Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Am J Ophthalmol. 2020 Jul;215:8-13. doi: 10.1016/j.ajo.2020.03.003. Epub 2020 Mar 20.
To measure and compare corneal biomechanics in patients with macular corneal dystrophy (MCD), versus those who underwent penetrating keratoplasty (PK) for MCD, versus normal subjects.
Cross-sectional study.
This study enrolled 24 eyes with MCD, 25 eyes that underwent PK in patients with preoperative diagnosis of MCD, and 28 normal eyes. The ocular response analyzer was used to measure corneal biomechanical properties, including corneal resistance factor (CRF) and corneal hysteresis (CH). Intraocular pressure (IOP) was measured using a Goldmann applanation tonometer, and central corneal thickness (CCT) was measured using an ultrasonic pachymeter. The CCT, CRF, CH, and IOP were compared among the study group.
CCT was significantly lower in the MCD group (423 ± 47 mμ) than in the PK group (541 ± 31 mμ; P < .001) and the controls (540 ± 26 mμ; P < .001). Meanwhile, CCT was comparable between the PK and control groups (P = .98). CRF did not differ between the MCD (8.34 ± 2.12 mm Hg) and the PK (8.66 ± 1.66 mm Hg) groups (P = .89); however, both of these groups had lower CRF values than the control (9.76 ± 1.83 mm Hg, P = .02) group. No significant differences were observed among the 3 groups in CH (P = .13). IOP values did not differ between the MCD (11.25 ± 1.69 mm Hg) and PK (12.0 ± 2.67 mm Hg) groups (P = .95); however, the IOP values for both of these groups differed significantly from those of the controls (13.46 ± 2.17 mm Hg; P = .006).
CRF was significantly reduced in MCD and did not return to normal values even after PK. The reduced corneal rigidity could result in underestimating IOP in patients with MCD and in those undergoing PK for this stromal dystrophy.
测量和比较黄斑角膜营养不良(MCD)患者、接受 MCD 穿透性角膜移植术(PK)的患者以及正常受试者的角膜生物力学。
横断面研究。
本研究纳入了 24 只患有 MCD 的眼睛、25 只术前诊断为 MCD 并接受 PK 的眼睛以及 28 只正常眼睛。使用眼反应分析仪测量角膜生物力学特性,包括角膜阻力因子(CRF)和角膜滞后(CH)。使用 Goldmann 压平眼压计测量眼压(IOP),使用超声角膜测厚仪测量中央角膜厚度(CCT)。比较研究组的 CCT、CRF、CH 和 IOP。
MCD 组的 CCT(423±47μm)明显低于 PK 组(541±31μm;P<.001)和对照组(540±26μm;P<.001)。同时,PK 组和对照组的 CCT 无差异(P=0.98)。MCD 组(8.34±2.12mm Hg)和 PK 组(8.66±1.66mm Hg)的 CRF 无差异(P=0.89);然而,这两组的 CRF 值均低于对照组(9.76±1.83mm Hg,P=0.02)。三组间 CH 无显著差异(P=0.13)。MCD 组(11.25±1.69mm Hg)和 PK 组(12.0±2.67mm Hg)的 IOP 无差异(P=0.95);然而,这两组的 IOP 值均明显低于对照组(13.46±2.17mm Hg;P=0.006)。
MCD 患者的 CRF 明显降低,即使接受 PK 后也未恢复正常。角膜刚性降低可能导致低估 MCD 患者和接受该基质营养不良 PK 患者的 IOP。