Liu Xin, Li Hua, Qu Shen, Yu Qiao, Lin Hui, Bi Yan-Long
Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200092, China.
Department of Ophthalmology, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou Province, China.
Int J Ophthalmol. 2022 Sep 18;15(9):1538-1543. doi: 10.18240/ijo.2022.09.18. eCollection 2022.
To evaluate the efficacy and safety of full-thickness sutures combined with intracameral air injection (FTS-AI) versus pre-Descemet's membrane sutures combined with intracameral air injection (PDS-AI) in the management of acute corneal hydrops in keratoconus.
The research included 8 patients (8 eyes) suffering from acute corneal hydrops caused by keratoconus. Four patients were randomly assigned to FTS-AI. And the other four were randomly assigned to PDS-AI. Corneal oedema, visual acuity, corneal thickness were assessed during follow-up.
The demographics, preoperative duration of symptoms and severity of corneal hydrops between the two groups were not significantly different. The mean corneal oedema resolution time after FTS-AI and PDS-AI were 11±1.15 and 15±1.41d, respectively (=0.005). The maximum corneal thickness of the scarred region decreased in both groups at one week postoperatively (<0.05). No obvious difference was found in the mean maximal corneal thickness between the two groups postoperatively. The BCVA improved significantly after FTS-AI and PDS-AI at three months postoperatively. No obvious difference was found in the BCVA after FTS-AI and PDS-AI at three months postoperatively.
FTS-AI and PDS-AI are safe and effective therapies to accelerate the resolution of corneal oedema in acute corneal hydrops secondary to keratoconus. Despite faster resolution of corneal oedema in the FTS-AI group, we recommend PDS-AI to avoid potential endothelium cell damage.
评估全层缝合联合前房注气(FTS-AI)与后弹力层前缝合联合前房注气(PDS-AI)治疗圆锥角膜急性角膜水肿的疗效和安全性。
该研究纳入8例(8眼)圆锥角膜所致急性角膜水肿患者。4例患者随机分配至FTS-AI组。另外4例随机分配至PDS-AI组。随访期间评估角膜水肿、视力、角膜厚度。
两组患者的人口统计学特征、术前症状持续时间和角膜水肿严重程度无显著差异。FTS-AI组和PDS-AI组角膜水肿平均消退时间分别为11±1.15天和15±1.41天(P=0.005)。两组术后1周瘢痕区最大角膜厚度均下降(P<0.05)。两组术后平均最大角膜厚度无明显差异。FTS-AI组和PDS-AI组术后3个月最佳矫正视力均显著提高。FTS-AI组和PDS-AI组术后3个月最佳矫正视力无明显差异。
FTS-AI和PDS-AI是加速圆锥角膜继发急性角膜水肿角膜水肿消退的安全有效疗法。尽管FTS-AI组角膜水肿消退更快,但为避免潜在的内皮细胞损伤,我们推荐PDS-AI。