Penetrating keratoplasty using femtosecond laser-enabled keratoplasty with zig-zag incisions versus a mechanical trephine in patients with keratoconus.
Penetrating keratoplasty using femtosecond laser-enabled keratoplasty with zig-zag incisions versus a mechanical trephine in patients with keratoconus.
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DOI：
10.1136/bjophthalmol-2012-301662
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发表时间：
2012-09
期刊：
影响因子：
--
通讯作者：
Rabinowitz YS
中科院分区：
文献类型：
--
作者：
Gaster RN;Dumitrascu O;Rabinowitz YS
本文将比较两种不同的穿透性角膜移植(PKP)技术对圆锥角膜患者的视觉效果。这是一组在美国加利福尼亚州贝弗利山庄的角膜眼科研究所接受PKP的116名圆锥角膜患者(137只眼)的回顾性对比手术病例。56例(66眼)圆锥角膜患者接受了锯齿形切口的飞秒激光角膜成形术。并与60例(71眼)行传统刀片式机械环钻的患者进行比较。术后随访3~6个月。主要观察指标包括裸眼视力、最佳矫正眼镜视力(BSCVA)、等值屈光度和地形图决定的散光。在FLEK组中，术后3个月的矫正视力明显好于对照组(p=0.001)。术后3个月视力恢复至20/40，FLEK组明显好于对照组(P<；0.001)。FLEK组的地形性散光程度较低，但仅在随访3个月时两组间差异有统计学意义(p=0.001)。两组患者术后并发症发生率无明显差异。术后随访6个月，圆锥角膜患者接受FLEK术后视力恢复快，远期疗效好。
This paper will compare the visual outcomes of two different penetrating keratoplasty (PKP) techniques in patients with keratoconus. It is a retrospective comparative surgical case series of 116 keratoconus patients (137 eyes) who had PKP at the Cornea Eye Institute, Beverly Hills, California, USA. 56 keratoconus patients (66 eyes) underwent femtosecond laser-enabled keratoplasty (FLEK) with a zig-zag incision configuration. Their visual parameters were compared with those of 60 patients (71 eyes) who had traditional blade mechanical trephination PKP. The range of follow-up was between 3 and 6 months. The main outcome measures included uncorrected visual acuity and best spectacle-corrected visual acuity (BSCVA), manifest refractive spherical equivalent and topographically determined astigmatism. BSCVA was significantly better as early as 3 months postoperatively (p=0.001) in the FLEK group. Visual recovery to 20/40 after 3 months was significantly better in the FLEK group (p<0.001). Topographic astigmatism was lower in the FLEK group, but the difference between the two groups reached significance only at 3 months of follow-up (p=0.001). Postoperative complications noted were not different between the two groups. Faster visual recovery and better long-term outcomes were observed in keratoconus patients who had FLEK compared with those who had the mechanical PKP procedure with 6 months of postoperative follow-up.
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