大直径改良深层板层角膜切开术治疗放射状角膜切开术后眼。

Large-Diameter Modified Big-Bubble Deep Anterior Lamellar Keratoplasty in Post-Radial Keratotomy Eyes.

机构信息

From the Department of Translational Medicine, University of Ferrara, Ferrara (M.P., A.C.Y., M.B.).

Department of Ophthalmology, Ospedali Privati Forlì "Villa Igea" (M.P., A.C.Y., M.B.).

出版信息

Am J Ophthalmol. 2023 Jul;251:1-4. doi: 10.1016/j.ajo.2022.12.012. Epub 2022 Dec 18.

DOI:10.1016/j.ajo.2022.12.012

PMID:36543313

Abstract

PURPOSE

To report the outcomes of our modified large-diameter (9-mm) big-bubble deep anterior lamellar keratoplasty (DALK) technique with improved success rates of pneumatic dissection in post-radial keratotomy (RK) eyes.

DESIGN

Retrospective case series.

METHODS

At Ospedali Privati Forlì, "Villa Igea," Forlì, Italy., modified big-bubble DALK was performed in consecutive post-RK eyes. The technique included large-diameter (9-mm) deep partial-thickness trephination based on the thinnest anterior segment optical coherence tomography pachymetry value at 9 mm, air injection through a cannula advanced 2 mm centripetally from the base of the trephination, limited stromal clearance of the central 6-mm optical zone, and suturing of a 9-mm anterior lamellar graft prepared by microkeratome dissection. Success rate of pneumatic dissection, corrected distance visual acuity (CDVA), keratometric astigmatism, and complications were recorded.

RESULTS

Eight eyes of 7 patients were included. Pneumatic dissection succeeded in 7 cases (87.5%). CDVA significantly improved from 0.94 ± 0.43 to 0.14 ± 0.06 logMAR (P < .001). All eyes reached Snellen CDVA ≥20/40, whereas 3 eyes (37.5%) reached ≥20/25. At the last follow-up, 5 eyes (62.5%) had a final keratometric astigmatism ≤4 diopters, whereas 2 eyes (25.0%) had ≤2 diopters.

CONCLUSION

Big-bubble DALK can be successfully performed in post-RK eyes with our standardized technique.

摘要

目的

报告我们改良的大直径（9 毫米）大泡深层前板层角膜切开术（DALK）技术的结果，该技术在放射状角膜切开术（RK）后眼的气动分离成功率更高。

设计

回顾性病例系列。

方法

在意大利福尔利的 Ospedali Privati Forlì，“Villa Igea”，对连续的 RK 后眼进行改良的大泡 DALK。该技术包括基于最薄的前节光学相干断层扫描（OCT）在 9 毫米处的角膜厚度值进行大直径（9 毫米）的深层部分厚度环钻，通过从环钻底部向中心推进 2 毫米的套管注射空气，对中央 6 毫米光学区进行有限的基质清除，以及缝合通过微角膜刀解剖制备的 9 毫米前板层移植物。记录气动分离成功率、矫正距离视力（CDVA）、角膜散光和并发症。

结果

纳入 7 名患者的 8 只眼。7 例（87.5%）气动分离成功。CDVA 从 0.94 ± 0.43 显著提高至 0.14 ± 0.06 logMAR（P <.001）。所有眼均达到 Snellen CDVA≥20/40，而 3 眼（37.5%）达到≥20/25。末次随访时，5 眼（62.5%）最终角膜散光≤4 屈光度，而 2 眼（25.0%）≤2 屈光度。