CAJ | 학술논문

目的评估传导性角膜成形术治疗老视2年的临床疗效.方法前瞻性研究传导性角膜成形术治疗老视患者34例,其中26例远视伴老视症状患者接受双眼手术,8例正视伴老视症状患者接受单眼手术.随访24个月.样本间统计学检验采用t检验和单因素方差分析.结果术后24个月时,远视眼组和正视眼组的双眼裸眼近视力(UNVA)(33 cm,5-logMAR值)(4.63±0.12;4.68±0.16)均比术前(4.06±0.15;4.13士0.18)提高(t=9.237,0.413;P＜0.001);远视眼组双眼裸眼远视力(UDVA)(4.99±0.02)比术前(4.82±0.21)改善(t=6.718,P＜0.05),正视眼组双眼裸眼远视力与术前相同;所有术眼等效球镜度数比术前[(+0.97±0.63)D]降低(t=14.704,P＜0.001),术后1周时达到峰值[(-1.21±1.00)D],并随时间推移缓慢回退,术后24个月[(-0.40±0.70)D]时渐趋平稳;回退速度由术后1个月的(+0.35±0.44)D/月逐渐减慢至24个月的(+0.01±0.01)D/月;对比敏感度和眩光敏感度,眼压、泪膜破裂时间、角膜内皮细胞数目、中央角膜厚度,双眼立体视功能和最佳矫正视力无明显变化.结论传导性角膜成形术治疗老视安全有效,具有较好的屈光状态预测性和控制性,术后以逐渐减缓的速度回退并于术后24个月时相对渐趋平稳,更远期效果尚待进一步观察.
목적 평고전도성각막성형술치료로시2년적림상료효.방법 전첨성연구전도성각막성형술치료로시환자34례,기중26례원시반로시증상환자접수쌍안수술,8례정시반로시증상환자접수단안수술.수방24개월.양본간통계학검험채용t검험화단인소방차분석.결과 술후24개월시,원시안조화정시안조적쌍안라안근시력(UNVA)(33 cm,5-logMAR치)(4.63±0.12;4.68±0.16)균비술전(4.06±0.15;4.13사0.18)제고(t=9.237,0.413;P＜0.001);원시안조쌍안라안원시력(UDVA)(4.99±0.02)비술전(4.82±0.21)개선(t=6.718,P＜0.05),정시안조쌍안라안원시력여술전상동;소유술안등효구경도수비술전[(+0.97±0.63)D]강저(t=14.704,P＜0.001),술후1주시체도봉치[(-1.21±1.00)D],병수시간추이완만회퇴,술후24개월[(-0.40±0.70)D]시점추평은;회퇴속도유술후1개월적(+0.35±0.44)D/월축점감만지24개월적(+0.01±0.01)D/월;대비민감도화현광민감도,안압、루막파렬시간、각막내피세포수목、중앙각막후도,쌍안입체시공능화최가교정시력무명현변화.결론 전도성각막성형술치료로시안전유효,구유교호적굴광상태예측성화공제성,술후이축점감완적속도회퇴병우술후24개월시상대점추평은,경원기효과상대진일보관찰.
Objective To investigate the effect of conductive keratoplasty (CK) for presbyopia and 2 years follow-up. Methods This study is prospective clinical trial. CK was performed on 34 patients for presbyopia, in which 26 hyperopic patients underwent binocular operations and 8 emmetropic patients underwent monocular operation. The following-up time was 24 months. Results At 24 months postoperatively, for the hyperopia group, binocular uncorrected near visual acuity (33 cm) (5-logMAR)(4. 63 ± 0. 12 ) was increased significantly ( t = 9. 237, P ＜ 0. 001) compared pre-operatively ( 4. 06 ±0. 15) ; binocular uncorrected distance visual acuity (4. 99 ±0. 02) was significantly increased (t =6. 718,P ＜0. 05) compared pre-operatively (4. 82 ±0. 21); for the emmetropia group, binocular uncorrected near visual acuity (33 cm) (5-logMAR) (4. 68 ± 0. 16) was increased significantly (t = 10. 413 ,P ＜ 0. 001)compared pre-operatively (4. 13 ±0. 18); binocular uncorrected distance visual acuity was same as preoperative one; compared pre-operatively ( +0.97 ±0. 63D), manifest refractive spherical equivalent was decreased significantly (P ＜0. 001) to peak value ( - 1. 21 ± 1. 00) D at 1 week, and then regressed to a relative plateau( -0. 40 ±0. 70)D at 24 months; the regressive rate was decreased from ( +0. 35 ±0. 44)D/month at 1 month postoperatively to ( +0.01 ± 0. 01 ) D/months at 24 months postoperatively. Contrast sensitivity and glare sensitivity, intraocular pressure, tear break-up time, endothelial cell count, central corneal thickness, stereopsis function and best corrected visual acuity were not significantly changed.Conclusions For treatment of presbyopia, CK appeared to be safe, effective, refractive-predictable and controllable, and relatively stable at 24 months post-operatively. More long-time follow-up is necessary for further evaluation.