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角膜缘皮样瘤患儿板层角膜巩膜移植术后弱视的屈光特征及相关因素

Refractive Characteristics and Related Factors of Amblyopia after Lamellar Keratoscleroplasty in Children with Limbal Dermoids.

作者信息

Luo Surong, Xu Jianjiang, Shao Tingting, Qu Xiaomei

机构信息

Department of Ophthalmology, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing 312000, China.

Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.

出版信息

J Clin Med. 2022 Jul 19;11(14):4176. doi: 10.3390/jcm11144176.

Abstract

We examined the refractive characteristics and related factors of amblyopia in pediatric patients with limbal dermoids undergoing lamellar keratoscleroplasty. Forty-one children (mean age: 56.15 ± 22.47 months) were enrolled. Cycloplegic refraction, corneal topography, and anterior segment photography were performed. The corneal topographic and distribution characteristics of the refractive state were summarized, and the relationship between limbal dermoid invasion size and the refractive state was analyzed. The relationship between invasion size and amblyopia severity and the effect of clinical intervention at different times on amblyopia treatment were also analyzed. The spherical power distribution was −1.0−+10.75 D (average: +4.79 ± 3.09 D). The cylinder power was −1.25−−8.75 D (average: −4.19 ± 1.93 D). The axial range of astigmatism was 10−180° (average: 103.54 ± 58.16°). Equivalent spherical refraction was −3.88−+7.76 D (average: +2.70 ± 3.08 D). Twenty-five, fifteen, and one case had limboid dermoid invasion of the central circular zone (CCZ), paracentral annular zone (PCZ), and corneal limbus within 1 mm, respectively. Corneal topography of 39 patients showed flat, steep, and mean curvatures of 38.48 ± 2.12 D, 43.29 ± 1.97 D, and 40.70 ± 1.48 D, respectively. The mean astigmatism was 4.80 ± 2.93 D in the 3-mm optical region. Astigmatism was higher in CCZ than in PCZ invasion (p < 0.05). Postoperative visual acuity was positively correlated with patients’ age and amblyopia treatment duration (r = 0.392, p = 0.048; r = 0.488, p = 0.011), and was negatively correlated with astigmatism (r = −0.646, p < 0.001). High hyperopia and astigmatism are the dominant refractive errors in patients with limbal dermoids undergoing lamellar keratoscleroplasty.

摘要

我们研究了接受板层角膜巩膜移植术的小儿角膜皮样瘤患者弱视的屈光特征及相关因素。纳入了41名儿童(平均年龄:56.15±22.47个月)。进行了睫状肌麻痹验光、角膜地形图检查和眼前节照相。总结了屈光状态的角膜地形图及分布特征,分析了角膜皮样瘤浸润大小与屈光状态之间的关系。还分析了浸润大小与弱视严重程度之间的关系以及不同时间临床干预对弱视治疗的效果。球镜度数分布为−1.0−+10.75 D(平均:+4.79±3.09 D)。柱镜度数为−1.25−−8.75 D(平均:−4.19±1.93 D)。散光轴向范围为10−180°(平均:103.54±58.16°)。等效球镜度为−3.88−+7.76 D(平均:+2.70±3.08 D)。分别有25例、15例和1例角膜皮样瘤浸润中央圆形区(CCZ)、旁中央环形区(PCZ)和距角膜缘1 mm以内。39例患者的角膜地形图显示,平坦、陡峭和平均曲率分别为38.48±2.12 D、43.29±1.97 D和40.70±1.48 D。在3 mm光学区平均散光为4.80±2.93 D。CCZ浸润患者的散光高于PCZ浸润患者(p<0.05)。术后视力与患者年龄和弱视治疗持续时间呈正相关(r = 0.392,p = 0.048;r = 0.488,p = 0.011),与散光呈负相关(r = −0.646,p<0.001)。高度远视和散光为接受板层角膜巩膜移植术的角膜皮样瘤患者的主要屈光不正类型。

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