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[飞秒激光基质内角膜环片植入术和MyoRing植入术治疗圆锥角膜后角膜像差的对比分析]

[Comparative analysis of corneal aberrations after intrastromal segments and MyoRing implantation using femtosecond laser in patients with keratoconus].

作者信息

Pashtaev N P, Pozdeeva N A, Sinitsyn M V

机构信息

Cheboksary branch of S. Fyodorov Eye Microsurgery Federal State Institution, 10 Traktorostroiteley St., Cheboksary, Chuvash Republic, Russia, 428028; I.N. Ulyanov Chuvash State University, 15 Moskovskiy pr., Cheboksary, Russia, 428015.

Cheboksary branch of S. Fyodorov Eye Microsurgery Federal State Institution, 10 Traktorostroiteley St., Cheboksary, Chuvash Republic, Russia, 428028.

出版信息

Vestn Oftalmol. 2017;133(3):3-8. doi: 10.17116/oftalma201713334-8.

Abstract

AIM

to comparatively analyze corneal aberrations after intrastromal corneal segments (ICS) and MyoRing implantation using femtosecond laser in patients with stage II-III keratoconus (KC) by Pentacam examination.

MATERIAL AND METHODS

We have operated on 135 patients (145 eyes) with stage II or III KC. Depending on surgical technique, all patients were divided into two groups. Group I consisted of patients with KC, who received optimized femtosecond laser-assisted MyoRing implantation, group II - of those, who received femtosecond laser-assisted ICS implantation. Depending on the stage of the disease, each group was further divided into two subgroups, for stage II and stage III KC, respectively. Before and after surgery, all patients underwent visometry, biomicroscopy, corneal topography, and corneal aberrations measurement under photopic and mesopic conditions on Pentacam. The follow-up period averaged 30 months (from 6 to 34 months).

RESULTS

In both groups corneal aberrations significantly decreased after surgery, which was confirmed by an improvement in parameters of refraction and keratometry readings.

CONCLUSION

Implantation of intrastromal MyoRings leads to a greater reduction in the total corneal aberration, higher-order aberrations under photopic and mesopic conditions, and spherical aberration under photopic conditions as compared to ICS in patients with stage III KC; a comparable reduction in the total corneal, higher-order, and spherical aberrations under photopic conditions as compared to ICS in patients with stage II KC; a comparable increase in spherical aberration under mesopic conditions as compared to ICS in patients with stage III KC.

摘要

目的

通过Pentacam检查,比较分析飞秒激光在II - III期圆锥角膜(KC)患者中植入基质角膜环片(ICS)和MyoRing后的角膜像差。

材料与方法

我们对135例(145只眼)II期或III期KC患者进行了手术。根据手术技术,将所有患者分为两组。第一组为接受优化飞秒激光辅助MyoRing植入的KC患者,第二组为接受飞秒激光辅助ICS植入的患者。根据疾病阶段,每组再进一步分为两个亚组,分别对应II期和III期KC。手术前后,所有患者均在Pentacam上进行了视力测定、生物显微镜检查、角膜地形图检查以及在明视和暗视条件下的角膜像差测量。随访期平均为30个月(6至34个月)。

结果

两组患者术后角膜像差均显著降低,屈光参数和角膜曲率读数的改善证实了这一点。

结论

与ICS相比,在III期KC患者中植入基质内MyoRing可使总角膜像差、明视和暗视条件下的高阶像差以及明视条件下的球差有更大程度的降低;在II期KC患者中,与ICS相比,明视条件下总角膜、高阶和球差的降低程度相当;在III期KC患者中,与ICS相比,暗视条件下球差的增加程度相当。

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