上皮CXL手术。排除标准为角膜厚度小于400μm和存在角膜瘢痕。使用标准化的临床决策工具来评估患者的配合程度以及在局部而非全身麻醉下成功进行手术的可能性。
结果
7只眼成功完成了CXL。由于在紫外线A照射前角膜厚度不足（<400μm），即使使用了低渗核黄素，仍有2只眼的治疗中止。术后除1例上皮愈合延迟（23天）外，未发生不良事件。
结论
通过适当的患者选择，唐氏综合征患者可在局部麻醉下进行CXL。
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