Hayashi H, Hayashi K, Nakao F, Hayashi F
Department of Ophthalmology, School of Medicine, Fukuoka University, Japan.
Ophthalmology. 1997 May;104(5):831-7. doi: 10.1016/s0161-6420(97)30226-7.
A prospective study was conducted to investigate the corneal shape changes due to scleral buckling surgery. These changes were analyzed based on the type of buckling procedures performed.
A total of 89 eyes from 88 patients were stratified into four groups based on the type of buckling procedures used, including:group A, local buckling; group B, encircling; group C, encircling with vitrectomy; and group D, encircling with additional segmental buckling. These eyes underwent keratometry and videokeratography examinations before surgery as well as at 1, 3, and 6 months after surgery.
No statistical significance was observed in the amounts of the induced corneal astigmatism and the refractive cylinder among the four groups. After local or segmental buckling (groups A and D), corneal steepening, which corresponded to the buckle, occurred at a high incidence. After encircling (groups B and C), either peripheral corneal flattening with focal central steepening or flattening on one side with coupled steepening on the opposite side was observed. Such corneal changes persisted for up to 6 months in an irregular and asymmetric configuration.
All four types of circumferential scleral buckling surgery were found to produce prolonged irregular and asymmetric corneal shape changes, whereas the patterns of the changes differed depending on the buckling procedures used.
进行一项前瞻性研究，以调查巩膜扣带术引起的角膜形状变化。根据所施行的扣带手术类型对这些变化进行分析。
将88例患者的89只眼根据所使用的扣带手术类型分为四组，包括：A组，局部扣带；B组，环扎；C组，环扎联合玻璃体切除术；D组，环扎联合附加节段性扣带。这些眼睛在手术前以及手术后1、3和6个月接受角膜曲率计和视频角膜地形图检查。
四组之间诱导的角膜散光量和屈光柱镜度数无统计学意义。在局部或节段性扣带（A组和D组）后，与扣带相对应的角膜陡峭化发生率较高。在环扎（B组和C组）后，观察到周边角膜变平伴局限性中央陡峭化或一侧变平伴对侧耦合陡峭化。这种角膜变化以不规则和不对称的形态持续长达6个月。
发现所有四种类型的环周巩膜扣带手术都会产生长期的不规则和不对称角膜形状变化，而变化模式因所使用的扣带手术不同而有所差异。
