Intrastromal clefts in keratoconus patients with hydrops.
Intrastromal clefts in keratoconus patients with hydrops.
复制标题
患有水肿的圆锥角膜患者的基质内裂隙。
DOI：
10.1016/s0002-9394(98)00068-3
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发表时间：
1998
期刊：
影响因子：
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通讯作者：
Richard B. O'Grady
中科院分区：
文献类型：
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作者：
Robert S. Feder;K. Wilhelmus;S. Vold;Richard B. O'Grady
目的报道急性圆锥角膜积液并发角膜间裂的临床表现和病程。方法8例双侧圆锥角膜患者中，9眼出现急性角膜积液并发角膜间裂。一名患者双眼出现这种并发症。患者为3名女性和5名男性，平均年龄为20岁（范围11至36岁），急性水肿发作后随访中位时间为8个月（范围2.5至21个月）。在这项回顾性研究中，患者被确定并在两个机构角膜转诊实践之一接受治疗。结果9只眼中有8只眼在6周至6个月间完全闭合。在一只眼睛中，一个病人在出现水肿后仅仅随访了4.5个月，就几乎完全闭合了。9只眼睛中有6只出现了角膜基质新生血管。在最后一次随访中，6只未接受治疗的眼睛中有4只的最佳矫正视力为20/200或更低。两眼间质裂患者均未发生间质新生血管形成，在未进行手术干预的情况下，每只眼的隐形眼镜矫正视力达到20/40或更好。结论晶状体间裂是圆锥角膜积液的一种表现。单侧或多侧唇裂均可发生，双侧也可能受累。裂口通常在几个月内愈合，但间质新生血管是常见的，可能会影响移植物未来的存活。
PurposeTo report the clinical appearance and course of intrastromal clefts occurring with acute hydrops in keratoconus.MethodsIn eight patients with bilateral keratoconus, nine eyes developed acute corneal hydrops complicated by intrastromal cleft formation. One patient developed this complication in both eyes. The patients, three female and five male, had a mean age of 20 years (range, 11 to 36 years) and were followed after onset of acute hydrops for a median of 8 months (range, 2.5 to 21 months). The patients in this retrospective study were identified and had been treated at one of two institutional cornea referral practices.ResultsIn eight of nine eyes with intrastromal clefts, complete cleft closure occurred between 6 weeks and 6 months. In one eye, cleft closure was nearly complete in a patient followed up for only 4.5 months after onset of hydrops. Corneal stromal neovascularization developed in six of the nine of eyes. At the last follow-up visit, four of the six untreated eyes had a best-corrected visual acuity of 20/200 or worse. The patient with intrastromal clefts in both eyes did not develop stromal neovascularization and achieved a contact lens corrected visual acuity of 20/40 or better in each eye without surgical intervention.ConclusionsIntrastromal cleft formation is a manifestation of corneal hydrops in keratoconus. Single or multiple clefts can occur, and bilateral involvement is possible. Clefts generally close over a period of months, but stromal neovascularization is common and may compromise future graft survival.