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圆锥角膜晚期的角膜内环植入术

Intracorneal ring segment implantation in advanced Keratoconus.

作者信息

Dockery Philip W, Parker John S, Massenzio Erik M, Parker Jack S

机构信息

Wills Eye Hospital, Philadelphia, USA.

Parker Cornea, Birmingham, USA.

出版信息

Eur J Ophthalmol. 2023 May;33(3):1324-1330. doi: 10.1177/11206721231155213. Epub 2023 Feb 5.

Abstract

PURPOSE

To compare the clinical outcomes of intracorneal ring segment (ICRS) implantation in eyes with advanced vs. mild/moderate keratoconus (KCN).

METHODS

A retrospective analysis of 141 eyes of 111 patients with KCN who underwent ICRS implantation. Preoperative maximum keratometry (Kmax) was <57 diopters (D) in 70 eyes and >57 D in 71 eyes. Postoperatively, corrected distance visual acuity (CDVA), Kmax, and intraoperative and postoperative complications were assessed at 1 day, 1 month, and 1 year.

RESULTS

Corneas with a preoperative Kmax >57 D experienced greater reduction in axial curvature after ICRS implantation than corneas with a preoperative Kmax <57 D (7.0 D vs. 5.5 D, =0.005) and gained more Snellen lines of CDVA (3 vs. 1, <0.001) by 1 year postoperatively. The incidences of the most prevalent complications (explantation, extrusion, and infectious keratitis) did not differ significantly between the two groups (p=0.29, p=0.99, p=0.98).

CONCLUSIONS

The visual and topographic effects of ICRS implantation are greater in eyes with more advanced KCN, with no increase in the incidence of the most common complications.

摘要

目的

比较角膜内环植入术(ICRS)治疗重度与轻/中度圆锥角膜(KCN)患者的临床效果。

方法

对111例接受ICRS植入术的KCN患者的141只眼进行回顾性分析。术前最大角膜曲率(Kmax)<57屈光度(D)的有70只眼,>57 D的有71只眼。术后分别于1天、1个月和1年评估矫正远视力(CDVA)、Kmax以及术中及术后并发症。

结果

术前Kmax>57 D的角膜在ICRS植入术后轴向曲率的降低幅度大于术前Kmax<57 D的角膜(7.0 D对5.5 D,P = 0.005),术后1年CDVA提高的Snellen行数更多(3行对1行,P<0.001)。两组中最常见并发症(取出、挤出和感染性角膜炎)的发生率无显著差异(P = 0.29,P = 0.99,P = 0.98)。

结论

ICRS植入术对重度KCN患者的视力和地形学效果更佳,且最常见并发症的发生率未增加。

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