Busin M, Zambianchi L, Franceschelli F, Lamberti G, al-Naweiseh I
University of Bonn, Germany.
Ophthalmology. 1998 Aug;105(8):1524-9; discussion 1529-30. doi: 10.1016/S0161-6420(98)98040-X.
This study aimed to evaluate the effect of intraoperative corneal cauterization on the postkeratoplasty refraction of patients with keratoconus.
A randomized clinical trial.
Thirty eyes of 29 patients with keratoconus undergoing standard penetrating keratoplasty by the same surgeon were evaluated (MB).
Standard penetrating keratoplasty included the use of an 8.0-mm donor button sutured into a 7.5-mm recipient bed by means of two running 10-0 nylon sutures with 16 bites each. Before trephination of the recipient bed, superficial cauterization causing tissue shrinkage was applied to a 6-mm central area of the cornea of only 15 eyes (group A). The remaining 15 eyes (group B) did not undergo intraoperative cauterization. Before surgery, 6 months, and 13 months after surgery, a complete ophthalmologic examination was performed on each patient, including uncorrected and best-corrected visual acuity, refraction, keratometry, computerized corneal topography, as well as A-scan contact ultrasonography.
Postkeratoplasty refractive error was measured.
Both 6 months (sutures still in place) and 13 months (suture removal performed in all patients) after surgery, the average spherical equivalent was significantly less myopic in the patients undergoing cauterization. At 6 months, it was +1.72 diopters (D) +/- 1.13 D in group A and -3.16 D +/- 2.84 D in group B; at 13 months, it was +0.09 D 1.52 D in group A and -3.89 D +/- 3.01 D in group B. The average keratometric astigmatism also was significantly lower in group A than in group B both at 6 (2.5 D +/- 1.6 D vs. 4.1 D +/- 2.3 D) and 13 months (2.7 D +/- 1.5 D vs. 4.4 D +/- 2.4 D) after surgery.
Cauterization of the central cornea improves the postkeratoplasty refractive results of patients with keratoconus.
本研究旨在评估术中角膜烧灼术对圆锥角膜患者角膜移植术后屈光的影响。
一项随机临床试验。
由同一位外科医生对29例接受标准穿透性角膜移植术的圆锥角膜患者的30只眼进行评估（MB）。
标准穿透性角膜移植术包括使用8.0毫米的供体植片，通过两根连续的10-0尼龙缝线（每根缝16针）缝合到7.5毫米的受体植床上。在切开受体植床之前，仅对15只眼（A组）角膜中央6毫米区域进行导致组织收缩的表面烧灼。其余15只眼（B组）未进行术中烧灼。在手术前、术后6个月和13个月，对每位患者进行全面的眼科检查，包括未矫正和最佳矫正视力、验光、角膜曲率测量、计算机化角膜地形图检查以及A超接触式超声检查。
测量角膜移植术后的屈光不正。
术后6个月（缝线仍在位）和13个月（所有患者均已拆线）时，接受烧灼术的患者平均等效球镜度数近视程度明显减轻。6个月时，A组为+1.72屈光度（D）±1.13 D，B组为-3.16 D±2.84 D；13个月时，A组为+0.09 D±1.52 D，B组为-3.89 D±3.01 D。术后6个月（2.5 D±1.6 D对4.1 D±2.3 D）和13个月（2.7 D±1.5 D对4.4 D±2.4 D）时，A组平均角膜散光也明显低于B组。
中央角膜烧灼术可改善圆锥角膜患者角膜移植术后的屈光结果。
