CAJ | 학술논문

目的评价飞秒激光辅助的深板层角膜移植术(DALK)治疗角膜基质病变的早期临床效果及安全性.方法系列病例研究.13例(14眼)各种角膜基质病变患者(外伤后角膜瘢痕1眼,角膜炎后角膜瘢痕8眼,角膜基质层营养不良5眼)采用飞秒激光辅助的DALK术进行治疗.评价指标包括手术前后裸眼视力、最佳矫正视力、内皮细胞密度和并发症.结果所有手术均顺利完成,术中无任何并发症.平均随访时间(7.3±3.8)个月(2～14个月).与术前相比,有11眼裸眼视力提高(78.6％),平均提高1.7行(未变～6行);所有患者最佳矫正视力均较术前提高,平均提高2.4行(1～8行).有3眼采用治疗性准分子激光消融术进行辅助治疗,最后一次随访时统计,内皮细胞密度丢失率为1％,未见植片排斥、感染、上皮植入等并发症.结论飞秒激光辅助的DALK术可提高各种角膜基质病变患者的裸眼视力及最佳矫正视力,飞秒激光可透过混浊的角膜进行基质深层的有效光滑的切割.
목적 평개비초격광보조적심판층각막이식술(DALK)치료각막기질병변적조기림상효과급안전성.방법 계렬병례연구.13례(14안)각충각막기질병변환자(외상후각막반흔1안,각막염후각막반흔8안,각막기질층영양불량5안)채용비초격광보조적DALK술진행치료.평개지표포괄수술전후라안시력、최가교정시력、내피세포밀도화병발증.결과 소유수술균순리완성,술중무임하병발증.평균수방시간(7.3±3.8)개월(2～14개월).여술전상비,유11안라안시력제고(78.6％),평균제고1.7행(미변～6행);소유환자최가교정시력균교술전제고,평균제고2.4행(1～8행).유3안채용치료성준분자격광소융술진행보조치료,최후일차수방시통계,내피세포밀도주실솔위1％,미견식편배척、감염、상피식입등병발증.결론 비초격광보조적DALK술가제고각충각막기질병변환자적라안시력급최가교정시력,비초격광가투과혼탁적각막진행기질심층적유효광활적절할.
Objective To describe the initial outcomes and safety of deep anterior lamellar keratoplasty (DALK) assisted by a femtosecond laser for stromal corneal pathology.Methods In a case series,14 eyes of 13 patients with various stromal corneal diseases (1 eye post-traumatic corneal scar,8 eyes post-keratitis corneal scars and 5 eyes stromal corneal dystrophies) underwent DALK procedures by using a femtosecond laser.The parameters measured include uncorrected visual acuity (UCVA),best-corrected visual acuity (BCVA),endothelial cell density (ECD) and complications.Results All eyes were successfully treated without intraoperative complications.Mean follow-up was 7.3±3.8 months (range,2-14 months).Uncorrected visual acuity improved in 11 eyes compared to preoperative UCVA.The mean difference between preoperative and postoperative UCVAs was a gain of 1.7 lines (range,unchanged-6 lines).Best-corrected visual acuity improved in all eyes compared to preoperative levels.The mean difference between preoperative and postoperative BCVAs was a gain of 2.4 lines (range,1-8 lines).Adjuvant surgical procedures were performed on 3 eyes (treated with phototherapeutic keratectomy),the mean reduction in endothelial cell density was 1％ at the last follow-up.No graft rejection,infection,or epithelial ingrowth was found in this series of pati ents.Conclusion Femtosecond laser-assisted deep anterior lamellar keratoplasty can improve UCVA and BCVA in patients with various stromal corneal pathologies.Our early results indicate that the femtosecond laser produced an effective and smooth dissection through opaque corneas even at deeper settings.