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光治疗性角膜切削术:三级眼科诊所的当前方法及变化趋势

Phototherapeutic keratectomy: current approaches and changing trends in a tertiary eye clinic.

作者信息

Taskoparan Sariye, Genc Selim, Cakmak Semih, Oztutuncu Ozum, Yildiz Burcin Kepez, Yildirim Yusuf

机构信息

Department of Ophthalmology, Beyoglu Eye Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey.

出版信息

Arq Bras Oftalmol. 2023 Jul-Aug;86(4):353-358. doi: 10.5935/0004-2749.20230055.

Abstract

PURPOSE

To examine the efficacy of phototherapeutic keratectomy as a treatment for variable pathologies with anterior corneal opacities and evaluate the distribution of phototherapeutic keratectomy indications over the past 10 years.

METHODS

The records of 334 eyes from 276 patients who underwent phototherapeutic keratectomy between March 2010 and 2020 were retrospectively reviewed. Etiologies of the patients who underwent phototherapeutic keratectomy were noted, and their changes were examined. Refractive and visual acuity results before and after the operation were recorded and analyzed according to etiology.

RESULTS

The mean age of the patients was 40.7 ± 16.2 years (range: 19-84). The mean follow-up was 25.5 ± 19.1 months (range: 3-96). Phototherapeutic keratectomy was most frequently applied for corneal stromal dystrophies (44%, 151 eyes from 111 patients), and granular dystrophy was the most common phototherapeutic keratectomy indication among corneal dystrophies. Unlike other indications, there has been an increase in the application of phototherapeutic keratectomy for persistent subepithelial opacities due to adenoviral conjunctivitis in the past 10 years. There was a significant increase in visual acuity in all groups except for the recurrent epithelial defect group (p<0.05). The greatest improvement in visual acuity was detected for stromal dystrophies in the granular dystrophy subgroup.

CONCLUSION

Despite changing indication trends, phototherapeutic keratectomy remains an effective and reliable treatment for anterior corneal lesions.

摘要

目的

探讨光治疗性角膜切削术治疗伴有前部角膜混浊的多种病变的疗效,并评估过去10年光治疗性角膜切削术适应证的分布情况。

方法

回顾性分析2010年3月至2020年期间276例患者334只眼行光治疗性角膜切削术的记录。记录接受光治疗性角膜切削术患者的病因,并观察其变化。根据病因记录并分析手术前后的屈光和视力结果。

结果

患者的平均年龄为40.7±16.2岁(范围:19 - 84岁)。平均随访时间为25.5±19.1个月(范围:3 - 96个月)。光治疗性角膜切削术最常用于角膜基质营养不良(44%,111例患者的151只眼),颗粒状营养不良是角膜营养不良中最常见的光治疗性角膜切削术适应证。与其他适应证不同,在过去10年中,光治疗性角膜切削术用于腺病毒性结膜炎所致持续性上皮下混浊的应用有所增加。除复发性上皮缺损组外,所有组的视力均有显著提高(p<0.05)。在颗粒状营养不良亚组中,角膜基质营养不良的视力改善最为明显。

结论

尽管适应证趋势有所变化,但光治疗性角膜切削术仍然是治疗前部角膜病变的一种有效且可靠的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8db1/11826725/f9737e579675/abo-86-04-0353-g01.jpg

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