Acute corneal hydrops in keratoconus.
Acute corneal hydrops in keratoconus.
复制标题
圆锥角膜中的急性角膜积水。
DOI：
10.1016/s0161-6420(94)31110-9
复制
发表时间：
1994
期刊：
影响因子：
13.7
通讯作者：
Roger J. Buckley
中科院分区：
文献类型：
--
作者：
S J Tuft;W. Gregory;Roger J. Buckley
目的：探讨与急性角膜积液发生及转归相关的临床因素。方法：从圆锥角膜患者的5242只眼(2723例)中鉴定出147只眼(124例)的急性角膜积液。他们比较了发生积水的患者和未受影响的患者的临床特征，并通过精算方法评估了向穿透性角膜移植的进展。结果：发生急性积水的患者倾向于较年轻的男性，他们在诊断圆锥角膜时有晚期角膜扩张和较差的矫正Snellen视力(P<；0.001)。患有严重过敏性眼病的患者中，急性积水也更为常见(P<；0.001)。积水的发展是随后接受穿透性角膜移植的一个非常重要的风险因素(P<；0.00001)，在研究结束时，147只眼中有87只眼(59%)接受了视力恢复手术。与无积水的移植眼相比，这些眼的移植排斥反应发生率更高(P=0.02)。水肿消退后，60只未手术眼中有46只眼配戴了隐形眼镜，其中28只眼(61%)的Snellen视力达到20/40或更高，但对侧眼的视力往往更好。结论：尽管穿透性角膜移植常用于急性角膜积水后的视力恢复，但排斥反应的发生率增加。在积水消退后，只有一小部分人重新戴上隐形眼镜，但一些患者达到了功能水平的视力，因此可以推迟或避免手术。
Purpose:To determine the clinical factors associated with the development of acute corneal hydrops and its subsequent outcome.Methods:The authors identified 147 eyes (124 patients) with acute hydrops from a database of 5242 eyes (2723 patients) with keratoconus. They compared the clinical features of patients in whom hydrops developed with unaffected patients and assessed the progression to penetrating keratoplasty by actuarial methods.Results:Patients in whom acute hydrops developed tended to be younger males who had advanced corneal ectasia and a poor corrected Snellen visual acuity at the diagnosis of their keratoconus (P< 0.001). Acute hydrops also was more common in the presence of severe allergic eye disease (P< 0.001). The development of hydrops was a very significant risk factor for subsequently receiving a penetrating keratoplasty (P< 0.00001) and at the end of the study period 87 (59%) of the 147 eyes had surgery for visual rehabilitation. These eyes had a greater rate of graft rejection than eyes grafted without hydrops (P= 0.02). After resolution of the hydrops, 46 of the 60 un-operated eyes had been refitted with contact lenses, of which 28 (61%) achieved a Snellen visual acuity of 20/40 or better, although a better visual acuity often was present in the contralateral eye. Microbial keratitis developed in two of these eyes after refitting.Conclusions:Although a penetrating keratoplasty often is indicated for visual rehabilitation after acute corneal hydrops, there is an increased rate of rejection. Only a minority of eyes were re-established in contact lenses after resolution of hydrops, but some patients achieved a functional level of visual acuity such that the procedure could be delayed or avoided.