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飞秒激光植入 340 度角膜基质环治疗圆锥角膜:短期疗效。

Femtosecond laser implantation of a 340-degree intrastromal corneal ring segment in keratoconus: Short-term outcomes.

机构信息

From the Ophthalmic Research Center (Sadoughi, B. Einollahi, Veisi, Zare, Roshandel, N. Einollahi, Rezaei) and Scientific Educational Ophthalmology Excellence (B. Einollahi), Shahid Beheshti University of Medical Sciences, Tehran, and the Eye Research Center (Sedaghat), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

From the Ophthalmic Research Center (Sadoughi, B. Einollahi, Veisi, Zare, Roshandel, N. Einollahi, Rezaei) and Scientific Educational Ophthalmology Excellence (B. Einollahi), Shahid Beheshti University of Medical Sciences, Tehran, and the Eye Research Center (Sedaghat), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

J Cataract Refract Surg. 2017 Oct;43(10):1251-1256. doi: 10.1016/j.jcrs.2017.07.026.

DOI:10.1016/j.jcrs.2017.07.026
PMID:29120710
Abstract

PURPOSE

To evaluate the short-term outcomes of femtosecond laser-assisted implantation of a 340-degree intracorneal ring (ICR) (Keraring) in patients with keratoconus.

SETTING

Four centers in Iran.

DESIGN

Prospective case series.

METHODS

All cases had implantation of the 340-degree ICR after tunnel creation with a femtosecond laser. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, sphere, cylinder, manifest refraction spherical equivalent (MRSE), mean keratometry (K), steep K, and flat K were evaluated preoperatively and 1, 3, and 6 months postoperatively.

RESULTS

Eighteen eyes of 17 patients were included. The mean follow-up was 4.33 months (range 1 to 6 months). The mean UDVA improved from 0.95 logarithm of the minimum angle of resolution (logMAR) ± 0.33 (SD) to 0.53 ± 0.35 logMAR (P = .001) and the mean CDVA from 0.39 ± 0.22 logMAR to 0.26 ± 0.21 logMAR (P = .09). The mean sphere decreased from -5.08 ± 3.74 diopters (D) to -1.67 ± 2.59 D, the mean cylinder from -5.83 ± 2.02 D to -2.72 ± 1.81 D, and the mean MRSE from -8.03 ± 3.88 D to -3.01 ± 2.82 D (P < .001). The mean K decreased from 51.43 ± 3.59 D to 47.42 ± 3.59 D (P < .001). All patients with a preoperative mean K greater than 55.0 D had worse CDVA.

CONCLUSIONS

Implantation of a 340-degree ICR using femtosecond laser improved the visual, refractive, and topographic parameters in keratoconic patients. The findings indicate that patients with severe keratoconus (mean K >55.0 D) are not good candidates for this type of ICR.

摘要

目的

评估飞秒激光辅助植入角膜环(ICR)治疗圆锥角膜的短期效果。

设置

伊朗的 4 个中心。

设计

前瞻性病例系列。

方法

所有病例均采用飞秒激光制作隧道后植入 340 度 ICR(Keraring)。评估术前及术后 1、3、6 个月的未矫正(UDVA)和矫正(CDVA)距离视力、球镜、柱镜、实际屈光球镜等效(MRSE)、平均角膜曲率(K)、陡峭 K 和扁平 K。

结果

纳入 17 例 18 只眼。平均随访时间为 4.33 个月(1 至 6 个月)。平均 UDVA 从 0.95 对数最小分辨角视力(logMAR)±0.33(SD)改善至 0.53±0.35 logMAR(P=0.001),平均 CDVA 从 0.39±0.22 logMAR 改善至 0.26±0.21 logMAR(P=0.09)。平均球镜从-5.08±3.74 屈光度(D)降至-1.67±2.59 D,平均柱镜从-5.83±2.02 D 降至-2.72±1.81 D,平均 MRSE 从-8.03±3.88 D 降至-3.01±2.82 D(P<0.001)。平均 K 值从 51.43±3.59 D 降至 47.42±3.59 D(P<0.001)。所有术前平均 K 值大于 55.0 D 的患者 CDVA 均较差。

结论

飞秒激光辅助植入 340 度 ICR 可改善圆锥角膜患者的视力、屈光和地形图参数。研究结果表明,严重圆锥角膜(平均 K>55.0 D)患者不适合这种 ICR 类型。

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