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老视眼中角膜形状改变水凝胶植入物取出后的视觉预后

Visual Prognosis after Explantation of a Corneal Shape-Changing Hydrogel Inlay in Presbyopic Eyes.

作者信息

Moshirfar Majid, Buckner Benjamin, Rosen David B, Heiland Madeline B, Ronquillo Yasmyne C, Skanchy David F, Liu Harry Y, Melton Tim, Werner Liliana, Hoopes Phillip C Jr

机构信息

John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Utah, Salt Lake City, UT, USA.

Utah Lions Eye Bank, Murray, UT, USA.

出版信息

Med Hypothesis Discov Innov Ophthalmol. 2019 Fall;8(3):139-144.

PMID:31598515
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6778472/
Abstract

The purpose of this case series is to report visual outcomes in patients who underwent explantation of the Raindrop® hydrogel corneal inlay. Retrospective chart review comprising four cases of explantation of the Raindrop® corneal shape-changing hydrogel inlay: pre-implantation, pre-explantation, and post-explantation values for uncorrected distance visual acuity, uncorrected near visual acuity, and corrected distance visual acuity (CDVA) were measured; keratometric and tomographic data were collected using the Pentacam system (Oculus, Inc). Three eyes were explanted for progressive haze after implantation that persisted even after removal; one eye was explanted due to poor visual acuity with no haze formation. All patients experienced decreased unaided and corrected distance visual acuity. Persistent increase in corneal thickness and mean keratometry was noted post-explantation. All four patients regained their original near visual acuities, but one patient had persistent one-line loss in CDVA. There are long lasting tomographic corneal changes following Raindrop inlay explantation. In addition, persistent increased corneal thickness could be related to semi-permanent changes in corneal structure and may account for residual haze experienced by patients. After explantation, patients may not return to baseline CDVA.

摘要

本病例系列的目的是报告接受Raindrop®水凝胶角膜嵌体取出术患者的视力结果。对4例Raindrop®角膜塑形水凝胶嵌体取出术进行回顾性病历审查：测量未矫正远视力、未矫正近视力和矫正远视力（CDVA）的植入前、取出前和取出后数值；使用Pentacam系统（奥culus公司）收集角膜曲率和断层扫描数据。3只眼因植入后出现渐进性混浊，即使取出后仍持续存在而被取出；1只眼因视力差且无混浊形成而被取出。所有患者的裸眼和矫正远视力均下降。取出后角膜厚度和平均角膜曲率持续增加。所有4例患者均恢复了原来的近视力，但1例患者的CDVA持续下降一行。Raindrop嵌体取出后角膜存在长期的断层扫描变化。此外，角膜厚度持续增加可能与角膜结构的半永久性变化有关，并可能解释患者经历的残留混浊。取出后，患者可能无法恢复到基线CDVA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cdb/6778472/8c22cb2e05f4/mehdiophth-8-139-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cdb/6778472/e50ee20cef82/mehdiophth-8-139-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cdb/6778472/17e4b4bb8262/mehdiophth-8-139-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cdb/6778472/561e4ffc3910/mehdiophth-8-139-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cdb/6778472/8c22cb2e05f4/mehdiophth-8-139-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cdb/6778472/e50ee20cef82/mehdiophth-8-139-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cdb/6778472/17e4b4bb8262/mehdiophth-8-139-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cdb/6778472/561e4ffc3910/mehdiophth-8-139-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cdb/6778472/8c22cb2e05f4/mehdiophth-8-139-g004.jpg

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本文引用的文献

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J Cataract Refract Surg. 2018 May;44(5):658-664. doi: 10.1016/j.jcrs.2018.03.029.
2
Corneal Inlays for Presbyopia Explanted Due to Corneal Haze.因角膜混浊而取出的用于治疗老花眼的角膜镶嵌物。
J Refract Surg. 2018 May 1;34(5):357-360. doi: 10.3928/1081597X-20180308-01.
3
Diagnostic and Management Tool for Monitoring Patients Implanted with a Shape-Changing Corneal Inlay.用于监测植入可变形角膜嵌体患者的诊断与管理工具
Case Rep Ophthalmol. 2018 Mar 2;9(1):190-196. doi: 10.1159/000484436. eCollection 2018 Jan-Apr.
4
Comparison of FDA safety and efficacy data for KAMRA and Raindrop corneal inlays.FDA关于KAMRA和Raindrop角膜镶嵌物的安全性和有效性数据比较。
Int J Ophthalmol. 2017 Sep 18;10(9):1446-1451. doi: 10.18240/ijo.2017.09.18. eCollection 2017.
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Preliminary Evidence of Successful Near Vision Enhancement With a New Technique: PrEsbyopic Allogenic Refractive Lenticule (PEARL) Corneal Inlay Using a SMILE Lenticule.一种新技术成功改善近视力的初步证据：使用小切口基质透镜切除术（SMILE）透镜的老花眼同种异体屈光性角膜嵌体（PEARL）
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