Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan.
Baptist Eye Institute, Kyoto, Japan.
Sci Rep. 2021 Mar 16;11(1):5995. doi: 10.1038/s41598-021-85470-5.
Microwave thermokeratoplasty (MTK) is a surgical procedure for the correction of pathologic corneal steepening. The purpose of this study was to examine the postoperative outcomes of eyes with advanced keratoconus that underwent femtosecond-laser zig-zag penetrating keratoplasty (z-PK) following MTK for reshaping of the central cornea. This study involved 32 eyes of 32 consecutive advanced keratoconus patients; i.e., 25 eyes of 25 patients who underwent MTK prior to z-PK (MTK + z-PK group), and 7 eyes of 7 patients who underwent z-PK alone (z-PK group). In all treated eyes, visual acuity (VA) and corneal topography were measured before surgery and at 6-months postoperative. At 6-months postoperative, the mean uncorrected distance VA (logarithm of the minimum angle of resolution) and surface regularity index (SRI) of the MTK + z-PK group was 0.62 ± 0.39 (mean ± standard deviation) and 1.26 ± 0.45, respectively, while that in the z-PK group was 1.02 ± 0.18 and 7.64 ± 3.22, respectively. Both variables were significantly better in the MTK + z-PK group than in the z-PK group (P < 0.05). The findings in this study reveal that MTK prior to z-PKP is effective for improving UDVA and reducing the irregularity of corneal topography in patients with advanced keratoconus.
微波角膜热成形术（MTK）是一种用于矫正病理性角膜陡峭的手术。本研究旨在研究接受飞秒激光 zig-zag 穿透性角膜移植术（z-PK）治疗的晚期圆锥角膜患者的术后结果，这些患者在进行中央角膜重塑之前先接受了 MTK。本研究共涉及 32 只眼 32 例连续的晚期圆锥角膜患者；即 25 只眼 25 例患者先接受 MTK 后行 z-PK（MTK+z-PK 组），7 只眼 7 例患者单独接受 z-PK（z-PK 组）。所有治疗眼在术前和术后 6 个月测量视力（VA）和角膜地形图。术后 6 个月，MTK+z-PK 组的平均未矫正远视力（最小分辨角对数）和表面不规则指数（SRI）分别为 0.62±0.39（均值±标准差）和 1.26±0.45，而 z-PK 组分别为 1.02±0.18 和 7.64±3.22。MTK+z-PK 组的这两个变量均明显优于 z-PK 组（P<0.05）。本研究的结果表明，在 z-PKP 之前进行 MTK 对于改善晚期圆锥角膜患者的 UDVA 和降低角膜地形图的不规则性是有效的。
