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圆锥角膜320度基质内环植入术的疗效:6个月随访结果

Outcomes of a 320-degree intrastromal corneal ring segment implantation for keratoconus: Results of a 6-month follow-up.

作者信息

Rocha Guilherme Andrade do Nascimento, Ferrara de Almeida Cunha Paulo, Torquetti Costa Leonardo, Barbosa de Sousa Luciene

机构信息

Hospital Oftalmológico de Brasília (HOB), Brasília, Brazil.

Private Clinic, Belo Horizonte, Brazil.

出版信息

Eur J Ophthalmol. 2020 Jan;30(1):139-146. doi: 10.1177/1120672118818018. Epub 2018 Dec 12.

Abstract

IMPORTANCE

This study shows that a newer long-arc length intrastromal corneal ring segment is efficient and safe for keratoconus treatment.

BACKGROUND

To evaluate visual, tomographic results and complications of a 320-degree intrastromal corneal ring segment implantation with the femtosecond laser for keratoconus treatment.

DESIGN

A prospective, nonrandomized, and interventional study.

PARTICIPANTS

A total of 34 eyes of 31 patients diagnosed with keratoconus were enrolled.

METHODS

Patients were divided into two groups based on the strategy used for 320-degree intrastromal corneal ring segment thickness selection. In one group, this selection was based on spherical equivalent (SE group) and in the other on the mean asphericity (Q group). The uncorrected and corrected distance visual acuities, spherical equivalent, , , , , and mean asphericity () on corneal tomography were evaluated preoperatively and at 3 and 6 months postoperatively. For astigmatism improvement, we analyzed the corneal tomographic vectorial astigmatism change preoperatively and at 6 months postoperatively. The mean follow-up period was 6.63 ± 0.96 months.

RESULTS

The mean uncorrected distance visual acuity and corrected distance visual acuity improved with a significant spherical equivalent improvement ( < 0.05), with no differences between the 320-degree intrastromal corneal ring segment groups. All corneal tomographic parameters improved significantly ( < 0.05) between the preoperative and postoperative intervals, with a significant better performance when we used spherical equivalent for the 320-degree intrastromal corneal ring segment thickness selection. Finally, the mean vectorial corneal tomographic astigmatism significantly improved after 6 months, again with no differences between groups.

CONCLUSION

This study suggests that implanting a 320-degree intrastromal corneal ring segment is a safe and effective procedure for treating patients with keratoconus. It also suggests that for thickness selection spherical equivalent is the better strategy.

摘要

重要性

本研究表明,一种新型长弧长基质内角膜环片用于圆锥角膜治疗有效且安全。

背景

评估使用飞秒激光植入320度基质内角膜环片治疗圆锥角膜的视力、断层扫描结果及并发症。

设计

一项前瞻性、非随机干预性研究。

参与者

共纳入31例诊断为圆锥角膜患者的34只眼。

方法

根据320度基质内角膜环片厚度选择策略将患者分为两组。一组基于球镜等效度(SE组),另一组基于平均非球面性(Q组)。术前及术后3个月和6个月评估未矫正及矫正远视力、球镜等效度、角膜地形图参数、平均非球面性。对于散光改善情况,分析术前及术后6个月角膜地形图矢量散光变化。平均随访期为6.63±0.96个月。

结果

平均未矫正远视力和矫正远视力提高,球镜等效度显著改善(P<0.05),320度基质内角膜环片组间无差异。术前与术后各角膜地形图参数均显著改善(P<0.05),采用球镜等效度选择320度基质内角膜环片厚度时表现更佳。最后,6个月后平均角膜地形图矢量散光显著改善,组间再次无差异。

结论

本研究提示,植入320度基质内角膜环片治疗圆锥角膜患者是一种安全有效的方法。还提示对于厚度选择,球镜等效度是更好的策略。

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