·AIM: To describe the initial outcomes and safety of femtosecond laser-assisted deep anterior lamellar keratoplasty(DALK) for keratoconus and post-LASIK keratectasia.·METHODS: In this non-comparative case se...·AIM: To describe the initial outcomes and safety of femtosecond laser-assisted deep anterior lamellar keratoplasty(DALK) for keratoconus and post-LASIK keratectasia.·METHODS: In this non-comparative case series, 10 eyes of 9 patients underwent DALK procedures with a femtosecond laser(Carl Zeiss Meditec AG, Jena,Germany). Of the 9 patients, 7 had keratoconus and 2had post-LASIK keratectasia. A 500 kHz VisuMax femtosecond laser was used to perform corneal cuts on both donor and recipient corneas. The outcome measures were the uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA), corneal thickness,astigmatism, endothelial density count(EDC), and corneal power.·RESULTS: All eyes were successfully treated. Early postoperative evaluation showed a clear graft in all cases. Intraoperative complications included one case of a small Descemet’s membrane perforation.Postoperatively, there was one case of stromal rejection,one of loosened sutures, and one of wound dehiscence.A normal corneal pattern topography and transparency were restored, UCVA and BCVA improved significantly,and astigmatism improved slightly. There was no statistically significant decrease in EDC.· CONCLUSION: Our early results indicate that femtosecond laser-assisted deep anterior lamellar keratoplasty could improve UCVA and BCVA in patients with anterior corneal pathology. This approach shows promise as a safe and effective surgical choice in the treatment of keratoconus and post-LASIK keratectasia.展开更多
目的:分析睑板腺功能障碍型干眼(MGD)和水液缺乏型干眼(ADDE)患者的像差和散射相关参数,评估两种干眼类型患者的视觉质量。方法:将2018-01/10在我院门诊就诊的MGD患者25例(MGD组),ADDE患者25例(ADDE组),同时期就诊的健康人25例(对照组)...目的:分析睑板腺功能障碍型干眼(MGD)和水液缺乏型干眼(ADDE)患者的像差和散射相关参数,评估两种干眼类型患者的视觉质量。方法:将2018-01/10在我院门诊就诊的MGD患者25例(MGD组),ADDE患者25例(ADDE组),同时期就诊的健康人25例(对照组)纳入此次研究。三组受试对象填写眼表疾病指数量表(OSDI),接受泪液相关检查:泪液分泌试验(SⅠt)、泪膜破裂时间(TBUT)、角膜荧光染色(FL)。使用iTrace分析仪记录三组受试对象的高阶像差(HO)、球差(SA)、彗差(CA)和三叶草差(TA)的均方根值(RMS)。利用双通道视觉分析仪(OQASⅡ)记录三组受试对象自然状态下的散射值,包括调制传递函数截止频率(MTF cutoff)、斯特列尔比(SR)、客观散射指数(OSI),以及持续睁眼状态下OSI动态变化值(OSI均值)。结果:MGD组的OSDI评分明显高于ADDE组(38.2±5.6 vs 32.2±7.2分,P<0.01)。ADDE组的SⅠt明显低于MGD组(1.98±0.92 vs 12.52±6.80mm/5min,P<0.001)。MGD组的TBUT和FL显著低于ADDE组(TBUT:3.27±1.91 vs 6.02±1.05s,FL:3.27±2.18 vs 6.23±2.19,均P<0.001)。MGD组和ADDE组的HO、CA、TA、SA的RMS值均显著高于对照组(均P<0.001)。MGD组和ADDE组的HO、CA、TA、SA均无显著性差异(HO:0.385±0.081 vs 0.344±0.092,CA:0.210±0.062 vs 0.175±0.075,TA:0.107±0.056 vs 0.086±0.042,SA:0.322±0.078 vs 0.273±0.097,HO:t=1.67,P>0.05;CA:t=1.80,P>0.05;TA:t=1.50,P>0.05;SA:t=1.97,P>0.05)。MGD和ADDE组之间的MTF cutoff、SR、OSI无差异(MTF cutoff:33.28±8.28 vs 37.12±9.53,SR:0.19±0.06 vs 0.22±0.08,OSI:1.30±0.32 vs 1.12±0.52,MTF cutoff:t=1.52,P>0.05;SR:t=1.50,P>0.05;OSI:t=1.47,P>0.05)。持续睁眼状态下MGD组的OSI均值明显高于ADDE组(2.386±0.118 vs 1.554±0.058,P<0.001)。结论:治疗干眼的同时需要关注改善患者的视觉质量,MGD患者的视觉质量影响比ADDE患者更加严重。泪膜动态状态下的OSI均值是评估干眼患者视觉质量的敏感指标。展开更多
基金National Natural Science Foundation of China (No. 81270979)Natural Science Foundation of Jiangsu Province, China (No.BK2012777)
文摘·AIM: To describe the initial outcomes and safety of femtosecond laser-assisted deep anterior lamellar keratoplasty(DALK) for keratoconus and post-LASIK keratectasia.·METHODS: In this non-comparative case series, 10 eyes of 9 patients underwent DALK procedures with a femtosecond laser(Carl Zeiss Meditec AG, Jena,Germany). Of the 9 patients, 7 had keratoconus and 2had post-LASIK keratectasia. A 500 kHz VisuMax femtosecond laser was used to perform corneal cuts on both donor and recipient corneas. The outcome measures were the uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA), corneal thickness,astigmatism, endothelial density count(EDC), and corneal power.·RESULTS: All eyes were successfully treated. Early postoperative evaluation showed a clear graft in all cases. Intraoperative complications included one case of a small Descemet’s membrane perforation.Postoperatively, there was one case of stromal rejection,one of loosened sutures, and one of wound dehiscence.A normal corneal pattern topography and transparency were restored, UCVA and BCVA improved significantly,and astigmatism improved slightly. There was no statistically significant decrease in EDC.· CONCLUSION: Our early results indicate that femtosecond laser-assisted deep anterior lamellar keratoplasty could improve UCVA and BCVA in patients with anterior corneal pathology. This approach shows promise as a safe and effective surgical choice in the treatment of keratoconus and post-LASIK keratectasia.
文摘目的:分析睑板腺功能障碍型干眼(MGD)和水液缺乏型干眼(ADDE)患者的像差和散射相关参数,评估两种干眼类型患者的视觉质量。方法:将2018-01/10在我院门诊就诊的MGD患者25例(MGD组),ADDE患者25例(ADDE组),同时期就诊的健康人25例(对照组)纳入此次研究。三组受试对象填写眼表疾病指数量表(OSDI),接受泪液相关检查:泪液分泌试验(SⅠt)、泪膜破裂时间(TBUT)、角膜荧光染色(FL)。使用iTrace分析仪记录三组受试对象的高阶像差(HO)、球差(SA)、彗差(CA)和三叶草差(TA)的均方根值(RMS)。利用双通道视觉分析仪(OQASⅡ)记录三组受试对象自然状态下的散射值,包括调制传递函数截止频率(MTF cutoff)、斯特列尔比(SR)、客观散射指数(OSI),以及持续睁眼状态下OSI动态变化值(OSI均值)。结果:MGD组的OSDI评分明显高于ADDE组(38.2±5.6 vs 32.2±7.2分,P<0.01)。ADDE组的SⅠt明显低于MGD组(1.98±0.92 vs 12.52±6.80mm/5min,P<0.001)。MGD组的TBUT和FL显著低于ADDE组(TBUT:3.27±1.91 vs 6.02±1.05s,FL:3.27±2.18 vs 6.23±2.19,均P<0.001)。MGD组和ADDE组的HO、CA、TA、SA的RMS值均显著高于对照组(均P<0.001)。MGD组和ADDE组的HO、CA、TA、SA均无显著性差异(HO:0.385±0.081 vs 0.344±0.092,CA:0.210±0.062 vs 0.175±0.075,TA:0.107±0.056 vs 0.086±0.042,SA:0.322±0.078 vs 0.273±0.097,HO:t=1.67,P>0.05;CA:t=1.80,P>0.05;TA:t=1.50,P>0.05;SA:t=1.97,P>0.05)。MGD和ADDE组之间的MTF cutoff、SR、OSI无差异(MTF cutoff:33.28±8.28 vs 37.12±9.53,SR:0.19±0.06 vs 0.22±0.08,OSI:1.30±0.32 vs 1.12±0.52,MTF cutoff:t=1.52,P>0.05;SR:t=1.50,P>0.05;OSI:t=1.47,P>0.05)。持续睁眼状态下MGD组的OSI均值明显高于ADDE组(2.386±0.118 vs 1.554±0.058,P<0.001)。结论:治疗干眼的同时需要关注改善患者的视觉质量,MGD患者的视觉质量影响比ADDE患者更加严重。泪膜动态状态下的OSI均值是评估干眼患者视觉质量的敏感指标。
