Wowra Bogumił, Wysocka-Kosmulska Marzena, Dobrowolski Dariusz, Wylęgała Edward
Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland.
Department of Ophthalmology, District Railway Hospital, 65 Panewnicka Street, 40-760 Katowice, Poland.
J Clin Med. 2024 May 31;13(11):3258. doi: 10.3390/jcm13113258.
: Aniridia-associated keratopathy (AAK) is a potentially vision-threatening pathology in congenital aniridia, for which both the underlying etiopathogenesis and effective treatment remain unclear. :This prospective study was conducted to assess and compare the short-term outcome after superficial keratectomy (SK) alone or in a combination with an amniotic membrane transplantation (AMT). Here, 76 eyes were enrolled in 76 patients with grade 4 AAK. In all eyes, in order to assess preoperatively the efficiency of the limbal epithelial stem cells (LESC), the presence of corneal epithelial cells in confocal microscopy was established. The analyses included: best corrected visual acuity (BCVA), the stage of AAK and the number of corneal quadrants involved in corneal neovascularization (CNV). : Six months after surgery, the mean BCVA was 0.05 and ranged from 0.002 up to 0.1 in both groups. Improvement in BCVA occurred in 94.29% patients when SK alone was performed, and in 92.68% when in combination with AMT. There were no statistically significant differences in the effect of therapy depending on the type of surgery, regarding BCVA, stage of AAK and the number of quadrants with CNV. : SK alone is an effective procedure in short outcomes limited to six months for advanced AAK in association with LESC partial efficiency.
无虹膜相关性角膜病变（AAK）是先天性无虹膜中一种潜在的视力威胁性病变，其潜在的病因发病机制和有效治疗方法均尚不清楚。本前瞻性研究旨在评估和比较单纯浅表角膜切除术（SK）或联合羊膜移植（AMT）后的短期疗效。在此，76例4级AAK患者的76只眼睛被纳入研究。在所有眼睛中，为了术前评估角膜缘上皮干细胞（LESC）的效能，通过共聚焦显微镜确定角膜上皮细胞的存在情况。分析内容包括：最佳矫正视力（BCVA）、AAK分期以及角膜新生血管化（CNV）累及的角膜象限数。手术6个月后，两组的平均BCVA均为0.05，范围从0.002至0.1。单独进行SK时，94.29%的患者BCVA有所改善；联合AMT时，92.68%的患者BCVA有所改善。就BCVA、AAK分期和CNV象限数而言，根据手术类型不同，治疗效果在统计学上无显著差异。对于伴有LESC部分效能的晚期AAK，单纯SK在限于6个月的短期疗效中是一种有效的手术方法。
