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三种角膜内植入物治疗中央圆锥角膜的对比研究。

Comparative study of 3 intracorneal implant types to manage central keratoconus.

机构信息

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

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

出版信息

J Cataract Refract Surg. 2018 Mar;44(3):295-305. doi: 10.1016/j.jcrs.2017.12.020. Epub 2018 Mar 30.

Abstract

PURPOSE

To compare the visual acuity, refraction, corneal topography, and corneal asphericity of intrastromal corneal implantation of Keratacx 160-degree 2 symmetrical ring segment, the Keratacx 320-degree near-total ring, and the Myoring continuous intracorneal ring (ICR) in central keratoconus.

SETTING

Ophthalmology Department, Ain Shams University, Cairo, Egypt.

DESIGN

Prospective case series.

METHODS

Surgeries were performed using a femtosecond laser for tunnel creation for the 160-degree 2-segment device (Group 1) and the 320-degree near-total ring (Group 2), and for pocket creation for the ICR (Group 3). The preoperative and 6-month postoperative uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical equivalent (SE), corneal and refractive astigmatism, keratometry (K) readings, and Q value using topography images were acquired.

RESULTS

The study included 73 eyes. No statistically significant differences were found in the preoperative parameters between groups (P > .05). The postoperative UDVA, CDVA, SE, corneal and refractive astigmatisms, K readings, and Q value were statistically better than the preoperative parameters in all study groups (P < .01). A statistically significant increase in the median UDVA and CDVA occurred in Group 2 compared with Group 1 (P < .01). Groups 2 and 3 had a more effective reduction in SE (P < .01). No statistically significant difference was found in the postoperative changes in the corneal and refractive cylinders, mean and maximum K readings, and corneal asphericity between the study groups (P > .05).

CONCLUSIONS

All devices were effective in improving UDVA, CDVA, refraction, K readings, and corneal asphericity. The 320-degree segment and ICR improved UDVA and SE more than the 2-segment device.

摘要

目的

比较 Keratacx 160 度 2 对称环段、Keratacx 320 度近全环和 Myoring 连续角膜内环(ICR)在中央圆锥角膜中的视力、屈光度、角膜地形和角膜非球面性。

设置

埃及开罗艾因夏姆斯大学眼科系。

设计

前瞻性病例系列。

方法

使用飞秒激光为 160 度 2 段装置(第 1 组)和 320 度近全环(第 2 组)创建隧道,并为 ICR 创建口袋(第 3 组)进行手术。获得术前和术后 6 个月的未矫正(UDVA)和矫正(CDVA)远视力、等效球镜(SE)、角膜和屈光性散光、角膜曲率(K)读数以及使用地形图图像的 Q 值。

结果

本研究包括 73 只眼。各组间术前参数无统计学差异(P>.05)。所有研究组术后 UDVA、CDVA、SE、角膜和屈光性散光、K 读数和 Q 值均明显优于术前参数(P<.01)。与第 1 组相比,第 2 组的术后 UDVA 和 CDVA 中位数有统计学显著提高(P<.01)。第 2 组和第 3 组的 SE 降低更有效(P<.01)。各组间术后角膜和屈光性圆柱、平均和最大 K 读数以及角膜非球面性的变化无统计学差异(P>.05)。

结论

所有装置均可有效改善 UDVA、CDVA、屈光不正、K 读数和角膜非球面性。320 度段和 ICR 比 2 段装置提高了 UDVA 和 SE。

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