Nowińska Anna, Chlasta-Twardzik Edyta, Dembski Michał, Ulfik-Dembska Klaudia, Wylęgała Edward
Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
Ophthalmology Department, Railway Hospital, 40-760 Katowice, Poland.
Diagnostics (Basel). 2021 Feb 2;11(2):223. doi: 10.3390/diagnostics11020223.
This study focused on defining the characteristic features of keratometry and pachymetry elevation maps based on swept source optical coherence tomography (SS OCT) in Fuchs endothelial corneal dystrophy (FECD) eyes with a coexisting cataract. 70 eyes of 35 patients diagnosed with FECD and a coexisting cataract and 70 control eyes were included in this prospective, controlled, observational, cross-sectional study. Features characteristic of intermediately affected eyes included an increased corneal thinnest thickness (CTT) ( = 0.01), 3 and 6 mm asymmetry ( < 0.0001), higher order Fourier indices ( < 0.05 and ≤ 0.0001, respectively), chord µ, and a posterior Ectasia Screening Index (pESI) ( < 0.01). The lack of agreement between the anterior and posterior elevation map and a significant area of negative values in the posterior map were detected. In advanced FECD eyes, our study additionally revealed decreased posterior keratometry steep (Ks), keratometry flat (Kf), keratometry average (AvgK), eccentricity (Ecc), an increased corneal apex thickness (CAT), and decreased 3 and 6 mm posterior spherical indices ( < 0.0001 for all of the above). Characteristic features of subclinical FECD, independent of the corneal thickness, can be detected by SS OCT and should be considered during the preoperative assessment of patients with a coexisting cataract.
本研究聚焦于确定基于扫频源光学相干断层扫描（SS OCT）的角膜曲率测量和角膜厚度测量高度图在合并白内障的Fuchs内皮性角膜营养不良（FECD）眼中的特征。这项前瞻性、对照、观察性横断面研究纳入了35例诊断为FECD且合并白内障患者的70只眼以及70只对照眼。中度受累眼的特征包括角膜最薄厚度（CTT）增加（ = 0.01）、3毫米和6毫米处的不对称性（ < 0.0001）、高阶傅里叶指数（分别为 < 0.05和 ≤ 0.0001）、弦µ以及后弹力层膨隆筛查指数（pESI）（ < 0.01）。检测到前、后高度图之间缺乏一致性以及后高度图中有显著的负值区域。在晚期FECD眼中，我们的研究还发现后角膜曲率陡峭度（Ks）、角膜曲率平坦度（Kf）、角膜曲率平均值（AvgK）、偏心率（Ecc）降低，角膜顶点厚度（CAT）增加，以及3毫米和6毫米处的后表面球镜指数降低（上述所有指标均 < 0.0001）。SS OCT可检测到与角膜厚度无关的亚临床FECD的特征，在合并白内障患者的术前评估中应予以考虑。
