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角膜移植术后非青光眼患者施莱姆管变化的傅里叶域光学相干断层扫描评估

Fourier-Domain Optical Coherence Tomographic Assessment of Changes in the Schlemm's Canal of Nonglaucomatous Subjects After Keratoplasty.

作者信息

Zhao Yujin, Li Yue, Hong Jiaxu, Le Qihua, Xu Jianjiang

机构信息

Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.

NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.

出版信息

Front Physiol. 2021 Dec 2;12:716117. doi: 10.3389/fphys.2021.716117. eCollection 2021.

Abstract

This study aimed to evaluate the impact of keratoplasty on the anatomical structures in the Schlemm's canal (SC) of nonglaucomatous subjects using Fourier-domain optical coherence tomography (FD-OCT). Sixty-six nonglaucomatous eyes that underwent penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), or triple surgery were enrolled in this prospective, comparative, observational study. The SC imaging was performed using FD-OCT before and after surgery in both the nasal and temporal quadrants. Patient demographics, SC parameters [e.g., cross-sectional area (CSA), meridional diameter of SC (MSC), sagittal diameter of SC (SSC), and circumference (CCF)], and the correlations between the variation of SC parameters and intraocular pressure (IOP) were analyzed. The mean age of all subjects was 40.27 ± 18.97 years. Among all cases, the nasal, temporal, and mean MSC significantly decreased on the first day after surgery and then increased at 1 week ( = 0.04, 0.017, and 0.01, respectively). Temporal CSA (tCSA), temporal MSC (tMSC), and temporal circumference (tCCF) after PK ( = 0.017, 0.020, and 0.018, respectively) and nasal MSC (nMSC) after DALK ( = 0.025) decreased significantly on the first day after surgery. The shift in mean IOP was significantly correlated with the changes in tMSC ( = 0.341, = 0.003) and CCF ( = 0.207, = 0.048). SC had significant morphological changes in the early period after keratoplasty in nonglaucomatous eyes, accompanied with elevation of IOP. Early intervention might be necessary to prevent secondary glaucoma early after keratoplasty.

摘要

本研究旨在使用傅里叶域光学相干断层扫描(FD-OCT)评估角膜移植术对非青光眼患者施累姆管(SC)解剖结构的影响。本前瞻性、对比性观察研究纳入了66只接受穿透性角膜移植术(PK)、深板层角膜移植术(DALK)或三联手术的非青光眼患眼。术前和术后均使用FD-OCT对鼻侧和颞侧象限的SC进行成像。分析了患者人口统计学数据、SC参数[如横截面积(CSA)、SC的子午线直径(MSC)、SC的矢状径(SSC)和周长(CCF)],以及SC参数变化与眼压(IOP)之间的相关性。所有受试者的平均年龄为40.27±18.97岁。在所有病例中,术后第1天鼻侧、颞侧和平均MSC均显著降低,然后在1周时升高(分别为P = 0.04、0.017和0.01)。PK术后的颞侧CSA(tCSA)、颞侧MSC(tMSC)和颞侧周长(tCCF)(分别为P = 0.017、0.020和0.018)以及DALK术后的鼻侧MSC(nMSC)(P = 0.025)在术后第1天显著降低。平均IOP的变化与tMSC(r = 0.341,P = 0.003)和CCF(r = 0.207,P = 0.048)的变化显著相关。非青光眼患眼角膜移植术后早期SC有显著的形态学变化,并伴有IOP升高。角膜移植术后早期可能需要进行早期干预以预防继发性青光眼。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dff0/8675085/0b6c67337c67/fphys-12-716117-g001.jpg

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