Wilbanks G A, Cohen S, Chipman M, Rootman D S
Department of Ophthalmology, University of Toronto, Ontario, Canada.
Cornea. 1996 Nov;15(6):589-98.
Two corneal suction trephination systems currently in use are the Barron-Hessburg and the Hanna trephine. This study assessed the outcome of patients who received penetrating keratoplasty using these two systems. One hundred twenty-four eyes (62 with the Hanna system, 62 with the Barron-Hessburg system) from 98 patients undergoing penetrating keratoplasty were evaluated retrospectively. Best corrected spectacle acuity and corneal astigmatism were assessed 6 and 12 months after surgery. No significant difference was noted between the groups 6 months after surgery. At 12 months, a significant improvement in spectacle acuity was present with 55% of the Hanna group having visual acuity of 20/40 or better compared with 33% of the Barron-Hessburg group (p < 0.005). This difference was greater if eyes having the best visual prognoses were separately evaluated: 74% of the Hanna group had 20/40 vision or better compared with 41% of the Barron-Hessburg group (p < 0.005). In eyes having a good visual prognosis, a significant improvement in visual acuity was present, with 33% of the Hanna group improving nine or more lines compared with 9% of the Barron-Hessburg group (p < 0.05). Postoperative keratometric and refractive astigmatism were not different at 6 or 12 months. We found that visual recovery at 1 year is better using the Hanna system, especially in eyes with good visual prognoses.
目前正在使用的两种角膜吸引环钻系统是巴伦 - 赫斯堡系统和汉纳环钻。本研究评估了使用这两种系统进行穿透性角膜移植术的患者的治疗结果。对98例行穿透性角膜移植术患者的124只眼（汉纳系统62只眼，巴伦 - 赫斯堡系统62只眼）进行了回顾性评估。在术后6个月和12个月时评估最佳矫正视力和角膜散光。术后6个月时两组之间未发现显著差异。在12个月时，汉纳组55%的患者视力达到20/40或更好，而巴伦 - 赫斯堡组为33%，视力有显著改善（p < 0.005）。如果分别评估视觉预后最佳的眼，这种差异会更大：汉纳组74%的患者视力达到20/40或更好，而巴伦 - 赫斯堡组为41%（p < 0.005）。在视觉预后良好的眼中，视力有显著改善，汉纳组33%的患者视力提高了9行或更多，而巴伦 - 赫斯堡组为9%（p < 0.05）。术后6个月和12个月时角膜曲率计测量的散光和屈光性散光没有差异。我们发现，使用汉纳系统1年时的视力恢复更好，尤其是在视觉预后良好的眼中。
