Min Byung Moo, Cheon Hee Jong
Woori Eye Clinic, Department of Ophthalmology, Yonsei University College of Medicine, Daeduk Daero 219, Dunsan-dong, Seo-gu, Daejon 35229, Republic of Korea.
GJ St. Mary Eye Clinic, Wongjin-Ro 223, Gongju 32539, Republic of Korea.
J Clin Med. 2025 Sep 18;14(18):6568. doi: 10.3390/jcm14186568.
The aim of this study was to assess a corneal remodeling technique using laser asymmetric keratectomy (C-LAK) treatment, and its outcome for keratoconus suspect (KCS) by evaluating corneal regularity. In this retrospective case-control study, 34 eyes of 20 patients with KCS were studied before and 1 year after L-LAK. This new technique could ablate the original refractive errors, the thicker peripheral cornea, and myopia induced by LAK simultaneously (crescentic customized ablation). Before and 1 year after the operation, the refraction, UDVA, keratometry, and corneal symmetry evaluated as the total corneal central-thickness deviation (SUM) and the distance between the maximum posterior elevation (best-fit-sphere [BFS]) and the visual axis (DISTANCE) were compared. Twenty patients with KCS aged 41.0 ± 13.5 years were evaluated. Preoperatively, the spherical equivalent (SE, D) -2.57 ± 1.64 and the Kmax was +48.21 ± 0.89 D. At 1 year postoperation, 79.4% (27/34) of the eyes had a UDVA of 20/20 or better. The SE and Kmax (D) were -0.40 ± 0.43, 44.47 ± 1.38 (Ps = 0.001, respectively), the corneal symmetry was better due to the decrease in the SUM (µm) (from 141.88 ± 48.24 to 66.21 ± 15.22) and DISTANCE (mm) (from 1.11 ± 1.14 to 0.46 ± 0.40). No postoperative corneal ectasia appeared. L-LAK made the corneas symmetric by decreasing the SUM and DISTANCE, decreased focal steepening, and showed good 1-year postoperative outcomes.
本研究的目的是评估一种使用激光非对称角膜切除术（C-LAK）治疗的角膜重塑技术，以及通过评估角膜规则性来观察其对疑似圆锥角膜（KCS）的治疗效果。在这项回顾性病例对照研究中，对20例KCS患者的34只眼在进行L-LAK治疗前及治疗后1年进行了研究。这项新技术能够同时消除原有的屈光不正、较厚的周边角膜以及LAK诱导的近视（新月形定制消融）。在手术前及术后1年，对验光、最佳矫正视力（UDVA）、角膜曲率测量以及角膜对称性进行了比较，角膜对称性通过总角膜中央厚度偏差（SUM）以及最大后表面高度（最佳拟合球面[BFS]）与视轴之间的距离（DISTANCE）来评估。对20例年龄为41.0±13.5岁的KCS患者进行了评估。术前，等效球镜度（SE，D）为-2.57±1.64，最大角膜曲率（Kmax）为+48.21±0.89D。术后1年，79.4%（27/34）的眼最佳矫正视力达到20/20或更好。等效球镜度和最大角膜曲率（D）分别为-0.40±0.43、44.47±1.38（P值均为0.001），由于SUM（μm）（从141.88±48.24降至66.21±15.22）和DISTANCE（mm）（从1.11±1.14降至0.46±0.40）的降低，角膜对称性更好。术后未出现角膜扩张。L-LAK通过降低SUM和DISTANCE使角膜变得对称，减少了局部陡峭程度，并且术后1年显示出良好疗效。
