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在轻度角膜顶端混浊的圆锥角膜中植入角膜环片段治疗后的临床结果。

Clinical outcomes after intracorneal ring segment implantation for keratoconus management in corneas with mild apical haze.

作者信息

Elalfy Mohamed, Maqsood Sundas, Reinhold Aja, Panos Georgios D, Khine Aye, Lake Damian, Hamada Samer, Gatzioufas Zisis

机构信息

Corneo-Plastic Unit, Queen Victoria Hospital NHS Trust, Holtye Road, East Grinstead RH19 3DZ, West Sussex, UK.

Corneo-Plastic Unit, Queen Victoria Hospital NHS, East Grinstead, UK.

出版信息

Ther Adv Ophthalmol. 2021 Mar 24;13:25158414211003378. doi: 10.1177/25158414211003378. eCollection 2021 Jan-Dec.

Abstract

PURPOSE

The implantation of intracorneal ring segments represents an effective and safe therapeutic option for visual improvement in patients with keratoconus. The presence of corneal opacities is considered an exclusion criterion for this operation.

METHODS

This is a retrospective cohort study of six eyes of six keratoconus patients at Queen Victoria Hospital, East Grinstead, UK, between January 2012 and December 2016. Femtosecond laser-assisted intracorneal ring segment implantation was performed in six eyes with apical corneal haze. Preoperative and postoperative visual acuity, keratometry readings, as well as corneal pachymetry were compared at 6-month follow-up.

RESULTS

Uncorrected visual acuity (UCVA) [LogMAR] improved significantly from median 1.05 [95% confidence interval (CI): 0.83-0.13] preoperatively to 0.9 (95% CI: 0.63-1.00) at 6 months postoperatively ( = 0.03). Corrected visual acuity (CDVA) also improved significantly from median 0.75 (95% CI: 0.43-1.00) preoperatively to 0.4 (95% CI: 0.23-0.50) at 6 months postoperatively ( = 0.03). Keratometric readings, -max (diopters) and -mean (diopters), decreased significantly from 54.5 and 47.85 preoperatively to 53.45 and 46.42 postoperatively, respectively ( = 0.03). Corneal pachymetry showed no significant changes postoperatively.

CONCLUSION

The results of this study show that the presence of apical haze should not exclude the implantation of intracorneal ring segments in patients with keratoconus.

摘要

目的

对于圆锥角膜患者,角膜内环植入术是一种有效且安全的视力改善治疗选择。角膜混浊的存在被视为该手术的排除标准。

方法

这是一项对英国伊斯特格里斯特维多利亚女王医院6例圆锥角膜患者的6只眼进行的回顾性队列研究,时间跨度为2012年1月至2016年12月。对6只角膜顶点有 haze的眼睛进行了飞秒激光辅助角膜内环植入术。在6个月随访时比较术前和术后的视力、角膜曲率测量值以及角膜厚度测量值。

结果

未矫正视力(UCVA)[LogMAR]从术前中位数1.05[95%置信区间(CI):0.83 - 0.13]显著提高到术后6个月时的0.9(95%CI:0.63 - 1.00)(P = 0.03)。矫正视力(CDVA)也从术前中位数0.75(95%CI:0.43 - 1.00)显著提高到术后6个月时的0.4(95%CI:0.23 - 0.50)(P = 0.03)。角膜曲率测量值,Kmax(屈光度)和Kmean(屈光度)分别从术前的54.5和47.85显著降低到术后的53.45和46.42(P = 0.03)。角膜厚度测量术后无显著变化。

结论

本研究结果表明,角膜顶点 haze的存在不应排除圆锥角膜患者进行角膜内环植入术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a510/8221670/8acc27e6923c/10.1177_25158414211003378-fig1.jpg

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