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与穿透性角膜移植术相比,深板层角膜移植术(液体分离法)治疗圆锥角膜后的视力质量。

Quality of Vision after Deep Anterior Lamellar Keratoplasty (Fluid Dissection) Compared to Penetrating Keratoplasty for the Treatment of Keratoconus.

作者信息

Hamdi Islam Mahmoud, Hamdi Momen Mahmoud

机构信息

Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

The Eye Consultants Center, Jeddah, Saudi Arabia.

出版信息

J Ophthalmol. 2017;2017:4507989. doi: 10.1155/2017/4507989. Epub 2017 Jul 20.

DOI:10.1155/2017/4507989
PMID:28808586
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5541790/
Abstract

PURPOSE

To compare the visual quality of patients with keratoconus who underwent penetrating keratoplasty (PKP) or deep anterior lamellar keratoplasty (DALK) with fluid dissection.

DESIGN

Cross-sectional, observational study.

METHODS

Twelve eyes that underwent PKP (PKP group) were compared to 24 eyes that underwent DALK (DALK group) after complete removal of sutures and stability of refraction. Visual, refractive, corneal topographic, corneal aberrometry, and ocular aberrometry parameters were compared for both groups. The and Mann-Whitney tests were used for comparisons as appropriate. < 0.05 was considered statistically significant.

RESULTS

Uncorrected and best spectacle-corrected visual acuity (UCVA and BSCVA, resp.), mean refractive spherical equivalent and mean refractive cylinder (MRSE and MRC, resp.), root mean square of the 3 mm and 5 mm OPD Scan (NIDEK Co. Ltd., Gamagori, Japan), steep and flat meridians (SimK1 and SimK2, resp.), and the difference (corneal cylinder) were not statistically significantly different between groups ( > 0.05, all comparisons). All aberrations, point spread functions (PSF), and the modulation transfer function (MTF) were not statistically different between groups ( > 0.05).

CONCLUSION

For our small study, the postoperative PKP and DALK with fluid dissection patient groups had vision/optical quality parameters that were not statistically different. This may indicate that DALK with fluid dissection can replace PKP for keratoconus without compromising vision quality.

摘要

目的

比较接受穿透性角膜移植术(PKP)或带液体分离的深板层角膜移植术(DALK)的圆锥角膜患者的视觉质量。

设计

横断面观察性研究。

方法

将12只接受PKP的眼(PKP组)与24只接受DALK的眼(DALK组)在缝线完全拆除且屈光稳定后进行比较。比较两组的视觉、屈光、角膜地形图、角膜像差和眼像差参数。根据情况使用t检验和曼-惠特尼U检验进行比较。P<0.05被认为具有统计学意义。

结果

两组之间的未矫正和最佳矫正视力(分别为UCVA和BSCVA)、平均等效球镜度和平均柱镜度(分别为MRSE和MRC)、3毫米和5毫米OPD扫描(日本蒲郡市尼德克有限公司)的均方根、陡峭和扁平子午线(分别为SimK1和SimK2)以及差值(角膜柱镜度)均无统计学显著差异(所有比较P>0.05)。两组之间所有像差、点扩散函数(PSF)和调制传递函数(MTF)均无统计学差异(P>0.05)。

结论

对于我们的小型研究,术后接受PKP和带液体分离的DALK的患者组的视力/光学质量参数无统计学差异。这可能表明带液体分离的DALK可以替代PKP治疗圆锥角膜且不影响视力质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e4e/5541790/881ed6c8054b/JOPH2017-4507989.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e4e/5541790/5bcb9b747f41/JOPH2017-4507989.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e4e/5541790/881ed6c8054b/JOPH2017-4507989.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e4e/5541790/5bcb9b747f41/JOPH2017-4507989.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e4e/5541790/881ed6c8054b/JOPH2017-4507989.002.jpg

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本文引用的文献

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Human corneal anatomy redefined: a novel pre-Descemet's layer (Dua's layer).人类角膜解剖结构的重新定义:一种新的前 Descemet 膜(Dua 层)。
Ophthalmology. 2013 Sep;120(9):1778-85. doi: 10.1016/j.ophtha.2013.01.018. Epub 2013 May 25.
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Refractive and visual outcomes of penetrating keratoplasty versus deep anterior lamellar keratoplasty with hydrodissection for treatment of keratoconus.穿透性角膜移植术与水分离深层前板层角膜移植术治疗圆锥角膜的屈光和视觉效果。
Cornea. 2013 Apr;32(4):e2-5. doi: 10.1097/ICO.0b013e31825ca70b.
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Penetrating keratoplasty versus deep anterior lamellar keratoplasty: comparison of optical and visual quality outcomes.
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Br J Ophthalmol. 2012 Aug;96(8):1063-7. doi: 10.1136/bjophthalmol-2011-301349. Epub 2012 Jun 20.
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Long-term results of deep anterior lamellar versus penetrating keratoplasty.深板层角膜移植与穿透性角膜移植的长期效果比较。
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Outcomes of deep anterior lamellar keratoplasty versus intralase enabled penetrating keratoplasty in keratoconus.深板层角膜移植与飞秒激光辅助的穿透性角膜移植治疗圆锥角膜的疗效比较。
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Influence of graft-host interface on the quality of vision after deep anterior lamellar keratoplasty in patients with keratoconus.圆锥角膜患者行深板层角膜移植术后植片-宿主界面影响视觉质量。
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