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圆锥角膜治疗进展

Updates on Managements for Keratoconus.

作者信息

Mohammadpour Mehrdad, Heidari Zahra, Hashemi Hassan

机构信息

Eye Research Center, Ophthalmology Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.

出版信息

J Curr Ophthalmol. 2017 Dec 6;30(2):110-124. doi: 10.1016/j.joco.2017.11.002. eCollection 2018 Jun.

Abstract

PURPOSE

Keratoconus is a progressive disease of the cornea which can lead to blindness as irregular astigmatism increases. Currently, a variety of methods are available for the treatment of keratoconus, and in certain cases, it may be difficult to choose the most appropriate option. This article reviews available treatment modalities for keratoconus to provide the practitioner with practical and useful information for selecting the most suitable option for each individual patient.

METHODS

To review treatment methods for different stages of keratoconus, PubMed (United States National Library of Medicine) and Scopus (Elsevier BV) databases were searched using the keywords "keratoconus", "contact lens", "cross-linking", "Intacs", "keratoplasty", "gene therapy", and "irregular astigmatism", and related articles were reviewed based on disease assessment parameters and treatment methods.

RESULTS

Various methods are available for the treatment of keratoconus: eyeglasses and contact lenses in the early stages, cross-linking for stabilizing disease progression, intrastromal corneal ring segments (ICRS) for reducing refractive errors or flattening the cornea, and penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK), conductive keratoplasty, gene therapy and more recently, bowman layer transplantation (BL transplantation) in advanced stages of the disease. To achieve optimum results, it is essential to choose the best option for each individual patient.

CONCLUSIONS

A commonality of the reviewed papers was the advancement of novel diagnostic and treatment methods in ophthalmology, which can delay the need for corneal grafting. A better understanding of keratoconus treatment options can help enhance visual rehabilitation and prevent blindness in keratoconus patients.

摘要

目的

圆锥角膜是一种角膜的进行性疾病,随着不规则散光的增加可导致失明。目前,有多种方法可用于治疗圆锥角膜,在某些情况下,可能难以选择最合适的治疗方案。本文综述了圆锥角膜的现有治疗方式,为从业者提供实用且有用的信息,以便为每位患者选择最合适的治疗方案。

方法

为了综述圆锥角膜不同阶段的治疗方法,使用关键词“圆锥角膜”“隐形眼镜”“交联”“角膜基质环植入术(Intacs)”“角膜移植术”“基因治疗”和“不规则散光”检索了美国国立医学图书馆的PubMed数据库和爱思唯尔公司的Scopus数据库,并根据疾病评估参数和治疗方法对相关文章进行了综述。

结果

圆锥角膜有多种治疗方法:早期使用眼镜和隐形眼镜,交联用于稳定疾病进展,角膜基质内角膜环片(ICRS)用于减少屈光不正或使角膜变平,穿透性角膜移植术(PK)和深板层角膜移植术(DALK)、传导性角膜成形术、基因治疗,以及在疾病晚期最近出现的Bowman层移植术(BL移植术)。为获得最佳效果,为每位患者选择最佳治疗方案至关重要。

结论

综述文章的一个共同特点是眼科新诊断和治疗方法的进步,这可以推迟角膜移植的需求。更好地了解圆锥角膜的治疗选择有助于加强视力康复并预防圆锥角膜患者失明。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/103d/6034171/e0a1f195249d/gr1.jpg

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