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角膜密度测定评估 PRK 术后角膜混浊及羊膜移植无缝线的效果。

Assessment of Corneal Haze After PRK and the Effect of Sutureless Amniotic Membrane Graft by Corneal Densitometry.

出版信息

J Refract Surg. 2020 May 1;36(5):293-299. doi: 10.3928/1081597X-20200406-01.

Abstract

PURPOSE

To assess whether densitometry analysis appropriately monitors the development of haze in myopic patients after photorefractive keratectomy (PRK) when compared to subjective slit-lamp haze grade examinations, and whether sutureless cryo-preserved amniotic membrane reduced postoperative haze development when compared to the standard bandage contact lens.

METHODS

In this retrospective cohort at the Center for Refractive Surgery, Walter Reed National Military Medical Center, a secondary analysis of prospectively collected data was performed. In the prospective study, participants underwent PRK for myopia. Postoperatively, a standard bandage contact lens was applied to the dominant eye and a sutureless cryo-preserved amniotic membrane graft to the nondominant eye. Participants were evaluated at 1, 3, and 6 months postoperatively for haze formation and corneal densitometry using slit-lamp biomicroscopy and Scheimpflug imaging, respectively.

RESULTS

Densitometry measurements at 6 months postoperatively were positively and significantly associated with the presence or absence of haze as assessed by slit-lamp examination in 39 patients (78 eyes; age range: 21 to 44 years). Eyes with increased densitometry measurements had 2.3 to 3.4 times the odds (P ⩽ .014) of having clinical haze on slit-lamp examination. Eyes with the amniotic membrane graft showed a positive correlation with increased corneal densitometry throughout most layers of the cornea.

CONCLUSIONS

Densitometry analysis appears to be a useful tool to supplement slit-lamp examination in monitoring haze development after PRK. The amniotic membrane failed to show a reduction in corneal densitometry in myopic eyes after PRK. [J Refract Surg. 2020;36(5):293-299.].

摘要

目的

评估与主观裂隙灯混浊分级检查相比,密度测定分析在评估光折射性角膜切削术(PRK)后近视患者混浊发展情况时是否更合适,以及与标准绷带接触镜相比,无缝线冷冻保存羊膜是否能减少术后混浊发展。

方法

在沃尔特里德国家军事医疗中心屈光手术中心进行的回顾性队列研究中,对前瞻性收集的数据进行了二次分析。在这项前瞻性研究中,参与者接受了 PRK 治疗近视。术后,主导眼应用标准绷带接触镜,非主导眼应用无缝线冷冻保存羊膜移植物。术后 1、3 和 6 个月,分别使用裂隙灯生物显微镜和 Scheimpflug 成像评估混浊形成和角膜密度。

结果

在 39 例(78 只眼;年龄范围:21 至 44 岁)患者中,术后 6 个月的密度测量值与裂隙灯检查评估的混浊存在或不存在呈正相关且具有显著意义。密度测量值增加的眼睛出现临床混浊的可能性是裂隙灯检查无混浊的眼睛的 2.3 至 3.4 倍(P ⩽.014)。羊膜移植物眼的角膜密度在角膜的大多数层中均呈正相关,表现为角膜密度增加。

结论

密度测定分析似乎是一种有用的工具,可补充 PRK 后裂隙灯检查来监测混浊发展。羊膜在 PRK 后未能降低近视眼中的角膜密度。[J Refract Surg. 2020;36(5):293-299.].

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