Comparison of Penetrating Keratoplasty Performed with a Femtosecond Laser Zig-Zag Incision versus Conventional Blade Trephination
Comparison of Penetrating Keratoplasty Performed with a Femtosecond Laser Zig-Zag Incision versus Conventional Blade Trephination
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DOI：
10.1016/j.ophtha.2009.05.003
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发表时间：
2009-09-01
期刊：
影响因子：
13.7
通讯作者：
Lin, Amy
中科院分区：
文献类型：
--
作者：
Farid, Marjan;Steinert, Roger F.;Lin, Amy
目的：评估采用 2 种不同切口技术进行穿透性角膜移植术 (PK) 的患者的视力结果和散光。设计：连续手术系列的回顾性比较。参与者：在加州大学欧文分校学术转诊实践中接受 PK 的 57 名连续患者。方法：对接受飞秒激光之字形切口模式 PK 的 43 名患者的 49 只眼睛与接受飞秒激光之字形切口模式 PK 的 17 只眼睛进行比较。 14 名接受传统 Barron 抽吸环钻 PK 的患者同时进行。所有 PK 均采用相同的 24 口连续尼龙缝合技术闭合。主要结果指标：地形确定的散光、最佳眼镜矫正视力 (BSCVA) 和完全视力恢复。结果：术后随访范围为 1 至 12 个月。术后第 1 个月（P = 0.013）和第 3 个月（P = 0.018），各组之间的平均散光存在显着差异。到第 3 个月时，Z 字形组的平均散光为 3 屈光度 (D)，传统组的平均散光为 4.46 D。在黄斑和视神经功能正常的患者中 (n(zz) = 32；n(con) = 14），第 1 个月 (P = 0.0003) 和第 3 个月 (P = 0.006) 时的 BSCVA 存在显着差异，Z 字形组中 81% 的患者在第 3 个月时达到了 >= 20/40 的 BSCVA，而传统组中这一比例为 45%（P = 0.03).结论：与传统刀片环钻 PK 相比，飞秒激光产生的锯齿形切口可以更快地恢复 BSCVA，并减少散光。
Purpose: To evaluate visual outcomes and astigmatism in patients who underwent penetrating keratoplasty (PK) with 2 different incision techniques.Design: Retrospective comparison of a consecutive surgical series.Participants: Fifty-seven consecutive patients who underwent PK at the University of California, Irvine, academic referral practice.Methods: A comparison of 49 eyes of 43 patients that underwent femtosecond laser zig-zag incision pattern PK versus 17 eyes of 14 patients that underwent conventional Barron suction trephination PK performed contemporaneously. All PKs were closed with an identical, 24-bite running nylon suture technique.Main Outcome Measures: Topographically determined astigmatism, best spectacle-corrected visual acuity (BSCVA), and recovery of full visual potential.Results: The postoperative follow-up ranged from 1 to 12 months. There was a significant difference in average astigmatism between the groups at postoperative month 1 (P = 0.013) and 3 (P = 0.018). By month 3, the average astigmatism was 3 diopters (D) in the zig-zag group and 4.46 D in the conventional group. Of the patients with normal macular and optic nerve function (n(zz) = 32; n(con) = 14), a significant difference in BSCVA was seen at month 1 (P = 0.0003) and month 3 (P = 0.006) with 81% of the zig-zag group versus 45% of the conventional group achieving BSCVA of >= 20/40 by month 3 (P = 0.03).Conclusions: The femtosecond laser generated zig-zag-shaped incision results in a more rapid recovery of BSCVA and induces less astigmatism compared with conventional blade trephination PK.