角膜环片植入术后角膜炎患者的角膜密度变化

IF 0.1 Q4 OPHTHALMOLOGY
A. Basiony, Mohammad M. E. Mohammad Abdulfattah, Asmaa M. Ibrahim
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引用次数: 0

摘要

角膜炎(KC)是一种外生性角膜疾病,其特征是角膜逐渐变薄并伴有近视散光。基质内角膜环切片(ICRS)已被广泛选作矫正 KC 的手术干预措施,以延迟角膜移植手术的需要。本研究的目的是评估角膜基质内环节段(ICRS)植入后,KC 角膜上不同环和深度的角膜密度变化,并将这些变化与其他光学和屈光结果联系起来。 这是一项前瞻性介入研究,共纳入了 40 名 KC 患者的 56 只眼睛,他们都接受了飞秒激光辅助的 Keraring ICRS 植入术。研究人员在术前和术后 90 天评估了所有环形区的未矫正和最佳矫正视力(UCVA 和 BCVA)、屈光度、角膜度数、Q 值、角膜最薄位置厚度(TCLT)和角膜密度。 植入 ICRS 3 个月后,与术前相比,UCVA、BCVA 从 0.21±0.12 和 0.44±0.15 显著提高到 0.27±0.12 和 0.58±0.15(P<0.001),球面等值(SE)显著降低,从 -5.而 K1、K2、Km、Kmax 则分别从 47.67±4.10 D、51.39±4.74 D、49.44±4.28 D 和 57.78±7.35 D 明显降低到 44.28±2.86 D、46.84±3.42 D、45.45±2.98 D 和 53.89±5.49 D(P<0.001)。角膜散光和 Q 值明显改善,分别从 3.73±2.17 D 和 -0.99±0.5 降至 2.55±2.08 和 -0.28±0.5 (P<0.001)。001),中央层的2-6毫米和6-10毫米环和总直径的平均密度(分别为P<0.001、P=0.047和P<0.001),以及角膜总厚度的2-6毫米环和总直径的平均密度(分别为P<0.001和P=0.014)。相比之下,角膜中央层、后角膜层和总角膜层的密度计读数在 10-12 环时明显下降(分别为 P=0.003、P<0.001 和 P=0.008)。角膜密度读数的百分比变化与 UCVA、BCVA、SE、CA 和 Q 值的百分比变化无明显相关性。中央和 2-6 毫米总环密度的百分比变化与 K1(分别为 r=-0.30,P=0.025 和 r=-0.29,P=0.029)、K2(分别为 r=-0.33,P=0.013 和 r=-0.31,P=0.021)和 Km(分别为 r=-0.34,P=0.010 和 r=-0.33,P=0.014)的百分比变化呈负相关。 植入 ICRS 后,角膜密度发生了显著变化,特别是在角膜中央层和 2-6 毫米的环区,与角膜前表面的角膜测量值呈反相关。此外,ICRS 还能显著改善屈光状态、视力、角膜角膜度数和非球面度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Corneal densitometry changes in keratoconus patients after intrastromal corneal ring segments implantation
Keratoconus (KC) is an ectatic corneal disorder characterized by progressive corneal thinning with myopic astigmatism. Intrastromal corneal ring segments (ICRS) have been broadly selected as a surgical intervention for KC correction to delay the need of keratoplasty. The purpose of this study was to evaluate the corneal densitometry changes in the various annuluses and depths in KC corneas after intrastromal corneal ring segment (ICRS) implantation and to correlate those changes with the other optical and refractive outcomes. This was a prospective interventional study included 56 eyes of 40 patients with KC who underwent femtosecond laser-assisted Keraring ICRS implantation. The uncorrected and best-corrected visual acuities (UCVA and BCVA), refraction, keratometry, Q-value, thinnest corneal location thickness (TCLT), and corneal densitometry in all the annular zones were assessed preoperatively and 90 days after surgery. Following the ICRS implantation after 3 months, when compared to preoperatively, the UCVA, BCVA, improved significantly from 0.21±0.12 and 0.44±0.15 to 0.27±0.12 and 0.58±0.15 (P<0.001) and spherical equivalent (SE) decreased significantly, from −5.28±1.65 D to −4.05±1.24 D (P<0.001) whereas the K1, K2, Km, Kmax, reduced significantly from 47.67±4.10 D, 51.39±4.74 D, 49.44±4.28 D, and 57.78±7.35 D, to 44.28±2.86 D, 46.84±3.42 D, 45.45±2.98 D, and 53.89±5.49 D (P<0.001) respectively. Corneal astigmatism, and Q-value were markedly improved from 3.73±2.17 D and −0.99±0.5 to 2.55±2.08 and −0.28±0.5 (P<0.001) .As regard corneal densitometry there was a significant elevation in the mean density of 2–6 mm annulus for the anterior and posterior layers (P=0.001), of 2–6 mm and 6–10 mm annuluses and total diameter for the central layer (P<0.001, P=0.047, and P<0.001, respectively), and of 2–6 mm annulus and total diameter for the total corneal thickness (P<0.001 and P=0.014, respectively). In contrast, a significant decline in the densitometry readings was observed in the 10–12 annulus for the central, posterior, and total corneal layers (P=0.003, P<0.001, and P=0.008, respectively). The percentage changes in the corneal densitometry readings did not significantly correlate with the percentage changes in the UCVA, BCVA, SE, CA and Q value. The percentage changes in the central and total 2–6 mm annuluses densities correlated negatively with the percentage changes in the K1 (r=−0.30, P=0.025 and r=−0.29, P=0.029, respectively), K2 (r=−0.33, P=0.013 and r=−0.31, P=0.021, respectively), and Km (r=−0.34, P=0.010 and r=−0.33, P=0.014, respectively). The ICRS implantation results in significant changes in corneal densitometry specifically in the central corneal layer and in the 2–6 mm annulus, with an inverse correlation with keratometric values of the front corneal surface. Besides, ICRS leads to substantial improvements of refractive status, visual acuity and corneal keratometry and asphericity.
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