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角膜移植术后患者行 340 度弧形段基质内角膜环段植入的飞秒激光辅助植入的临床疗效:12 个月随访。

Clinical outcomes after femtosecond laser-assisted implantation of an intrastromal corneal ring segment with a 340-degree arc length in postkeratoplasty patients: 12-month follow-up.

机构信息

Department of Ophthalmology, Hospital Oftalmológico de Brasília-HOB, DF, Brazil.

出版信息

J Cataract Refract Surg. 2020 Jan;46(1):78-85. doi: 10.1016/j.jcrs.2019.08.006.

Abstract

PURPOSE

To assess the clinical outcomes after implantation of a new 340-degree arc length intrastromal corneal ring segment (ICRS) aided by the femtosecond laser in postkeratoplasty patients after a 12-month follow-up.

SETTING

Private practice, Brasilia, Brazil.

DESIGN

Prospective case series.

METHODS

Eyes with previous keratoplasty had ICRS implantation assisted by femtosecond laser. The primary outcome measure was the change in the uncorrected distance visual acuity (UDVA) 12 months postoperatively. The secondary outcome measures were the corrected distance visual acuity (CDVA), refraction, and corneal tomography 1, 3, 6, and 12 months postoperatively. The astigmatism results were analyzed using vector analysis through the double-angle polar plot.

RESULTS

Of the 18 patients, 7 (38.9%) were men, and 11 (61.1%) were women. The mean UDVA was 20/250 (1.15 logarithm of the minimum angle of resolution [logMAR]) before implantation and 20/70 (0.54 logMAR) at the last follow-up (P < .001). The mean CDVA improved from 20/35 (0.26 logMAR) to 20/25 (0.10 logMAR) (P < .001). The mean spherical equivalent and astigmatism components were significantly reduced after ICRS implantation. The mean corneal astigmatism decreased from 5.55 ± 2.29 D preoperatively to 3.92 ± 1.82 D postoperatively (P < .001). The CDVA remained the same or improved in 19 of 20 eyes and decreased by 1 line in 1 patient. There were no surgical complications.

CONCLUSION

A new ICRS with a 340-degree arc length was effective in treating postkeratoplasty eyes, improving visual acuity and reducing corneal astigmatism.

摘要

目的

评估在 12 个月随访后,接受飞秒激光辅助的新型 340 度弧长间质角膜环段(ICRS)植入术后的角膜移植术后患者的临床结果。

设置

巴西巴西利亚的私人诊所。

设计

前瞻性病例系列。

方法

接受过角膜移植术的眼睛接受飞秒激光辅助的 ICRS 植入。主要观察指标是术后 12 个月时未矫正的距离视力(UDVA)的变化。次要观察指标是术后 1、3、6 和 12 个月时的矫正距离视力(CDVA)、屈光度和角膜断层扫描。使用双角度极坐标图的矢量分析来分析散光结果。

结果

18 例患者中,男性 7 例(38.9%),女性 11 例(61.1%)。植入前 UDVA 平均为 20/250(1.15 最小分辨角对数[logMAR]),最后一次随访时为 20/70(0.54 logMAR)(P <.001)。平均 CDVA 从 20/35(0.26 logMAR)提高到 20/25(0.10 logMAR)(P <.001)。ICRS 植入后平均球镜和散光成分明显降低。平均角膜散光从术前的 5.55 ± 2.29 D 降至术后的 3.92 ± 1.82 D(P <.001)。20 只眼中 19 只视力保持不变或提高,1 只下降 1 行。无手术并发症。

结论

新型 340 度弧长 ICRS 治疗角膜移植术后眼有效,可提高视力,降低角膜散光。

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