Feizi Sepehr, Najafi Maryam, Javadi Mohammad Ali, Azari Amir A
Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Boostan 9 St., Pasdaran Ave., Tehran, 16666, Iran.
Int Ophthalmol. 2019 Nov;39(11):2553-2559. doi: 10.1007/s10792-019-01103-x. Epub 2019 Apr 9.
To determine the roundness of recipient corneal cuts after mechanical trephination and to investigate possible factors that could affect the corneal bed configuration in deep anterior lamellar keratoplasty (DALK).
This study enrolled 85 eyes with keratoconus that underwent DALK. Recipient corneas were partially trephined using a new, unused, disposable Hessburg-Barron suction trephine. Photographs that best represented the recipient corneal cut were selected, and ImageJ software was used to evaluate the roundness of recipient bed. The effect of potential variables on the roundness of cuts was investigated using the univariate analyses.
The mean patient age was 31.0 ± 9.0 years. The mean recipient trephine size was 8.04 ± 0.29 mm (range 7.5-8.50 mm). The recipient cut roundness was 0.922 ± 0.070, varying from 0.78 to 1.0. The roundness of the corneoscleral limbus (0.874 ± 0.074) which represented the shape of recipient cornea was the main predictor of the configuration of recipient cut (r = 0.84, P < 0.001). Other preoperative characteristics investigated were mean keratometry (P = 0.63), keratometric astigmatism (P = 0.18), central corneal thickness (P = 0.64), keratoconus severity (P = 0.37), and trephine size (P = 0.50) that demonstrated no significant associations with the roundness of cut.
The recipient corneal cut after mechanical trephination may not be circular. The roundness of recipient bed was primarily affected by the roundness of corneoscleral limbus, indicating that the shape of recipient cut tends to follow the original shape of the cornea.
确定机械环钻术后受体角膜切口的圆度，并研究可能影响深前板层角膜移植术（DALK）中角膜床形态的因素。
本研究纳入了85例行DALK的圆锥角膜患者。使用全新、未使用过的一次性Hessburg-Barron吸引环钻对受体角膜进行部分环钻。选择最能代表受体角膜切口的照片，并用ImageJ软件评估受体床的圆度。采用单因素分析研究潜在变量对切口圆度的影响。
患者平均年龄为31.0±9.0岁。受体环钻平均尺寸为8.04±0.29mm（范围7.5 - 8.50mm）。受体切口圆度为0.922±0.070，范围为0.78至1.0。代表受体角膜形状的角膜缘圆度（0.874±0.074）是受体切口形态的主要预测因素（r = 0.84，P < 0.001）。研究的其他术前特征包括平均角膜曲率（P = 0.63）、角膜曲率性散光（P = 0.18）、中央角膜厚度（P = 0.64）、圆锥角膜严重程度（P = 0.37）和环钻尺寸（P = 0.50），均与切口圆度无显著关联。
机械环钻术后受体角膜切口可能不是圆形。受体床的圆度主要受角膜缘圆度影响，表明受体切口形状倾向于遵循角膜的原始形状。
