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角膜移植术后眼的重复飞秒激光辅助散光性角膜切开术

Repeated Femtosecond Laser-Assisted Astigmatic Keratotomies in Post-Keratoplasty Eyes.

作者信息

Levinger Nadav, Levinger Shmuel, Erdinest Nir, Achiron Asaf, London Naomi, Trivizki Omer, Levinger Eliya, Barequet Irina S

机构信息

Hadassah Medical Center, Jerusalem 9574409, Israel.

Enaim Medical Center Jerusalem, Tel Aviv 9438307, Israel.

出版信息

J Clin Med. 2022 Jul 20;11(14):4221. doi: 10.3390/jcm11144221.

Abstract

Visual rehabilitation after a keratoplasty is often compromised due to high amounts of residual astigmatism. Femtosecond laser-assisted astigmatic keratotomy (FLAK) is gaining popularity in decreasing this astigmatism. Though one set of two incisions suffices in most cases, sometimes the treatment proves insufficient and additional treatment is required. This case series evaluates the outcomes in patients who underwent two consecutive FLAK sets to correct post-keratoplasty residual astigmatism. All repeated FLAK cases performed on post-keratoplasty eyes were reviewed in a high-volume clinic as a non-comparative retrospective case series. The data extracted include the procedure parameters, time between procedures, refraction including sphere, astigmatism, spherical equivalent (SE), and uncorrected and best-spectacle-corrected distance visual acuity (UDVA, BSDVA, respectively). Eleven eyes of eleven patients aged 25.5 ± 10 treated with more than one FLAK procedure were identified. The average follow-up time was 6 months after the first FLAK and 24 ± 10 months after the second. The second FLAK was performed six months after the first. The preoperative mean astigmatism was -9.59 ± 2.36 D. At the final follow-up, the mean astigmatism decreased to -5.38 ± 1.79 D ( = 0.001). Repeated FLAK procedures achieved a significant and stable reduction of astigmatism in post-keratoplasty eyes. This procedure shows safety and effectivity in these complex eyes and may prevent the need for a further keratoplasty.

摘要

角膜移植术后的视觉康复常常因大量残余散光而受到影响。飞秒激光辅助散光角膜切开术(FLAK)在减少这种散光方面越来越受欢迎。虽然在大多数情况下一组两个切口就足够了,但有时治疗效果不佳,需要额外治疗。本病例系列评估了连续接受两组FLAK治疗以矫正角膜移植术后残余散光的患者的治疗效果。在一家大型诊所对所有在角膜移植术后眼睛上进行的重复FLAK病例进行回顾性研究,作为非对照病例系列。提取的数据包括手术参数、两次手术之间的时间间隔、屈光情况,包括球镜、散光、等效球镜(SE)以及未矫正和最佳矫正眼镜下的远距离视力(分别为UDVA、BSDVA)。确定了11例年龄为25.5±10岁、接受不止一次FLAK手术治疗的患者的11只眼睛。首次FLAK术后平均随访时间为6个月,第二次术后为24±10个月。第二次FLAK在第一次术后6个月进行。术前平均散光为-9.59±2.36 D。在最后一次随访时,平均散光降至-5.38±1.79 D( = 0.001)。重复FLAK手术在角膜移植术后眼睛中显著且稳定地降低了散光。该手术在这些复杂眼睛中显示出安全性和有效性,可能避免进一步角膜移植的需要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cafc/9316233/bd8197490435/jcm-11-04221-g001.jpg

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