圆锥角膜眼60%深度植入费拉拉角膜环片段后的屈光和视觉效果：病例系列
Refractive and visual outcomes after Ferrara corneal ring segment implantation at a 60% depth in keratoconic eyes: case series.
作者信息
Renesto Adimara da Candelaria, Hirai Flávio E, Campos Mauro
机构信息
Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
出版信息
Arq Bras Oftalmol. 2019 Aug 29;82(6):488-494. doi: 10.5935/0004-2749.20190091. eCollection 2019.
PURPOSE
This report addresses refractive, topographic, visual acuity, and optical coherence tomography outcomes 12 months after femtosecond, laser-assisted insertion of Ferrara intrastromal corneal ring segments in keratoconic eyes at a depth of 60%.
METHODS
Interventional, prospective, non-comparative case series. We performed femtosecond, laser-assisted insertion of Ferrara intrastromal corneal ring segments in 15 keratoconic eyes. We included patients with documented keratoconus who voluntarily signed informed consents if they had best spectacle-corrected visual acuity ≥0.30 logMAR and corneal thickness ≥400 μm. We excluded patients with previous ocular surgery or corneal curvatures >65 diopters (D). Our main outcome measures were best spectacle-corrected visual acuity and corneal topographic parameters (flattest, steepest and average keratometry [K]), evaluated at baseline and at 1-,3-,6-, and 12-month follow-ups.
RESULTS
The mean ± standard deviation baseline uncorrected visual acuity and best spectacle-corrected visual acuity were 1.03 ± 0.46 and 0.42 ± 0.13, respectively; the 12-month mean standard deviation uncorrected visual acuity and best spectacle-corrected visual acuity were 0.72 ± 0.37 and 0.31 ± 0.16, respectively, without significant differences (p=0.05 for both). The mean best spectacle-corrected visual acuity improvements were statistically significant after 3- (p=0.02) and after 6-months (p=0.02). The mean baseline flattest (K1), steepest (K2), and overall keratometries (mean power) were 48.35 ± 3.65 D, 53.67 ± 3.38 D, and 50.84 ± 3.36 D, respectively. The 12-month mean ± standard deviations for flattest-K1, steepest-K2, and overall K were 46.53 ± 3.70 D, 49.83 ± 3.50 D, and 48.12 ± 3.49 D respectively, with statistically significant differences for all three topographic parameters (p=0.01).
CONCLUSIONS
Ferrara intrastromal corneal ring segment insertions at a depth of 60% yield satisfactory visual, refractive, and keratometric results in keratoconic eyes.
目的
本报告阐述了在圆锥角膜眼中，飞秒激光辅助下以60%的深度植入费拉拉基质内角膜环段12个月后的屈光、地形图、视力及光学相干断层扫描结果。
方法
干预性、前瞻性、非对照病例系列研究。我们对15只圆锥角膜眼进行了飞秒激光辅助下的费拉拉基质内角膜环段植入术。纳入标准为确诊圆锥角膜且自愿签署知情同意书的患者，其最佳矫正视力≥0.30 logMAR且角膜厚度≥400μm。排除既往有眼部手术史或角膜曲率>65屈光度（D）的患者。主要观察指标为最佳矫正视力和角膜地形图参数（最平坦、最陡峭及平均角膜曲率[K]），于基线及1、3、6和12个月随访时进行评估。
结果
平均±标准差的基线未矫正视力和最佳矫正视力分别为1.03±0.46和0.42±0.13；12个月时平均标准差未矫正视力和最佳矫正视力分别为0.72±0.37和0.31±0.16，均无显著差异（两者p均=0.05）。最佳矫正视力的平均改善在3个月后（p=0.02）及6个月后（p=0.02）具有统计学意义。平均基线最平坦（K1）、最陡峭（K2）及总体角膜曲率（平均屈光度）分别为48.35±3.65 D、53.67±3.38 D及50.84±3.36 D。12个月时最平坦-K1、最陡峭-K2及总体K的平均±标准差分别为46.53±3.70 D、49.83±3.50 D及48.12±3.49 D，所有三个地形图参数均有统计学意义（p=0.01）。
结论
在圆锥角膜眼中，以60%的深度植入费拉拉基质内角膜环段可获得满意的视力、屈光及角膜曲率测量结果。
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