重复Descemet膜剥脱自动内皮角膜移植术后不规则角膜后表面导致视力下降

Decreased Visual Acuity by an Irregular Corneal Posterior Surface After Repeat Descemet Stripping Automated Endothelial Keratoplasty.

作者信息

Yazu Hiroyuki, Yamaguchi Takefumi, Dogru Murat, Satake Yoshiyuki, Tsubota Kazuo, Shimazaki Jun

机构信息

Department of Ophthalmology (H.Y., T.Y., M.D., Y.S., K.T., J.S.), Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan; Department of Ophthalmology (H.Y.), Hino Municipal Hospital, Tokyo, Japan; and Department of Ophthalmology (H.Y.), Keio University School of Medicine, Tokyo, Japan.

出版信息

Eye Contact Lens. 2018 Sep;44 Suppl 1:S249-S254. doi: 10.1097/ICL.0000000000000394.

DOI:10.1097/ICL.0000000000000394

PMID:28520595

Abstract

PURPOSE

To investigate the impact of higher-order aberrations (HOAs) on visual acuity after repeat Descemet stripping automated endothelial keratoplasty (DSAEK) in the same eyes.

METHODS

This retrospective comparative case series includes 23 patients who underwent DSAEK twice in the same eyes (46 DSAEK in total). We evaluated the HOAs of the anterior and posterior corneal surfaces, and total cornea using the Fourier analysis data from anterior segment optical coherence tomography. Eyes were divided into one of the following groups, based on the improvement and decline in the best-corrected visual acuity (BCVA) after repeat DSAEK; group A: 12 eyes with an improvement ≥ 2 lines, group B: 12 eyes with a decline ≤ 2 lines, and group C: 11 eyes with no change or change within 1 line.

RESULTS

The HOAs of the posterior surface in group B were significantly greater than those of group A (P=0.028), whereas there were no significant differences in the anterior surface and total corneal HOAs between groups A and B (P=0.12 and 0.08). There were no significant differences in the anterior and posterior surface as well as total cornea HOAs between initial DSAEK and repeat DSAEK in group C (P=0.87, 0.65, and 0.42). The postoperative BCVA had a significant correlation with the HOAs of the anterior and posterior surfaces as well as the total cornea (R=0.40, 0.46, and 0.53; P=0.01, 0.002, and 0.001).

CONCLUSIONS

Posterior corneal HOAs can have a negative influence on the visual acuity after endothelial keratoplasty.

摘要

目的

研究高阶像差（HOAs）对同一只眼睛重复进行深板层角膜内皮移植术（DSAEK）后视力的影响。

方法

本回顾性比较病例系列研究纳入了23例在同一只眼睛上接受两次DSAEK手术的患者（共46次DSAEK手术）。我们使用眼前节光学相干断层扫描的傅里叶分析数据评估了角膜前表面、后表面及整个角膜的高阶像差。根据重复DSAEK术后最佳矫正视力（BCVA）的改善和下降情况，将眼睛分为以下几组：A组：12只眼睛，视力提高≥2行；B组：12只眼睛，视力下降≤2行；C组：11只眼睛，视力无变化或变化在1行以内。

结果

B组后表面的高阶像差显著大于A组（P = 0.028），而A组和B组前表面及整个角膜高阶像差无显著差异（P = 0.12和0.08）。C组初次DSAEK和重复DSAEK之间，前表面、后表面及整个角膜高阶像差均无显著差异（P = 0.87、0.65和0.42）。术后BCVA与前表面、后表面及整个角膜的高阶像差均有显著相关性（R = 0.40、0.46和0.53；P = 0.01、0.002和0.001）。