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儿童圆锥角膜治疗中角膜环片植入术

Intracorneal Ring Segment Implantation for the Management of Keratoconus in Children.

作者信息

Larco Pablo, Larco Pablo, Torres Daniel, Piñero David P

机构信息

Clínica Larco Visión, Quito 170135, Ecuador.

Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain.

出版信息

Vision (Basel). 2020 Dec 23;5(1):1. doi: 10.3390/vision5010001.

Abstract

The short-term safety and efficacy of intracorneal ring segment (ICRS) implantation in keratoconus eyes of children are investigated in this study. A retrospective interventional case series study including a total of 33 keratoconus eyes (age 8 to 17 years) that had undergone ICRS (Keraring segments, Mediphacos) implantation was conducted. Information about visual, refractive, pachymetric, corneal topographic and aberrometric, and corneal endothelial changes during a 3-month follow-up were extracted and analysed. A significant improvement was observed in logMAR corrected distance visual acuity ( = 0.005), combined with a statistically significant reduction in keratometric readings ( < 0.001). A reduction in the magnitude of corneal astigmatism of ≥1 D was observed in 52.8% of eyes. No significant changes were observed in corneal endothelial density ( = 0.317). Significant changes were found in the anterior vertical coma component ( = 0.002) as well as in the spherical aberration of the posterior corneal surface ( = 0.004). Only two relevant complications were described: one corneal microperforation with penetration of the ring segment into the anterior chamber (1 eye, 2.8%), and a case of ring extrusion (1 eye, 2.8%). ICRS implantation in children keratoconus eyes allows a reduction of corneal astigmatism, irregularity, and aberrations, leading to a significant visual improvement.

摘要

本研究探讨了儿童圆锥角膜眼内角膜环植入术(ICRS)的短期安全性和有效性。进行了一项回顾性干预病例系列研究,共纳入33只接受ICRS(Keraring节段,Mediphacos)植入术的圆锥角膜眼(年龄8至17岁)。提取并分析了3个月随访期间的视力、屈光、角膜厚度、角膜地形图和像差以及角膜内皮变化等信息。观察到logMAR矫正远视力有显著改善( = 0.005),同时角膜曲率读数有统计学意义的降低( < 0.001)。52.8%的眼睛角膜散光度数降低≥1 D。角膜内皮密度未见显著变化( = 0.317)。在前垂直彗差分量( = 0.002)以及后角膜表面的球差( = 0.004)方面发现了显著变化。仅描述了两个相关并发症:1例角膜微穿孔伴环段穿透至前房(1只眼,2.8%),1例环段脱出(1只眼,2.8%)。儿童圆锥角膜眼植入ICRS可减少角膜散光、不规则性和像差,从而显著改善视力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fea/7838879/6363def49876/vision-05-00001-g001.jpg

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