摘要
目的比较飞秒激光辅助的深板层角膜移植(去除75%以上的角膜基质层)和飞秒激光联合大气泡技术(去除全部基质层,只保留后弹力层和内皮层)的全板层角膜移植治疗中晚期圆锥角膜的远期临床效果及安全性。方法回顾性病例对照分析。28例(32只眼)圆锥角膜患者9例(10只眼)行飞秒激光辅助的深板层角膜移植手术,19例(22只眼)行飞秒激光联合大气泡技术的全板层角膜移植手术。随访4年,比较最佳矫正视力、角膜散光、残留近视度数、角膜曲率、中央角膜厚度及内皮细胞丢失率在两种手术方式之间的差异。结果两种手术方式在术后最佳矫正视力、角膜散光、角膜曲率、中央角膜厚度及内皮细胞丢失率等方面无显著差异(P> 0. 05),但飞秒激光联合大气泡技术全板层角膜移植术后残留近视度数更低,与飞秒激光辅助的深板层角膜移植相比,具有显著差异(P <0. 05)。结论远期随访结果表明飞秒激光辅助的大气泡全板层角膜移植具有良好的临床效果及安全性,是治疗圆锥角膜更好的手术方式。
Objective To compare the long-term clinical effects and safety of femtosecond laser-assisted deep anterior lamellar keratoplasty(DALK)(pre-Descemetic DALK)(removing more than 75% of the corneal stroma)and the femtosecond laser-assisted DALK performed with the big bubble technique(Descemetic DALK)(removing the whole stroma,leaving only the Descemet membrane and endothelium)in cases of moderate or advanced keratoconus.Methods Retrospective case-control analysis.32 eyes of 28 patients diagnosed as keratoconus were included in the analysis.Femtosecond laser-assisted pre-Descemetic DALK was performed in 10 eyes of 9 patients and femtosecond laser-assisted Descemetic DALK using big bubble technique was performed in 22 eyes of 19 patients.The mean follow-up period was 4 years.The postoperative best-corrected visual acuity(BCVA),corneal astigmatism,the residual diopter of myopia,keratometry,central corneal thickness,and endothelial cell loss were compared between the two surgical techniques.Results There was no significantly difference(P>0.05)in BCVA,corneal astigmatism,keratometry,corneal thicknesses and endothelial cell loss between the two surgical methods.However,patients who underwent the femtosecond laser-assisted Descemetic DALK using the big-bubble technique showed significantly lower(P<0.05)postoperative residual diopter of myopia when compared to the femtosecond laser-assisted pre-Descemetic DALK.Conclusions The long-term follow-up indicated that Descemetic DALK technique using the big-bubble technique is effective and safety,and it can be considered as a better surgical choice for patients with keratoconus.
作者
王振茂
肖凯霖
葛轶睿
黄振平
陆燕
Wang Zhenmao;Xiao Kailin;Ge Yirui;Huang Zhenping;Lu Yan(Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong,Shantou,Guangdong 515000,China;Department of Ophthalmology,General Hospital of Eastern Theater Command,Nanjing,Jiangsu 210002,China)
出处
《临床眼科杂志》
2019年第2期97-100,共4页
Journal of Clinical Ophthalmology
基金
国家自然科学基金项目(编号:81270979)
江苏省青年医学人才项目(编号:QNRC2016905)
广东省医学科学技术研究基金项目(编号:A2018478)
关键词
深板层角膜移植
大气泡全板层角膜移植
圆锥角膜
飞秒激光
远期随访
Deep anterior lamellar keratoplasty
Deep anterior lamellar keratoplasty by using big-bubble technique
Keratoconus
Femtosecond laser
Long-term follow-up
作者简介
通讯作者:陆燕(Email:luyan366@126.com).
