Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba, 272-8513, Japan.
Department of Ophthalmology, Shinshu University School of Medicine, Nagano, Japan.
Sci Rep. 2023 Apr 3;13(1):5389. doi: 10.1038/s41598-023-32683-5.
Forceps corneal injuries during infant delivery cause Descemet membrane (DM) breaks, that cause corneal astigmatism and corneal endothelial decompensation. The aim of this study is to characterise corneal higher-order aberrations (HOAs) and corneal topographic patterns in corneal endothelial decompensation due to obstetric forceps injury. This retrospective study included 23 eyes of 21 patients (54.0 ± 9.0 years old) with forceps corneal injury, and 18 healthy controls. HOAs and coma aberrations were significantly larger in forceps injury (1.05 [0.76-1.98] μm, and 0.83 [0.58-1.69], respectively) than in healthy controls (0.10 [0.08-0.11], and 0.06 [0.05-0.07], respectively, both P < 0.0001). Patient visual acuity was positively correlated with coma aberration (r = 0.482, P = 0.023). The most common topographic patterns were those of protrusion and regular astigmatism (both, six eyes, 26.1%), followed by asymmetric (five eyes, 21.7%), and flattening (four eyes, 17.4%). These results indicate that increased corneal HOAs are associated with decreased visual acuity in corneal endothelial decompensation with DM breaks and corneal topography exhibits various patterns in forceps injury.
产钳引起的角膜损伤会导致角膜后弹力层（Descemet membrane，DM）破裂，引起角膜散光和角膜内皮失代偿。本研究旨在描述因产钳损伤导致的角膜内皮失代偿的角膜高阶像差（higher-order aberrations，HOAs）和角膜地形图模式。本回顾性研究纳入了 21 名患者（54.0±9.0 岁）的 23 只眼，这些患者均存在产钳性角膜损伤，同时纳入了 18 名健康对照者。产钳损伤组的 HOAs 和彗差像差明显大于健康对照组（1.05 [0.76-1.98] μm 和 0.83 [0.58-1.69]，分别与 0.10 [0.08-0.11] 和 0.06 [0.05-0.07]，P 均<0.0001）。患者视力与彗差呈正相关（r=0.482，P=0.023）。最常见的地形图模式为隆起和规则散光（均为 6 只眼，26.1%），其次是不对称（5 只眼，21.7%）和变平（4 只眼，17.4%）。这些结果表明，在 DM 破裂和角膜内皮失代偿的角膜中，增加的角膜 HOAs 与视力下降有关，而角膜地形图在产钳损伤中呈现出各种模式。
