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双连续缝线在飞秒激光辅助角膜层间角膜移植治疗圆锥角膜中的临床效果。

Clinical outcomes of double continuous suture in femtosecond laser-assisted lamellar keratoplasty for keratoconus.

机构信息

Shandong Eye Hospital, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, 372 Jingsi Road, Jinan, 250021, China.

出版信息

Lasers Med Sci. 2021 Jul;36(5):951-956. doi: 10.1007/s10103-020-03114-y. Epub 2020 Aug 3.

Abstract

To assess the surgical outcomes in patients who underwent femtosecond laser-assisted lamellar keratoplasty with double continuous suture for keratoconus, 100 patients (102 eyes) with keratoconus in advanced stages undergoing femtosecond laser-assisted lamellar keratoplasty in Shandong Eye Hospital were studied. In the management of keratoconus, 50 patients (52 eyes) received double continuous suture, and 50 patients (50 eyes) underwent interrupted suture. The follow-up duration was 1 year. Best-corrected visual acuity (BCVA), corneal astigmatism, cosmetic outcomes, and surgical complications were measured as outcome indicators. The epithelium healed at 3 ± 2 days and 4 ± 2 days in the double continuous suture group and the interrupted suture groups, respectively (P > 0.05). At 6 months after surgery, the average visual acuity was 20/125 and 20/100 (P > 0.05), and the average BCVA was 20/32 and 20/40 (P > 0.05), respectively. At 1 year after surgery, the average visual acuity was 20/63 and 20/80 (P > 0.05), and the average BCVA was 20/32 and 20/25 (P > 0.05), respectively; the mean curvature was 43.24 ± 5.15 D and 43.31 ± 5.58 D (P > 0.05), the mean astigmatism was 3.21 ± 1.74 D and 5.35 ± 1.37 D (P < 0.05).The looseness of sutures were found in 2 patients and 15 patients in both groups, respectively (P < 0.05). No postoperative infection or immune rejection occurred in either group during the follow-up. Comparing with the interrupted suture, using the continuous suture in femtosecond laser-assisted lamellar keratoplasty for keratoconus markedly limited the looseness of sutures with lesser corneal astigmatism and better visual quality postoperative.

摘要

为了评估接受飞秒激光辅助层状角膜切除术(FS-LASIK)联合双层连续缝线治疗圆锥角膜的手术效果,我们对山东眼科医院收治的 100 例(102 只眼)晚期圆锥角膜患者进行了研究。在圆锥角膜的治疗中,50 例(52 只眼)患者接受双层连续缝线,50 例(50 只眼)患者接受间断缝线。随访时间为 1 年。最佳矫正视力(BCVA)、角膜散光、美容效果和手术并发症作为疗效观察指标。上皮愈合时间在双层连续缝线组和间断缝线组分别为 3±2 天和 4±2 天(P>0.05)。术后 6 个月,平均视力分别为 20/125 和 20/100(P>0.05),平均 BCVA 分别为 20/32 和 20/40(P>0.05)。术后 1 年,平均视力分别为 20/63 和 20/80(P>0.05),平均 BCVA 分别为 20/32 和 20/25(P>0.05);平均曲率分别为 43.24±5.15D 和 43.31±5.58D(P>0.05),平均散光分别为 3.21±1.74D 和 5.35±1.37D(P<0.05)。两组各有 2 例和 15 例患者出现缝线松动(P<0.05)。两组患者在随访期间均未发生术后感染或免疫排斥反应。与间断缝线相比,FS-LASIK 术中使用连续缝线治疗圆锥角膜可明显减少缝线松动,术后角膜散光较小,视力质量较好。

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