Belmont S C, Zimm J L, Storch R L, Draga A, Troutman R C
Manhattan Eye, Ear, and Throat Hospital, New York, NY.
Refract Corneal Surg. 1993 Jul-Aug;9(4):250-4.
The use of a suction trephine during penetrating keratoplasty has the potential to reduce trephination errors and astigmatism after suture removal.
In this study, we evaluated refractive astigmatism after suture removal in 26 eyes that had penetrating keratoplasty for keratoconus using refraction, keratometry, and videokeratography. Group I (11 eyes) had manual trephination with an open disposable blade of both the donor (8.2 mm) and the recipient (8.0 mm). Group II (10 eyes) had manual trephination with an open disposable blade of the donor (8.2 mm) and Krumeich guided trephine system trephination of the recipient (8.0 mm). Group III (5 eyes) had guided trephination of both the donor (8.0 mm) and the recipient (8.0 mm).
The guided trephine groups II and III demonstrated statistically significant less refractive cylinder when compared to manual trephination group I (p < .01). The mean keratometric cylinder for group I was 6.50 diopters (D) (range, 1.50 to 9.00 D), for group II was 3.00 D (range, 0.50 to 7.00 D), and for group III was 2.55 D (range, 0 to 4.00 D).
The Krumeich guided trephine system produced less keratometric astigmatism than manual trephination after penetrating keratoplasty for keratoconus.
穿透性角膜移植术中使用抽吸环钻有可能减少钻切误差以及拆线后的散光。
在本研究中，我们使用验光、角膜曲率计测量法和角膜地形图测量法评估了26只因圆锥角膜接受穿透性角膜移植术的眼睛在拆线后的屈光性散光。第一组（11只眼）供体（8.2毫米）和受体（8.0毫米）均采用开放式一次性刀片进行手动钻切。第二组（10只眼）供体（8.2毫米）采用开放式一次性刀片进行手动钻切，受体（8.0毫米）采用克鲁梅希引导环钻系统进行钻切。第三组（5只眼）供体（8.0毫米）和受体（8.0毫米）均采用引导式钻切。
与手动钻切的第一组相比，引导环钻组（第二组和第三组）的屈光性柱镜度数在统计学上显著更低（p < 0.01）。第一组的平均角膜曲率计柱镜度数为6.50屈光度（D）（范围为1.50至9.00 D），第二组为3.00 D（范围为0.50至7.00 D），第三组为2.55 D（范围为0至4.00 D）。
对于圆锥角膜穿透性角膜移植术，克鲁梅希引导环钻系统产生的角膜曲率性散光比手动钻切更少。
