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应用角膜波前引导的经上皮光性角膜切削术治疗流行性角膜结膜炎后角膜混浊的视力康复。

Visual rehabilitation by using corneal wavefront-guided transepithelial photorefractive keratectomy for corneal opacities after epidemic keratoconjunctivitis.

机构信息

Beyoglu Eye Training and Research Hospital, University of Health Sciences, Bereketzade Camii Sok., No 2 Beyoglu, Istanbul, Turkey.

出版信息

Int Ophthalmol. 2021 Jun;41(6):2149-2156. doi: 10.1007/s10792-021-01772-7. Epub 2021 Mar 17.

Abstract

PURPOSE

To evaluate long-term visual and refractive outcomes of corneal wavefront-guided transepithelial photorefractive keratectomy (t-PRK) with mitomycin C for the treatment of corneal opacities secondary to adenoviral epidemic keratoconjunctivitis.

METHODS

Records of patients who underwent corneal wavefront-guided t-PRK with excimer laser from January 2012 to December 2018 were retrospectively reviewed. Preoperative and postoperative uncorrected visual acuity, best-spectacle corrected visual acuity, slit-lamp biomicroscopic examination findings, manifest refraction, and corneal aberrations and fundus examination findings were evaluated.

RESULTS

Twenty-two eyes of 22 patients comprising 12 male (55%) and 10 female (45%) were treated. The mean age was 34.5 ± 10.8 years (range 19-55). The mean follow-up time was 34.4 ± 17.50 months (range 13-61 months). There was a statistically significant improvement in UCVA and BSCVA (p < 0.001 and p = 0.02), and there was a significant decrease in total higher-order aberrations, spherical, coma and trefoil aberration at postoperative first year (p < 0.001 in each). In two eyes of two patients, minimal haze formation was observed after the procedure, and both eyes were treated with topical steroid. No recurrence was observed in subepithelial infiltrates in any patient during long-term follow-up.

CONCLUSION

In long-term clinical follow-up, corneal wavefront-guided t-PRK treatment is an effective and reliable treatment method for rehabilitation of visual impairment due to corneal scars following adenoviral infections, in properly selected patients.

摘要

目的

评估角膜波前引导的经上皮准分子激光光折射性角膜切削术(t-PRK)联合丝裂霉素 C 治疗腺病毒性流行角膜结膜炎后角膜混浊的长期视力和屈光结果。

方法

回顾性分析 2012 年 1 月至 2018 年 12 月期间接受角膜波前引导 t-PRK 联合准分子激光治疗的患者的病历。评估术前和术后的未矫正视力、最佳矫正视力、裂隙灯显微镜检查结果、显斜视、角膜像差和眼底检查结果。

结果

22 例 22 眼患者(12 例男性,占 55%;10 例女性,占 45%)接受了治疗。平均年龄为 34.5 ± 10.8 岁(范围 19-55 岁)。平均随访时间为 34.4 ± 17.50 个月(范围 13-61 个月)。UCVA 和 BSCVA 均有统计学显著改善(p < 0.001 和 p = 0.02),术后第一年总高阶像差、球镜、彗差和三叶像差显著降低(p < 0.001)。两名患者的两眼中术后出现轻微混浊,均接受局部皮质类固醇治疗。在长期随访中,没有发现任何患者的上皮下浸润有复发。

结论

在长期临床随访中,角膜波前引导的 t-PRK 治疗是一种有效和可靠的治疗方法,适用于适当选择的患者,可改善腺病毒感染后角膜瘢痕导致的视力损害。

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