超声乳化白内障吸除术后、穿透性角膜移植术和撕囊全自动角膜内皮移植术后的角膜生物力学变化。

Corneal biomechanical changes after Descemet stripping automated endothelial keratoplasty, penetrating keratoplasty, and phacoemulsification.

机构信息

Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science and Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Int Ophthalmol. 2022 Oct;42(10):3183-3190. doi: 10.1007/s10792-022-02318-1. Epub 2022 May 12.

DOI:10.1007/s10792-022-02318-1

PMID:35552955

Abstract

PURPOSE

To evaluate corneal biomechanical changes after Descemet stripping automated endothelial keratoplasty (DSAEK), penetrating keratoplasty (PK), and phacoemulsification (PE).

METHODS

This prospective study included 138 eyes which underwent PK (26 eyes), DSAEK (26 eyes), PE (57 eyes), and 29 normal eyes. Intraocular pressure (IOP) was measured by Goldmann applanation tonometer (GAT), and central corneal thickness (CCT) and axial length by ultrasound. The ocular response analyzer was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-related IOP (IOPg), and cornea-compensated IOP (IOPcc) preoperatively and 1, 3, and 6 months postoperatively.

RESULTS

At baseline, PK group had the lowest CH and CRF. There was a significant increase in CH and CRF to normal values in PK (P = 0.015 and 0.006) and PE (P = 0.005 and 0.0001) groups over the study period. At 6 months, CH and CRF increased and reached normal values in the PK group; increased to a lower level than normal in the DSAEK group; and, after an initial reduction, increased to normal values in the PE group. At 6 months, DSAEK group had the lowest CH and CRF. There was a significant positive correlation between CRF and GAT (r = 0.281, P = 0.009), IOPg and GAT (r = 0.335, P = 0.001), and IOPcc and GAT (r = 0.282, P = 0.001). CH was negatively correlated with age (r = - 0.189, P = 0.04).

CONCLUSION

Corneal biomechanical factors increase after DSAEK and PK. At post-operative month six, they reach normal values in PK group, but are lower than normal in DSAEK group.

摘要

目的

评估去表皮角膜内皮移植术（DSAEK）、穿透性角膜移植术（PK）和超声乳化白内障吸除术（PE）后角膜生物力学的变化。

方法

本前瞻性研究纳入了 138 只眼，包括行 PK（26 只眼）、DSAEK（26 只眼）、PE（57 只眼）和 29 只正常眼。采用 Goldmann 压平眼压计（GAT）测量眼压（IOP），采用超声测量中央角膜厚度（CCT）和眼轴。采用眼反应分析仪（ORA）测量术前及术后 1、3 和 6 个月的角膜滞后量（CH）、角膜阻力因子（CRF）、Goldmann 相关眼压（IOPg）和角膜补偿眼压（IOPcc）。

结果

在基线时，PK 组的 CH 和 CRF 最低。在 PK（P=0.015 和 0.006）和 PE（P=0.005 和 0.0001）组中，CH 和 CRF 显著增加并恢复至正常值。在 6 个月时，PK 组 CH 和 CRF 增加并恢复至正常值；DSAEK 组增加至低于正常值的水平；PE 组则在初始降低后恢复至正常值。在 6 个月时，DSAEK 组的 CH 和 CRF 最低。CRF 与 GAT（r=0.281，P=0.009）、IOPg 与 GAT（r=0.335，P=0.001）和 IOPcc 与 GAT（r=0.282，P=0.001）呈显著正相关。CH 与年龄呈负相关（r=-0.189，P=0.04）。