CAJ | 학술논문

目的探讨飞秒激光辅助的深板层角膜移植术治疗圆锥角膜的临床效果及安全性.方法回顾性病例研究.采用飞秒激光辅助进行深板层角膜移植手术治疗5例(6只眼)圆锥角膜患者.术前A超测量角膜厚度及角膜最薄点,采用标准对数视力表测量视力,供体及受体角膜均采用飞秒激光进行切削.平均随访时间为(8.9±2.3)个月.对术前、术后的UCVA、BCVA的数据比较采用配对t检验.结果术前平均角膜厚度为(385±48) μm(380～ 460 μm),术前平均裸眼视力为0.06±0.06(0.01～0.15),术前平均最佳矫正视力为0.41±0.35(0.12～1.00),供体直径比受体直径大0.2 mm,供体平均直径为(7.8±0.2) mm(7.3 ～8.0 mm),供体厚度大于受体切割厚度,供体平均厚度为(372±40) μm(350 ～ 400 μm),术后早期所有角膜植片透明,角膜平均厚度为(459±36) μm(389～488 μm),术后最后一次随访,平均UCVA为0.32±0.19(0.12 ～0.60),与术前相比差异有统计学意义(t=-4.433,P＜0.01),BCVA为0.58±0.29(0.20～ 1.00),与术前相比,差异有统计学意义(t=-3.348,P＜0.05).结论飞秒激光辅助的深板层角膜移植对于圆锥角膜患者具有良好的临床效果及安全性.
목적 탐토비초격광보조적심판층각막이식술치료원추각막적림상효과급안전성.방법 회고성병례연구.채용비초격광보조진행심판층각막이식수술치료5례(6지안)원추각막환자.술전A초측량각막후도급각막최박점,채용표준대수시력표측량시력,공체급수체각막균채용비초격광진행절삭.평균수방시간위(8.9±2.3)개월.대술전、술후적UCVA、BCVA적수거비교채용배대t검험.결과 술전평균각막후도위(385±48) μm(380～ 460 μm),술전평균라안시력위0.06±0.06(0.01～0.15),술전평균최가교정시력위0.41±0.35(0.12～1.00),공체직경비수체직경대0.2 mm,공체평균직경위(7.8±0.2) mm(7.3 ～8.0 mm),공체후도대우수체절할후도,공체평균후도위(372±40) μm(350 ～ 400 μm),술후조기소유각막식편투명,각막평균후도위(459±36) μm(389～488 μm),술후최후일차수방,평균UCVA위0.32±0.19(0.12 ～0.60),여술전상비차이유통계학의의(t=-4.433,P＜0.01),BCVA위0.58±0.29(0.20～ 1.00),여술전상비,차이유통계학의의(t=-3.348,P＜0.05).결론 비초격광보조적심판층각막이식대우원추각막환자구유량호적림상효과급안전성.
Objective To evaluate the clinical results and safety of deep anterior lamellar keratoplasty(DALK) in patients with keratoconus assisted by a femtosecond laser.Methods Six eyes of 5 patients with keratoconus underwent DALK procedures by using a femtosecond laser.The mean thinnest corneal thickness,evaluated with ultrasound and measurement of visual acuity by using the standard logarithm visual chart.A femtosecond laser was used to perform corneal cuts on both donor and recipient corneas.The data were expressed as mean ± SD.Mean follow-up was (8.9 ± 2.3) month (range,5-12 months).Results Corneal pachymetry was (385 ± 48) μm(range,380-460 μm).Mean preoperative uncorrected visual acuity was 0.06 ± 0.06 (range,0.01-0.15)and mean preoperative best spectacle-corrected visual acuity was 0.41 ± 0.35 (range,0.12-1.00).The donor corneal lamella diameters were 0.20 mm larger and thicker than the recipient to restore a physiologic corneal thickness and shape.Mean donor diameter was (7.8 ± 0.2) mm (range,7.3-8.0 mm) and mean thickness was (372 ± 40) μm (range,350-400 μm).Early postoperative evaluation showed a clear graft in all cases.Mean corneal thickness was (459 ± 36) μm(range,389-488 μm).At the last postoperative examination mean uncorrected visual acuity was 0.32 ± 0.19 (range,0.12-0.60),and the mean best corrected visual acuity was 0.58 ± 0.29 (range,0.20-1.00).The UCVA and BCVA improved significantly after surgery (t =-4.433,-3.348,P ＜ 0.05).Conclusions Our early results indicate that femtosecond laser-assisted deep anterior lamellar keratoplasty shows promise as a safe and effective surgical choice in the treatment of keratoconus.