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板层角膜切开术后角膜神经改变与角膜并发症相关。

Corneal Nerves Alteration Associated with Corneal Complications after Pars Plana Vitrectomy.

机构信息

Department of Vitreous and Retina, He Eye Specialist Hospital, Shenyang, China.

Department of Vitreous and Retina, Bright Eye Hospital, Hefei, China.

出版信息

Korean J Ophthalmol. 2021 Aug;35(4):255-260. doi: 10.3341/kjo.2021.0048. Epub 2021 Jun 21.

Abstract

PURPOSE

To evaluate the effect of corneal nerves assessment on predicting corneal complications following pars plana vitrectomy (PPV).

METHODS

In this prospective single-center cohort study, 94 patients (94 eyes) received PPV, and were divided into postoperative groups with and without corneal complications. All eyes had corneal nerve fiber length (CNFL), corneal nerve fiber density, and branch density of corneal nerve fibers assessed and calculated with Image J preoperatively. Multivariate logistic regression analysis was used to identify corneal nerve fiber parameters that correlated to post-operative corneal complications. Receiver operator characteristic curve analysis was performed to identify the optimal cut-off point of the corneal fibers' parameters for predicting corneal complications after PPV.

RESULTS

Eleven eyes (11.70%) developed corneal complications at 1 week after PPV. There was significant difference between CNFL (19.44 ± 6.88 vs. 26.84 ± 7.53, p = 0.003), corneal nerve fiber density (28.82 ± 9.91 vs. 37.10 ± 10.16, p = 0.013) and branch density of corneal nerve fibers (55.84 ± 21.08 vs. 82.04 ± 31.89, p = 0.01) in two groups, respectively. Receiver operator characteristic analysis showed that the optimal cutoff value of CNFL to predict corneal complications following PPV was <26.495 mm/mm2.

CONCLUSIONS

The decrease of CNFL may predict corneal complications following PPV. Regular preoperative corneal confocal microscopy test in PPV patients could be considered.

摘要

目的

评估角膜神经评估对预测玻璃体切除术(PPV)后角膜并发症的效果。

方法

在这项前瞻性单中心队列研究中,94 名患者(94 只眼)接受了 PPV,并分为术后有角膜并发症和无角膜并发症两组。所有患者均在术前使用 Image J 评估角膜神经纤维长度(CNFL)、角膜神经纤维密度和角膜神经纤维分支密度。采用多变量逻辑回归分析确定与术后角膜并发症相关的角膜神经纤维参数。进行受试者工作特征曲线分析,以确定预测 PPV 后角膜并发症的角膜纤维参数的最佳截断点。

结果

11 只眼(11.70%)在 PPV 后 1 周出现角膜并发症。两组间 CNFL(19.44±6.88 与 26.84±7.53,p=0.003)、角膜神经纤维密度(28.82±9.91 与 37.10±10.16,p=0.013)和角膜神经纤维分支密度(55.84±21.08 与 82.04±31.89,p=0.01)差异均有统计学意义。受试者工作特征分析显示,CNFL 预测 PPV 后角膜并发症的最佳截断值为<26.495mm/mm2。

结论

CNFL 的降低可能预测 PPV 后角膜并发症。可考虑对 PPV 患者进行常规术前角膜共焦显微镜检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/226a/8357606/50e03bef4783/kjo-2021-0048f1.jpg

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