Küchle M, Nguyen N X, Seitz B, Langenbucher A, Naumann G O
Department of Ophthalmology, University Erlangen-Nürnberg, Germany.
Am J Ophthalmol. 1998 Feb;125(2):177-81. doi: 10.1016/s0002-9394(99)80088-9.
To analyze whether nonmechanical trephination with an excimer laser influences post-operative blood-aqueous barrier breakdown after penetrating keratoplasty.
Patients undergoing penetrating keratoplasty for keratoconus or Fuchs dystrophy were prospectively randomly assigned to trephination by either excimer laser or conventional mechanical handheld motorized trephine. All surgery was performed by one surgeon, and preoperative, intraoperative, and postoperative treatment was identical in both groups. Aqueous flare was quantitatively determined postoperatively in a masked fashion by laser flare-cell meter. For statistical analysis, the nonparametric Wilcoxon-Mann-Whitney test was used.
A total of 52 eyes of 52 patients were examined (Fuchs dystrophy, 10; keratoconus, 42). During the early postoperative period (days 3 to 9), eyes that had undergone nonmechanical excimer laser trephination (25/52) showed significantly (P < .005) lower flare values than did eyes that had undergone mechanical trephination (27/ 52). In both groups, flare values returned to normal levels by 6 weeks postoperatively.
Early postoperative blood-aqueous barrier breakdown is less pronounced after penetrating keratoplasty with nonmechanical excimer laser trephination.
分析准分子激光非机械性环钻术是否会影响穿透性角膜移植术后的血-房水屏障破坏情况。
对因圆锥角膜或富克斯角膜内皮营养不良而接受穿透性角膜移植术的患者进行前瞻性随机分组，分别采用准分子激光或传统手持式电动机械环钻进行环钻术。所有手术均由同一位外科医生完成，两组患者的术前、术中和术后治疗均相同。术后采用激光散射细胞仪以盲法对房水闪光进行定量测定。统计分析采用非参数威尔科克森-曼-惠特尼检验。
共检查了52例患者的52只眼（富克斯角膜内皮营养不良10只眼；圆锥角膜42只眼）。在术后早期（第3至9天），接受非机械性准分子激光环钻术的眼（25/52）的闪光值显著低于接受机械性环钻术的眼（27/52）（P <.005）。两组患者的闪光值在术后6周均恢复至正常水平。
非机械性准分子激光环钻术穿透性角膜移植术后早期血-房水屏障破坏较轻。
