Paired arcuate and modified circular keratotomy in keratoconus  

作　　者：Samir A Quawasmi 

机构地区：[1]Cornea Specialized Clinic,Amman 11118,Jordan

出　　处：《World Journal of Ophthalmology》2013年第1期1-15,共15页世界眼科杂志

摘　　要：AIM: To reduce astigmatism, increase corneal volume and improve visual acuity. METHODS: A retrospective, single-surgeon, singlecenter, clinic-based study of a surgical procedure on twenty-four eyes of fourteen patients diagnosed with stage Ⅲ or stage Ⅳ keratoconus. Paired arcuate keratotomy coupled with modified circular keratotomy was performed at a single center by a single surgeon as an outpatient procedure with local anaesthetic in a minor surgery room. Modified circular keratotomy was performed 7 mm from the pupillary center with depth of incision ranging between 70% and 90% of corneal thickness. Arcuate keratotomy was performed 2.5 mm from the pupillary center with the depth of incision at 90% of corneal thickness. Angular length of the arcs ranged between 60° and 120° depending on the astigmatic power of the cornea. RESULTS: Astigmatism decreased in 87.5% of the 24 treated eyes, increased in 8.33% and did not change in 4.17%. Corneal volume increased in 91.66% of the 24 eyes and decreased in 8.34%. Visual acuity improved in 100% of the eyes; there was a mean improvement of 59% from preoperative visual acuity, 8.34% of the treated eyes reaching a visual acuity of 1.0(20/20) with correction. No complications occurred during orafter surgery. No suturing was performed and there was no rupturing at incision sites. There was statistical significance difference between pre.sph against post.sph(P = 0.001). Also between pre.cyl against post.cyl(P = 0.005), there was no significance difference between pre.axis against post.axis(P = 0.05).CONCLUSION: Paired arcuate keratotomy coupled with modified circular keratotomy should be considered as an intervention before performing keratoplasty.AIM： To reduce astigmatism, increase corneal volume and improve visual acuity.METHODS： A retrospective, single-surgeon, single-center, clinic-based study of a surgical procedure on twenty-four eyes of fourteen patients diagnosed with stage Ⅲ or stage Ⅳ keratoconus. Paired arcuate kera-totomy coupled with modified circular keratotomy was performed at a single center by a single surgeon as an outpatient procedure with local anaesthetic in a minor surgery room. Modified circular keratotomy was performed 7 mm from the pupillary center with depth of incision ranging between 70% and 90% of corneal thickness. Arcuate keratotomy was performed 2.5 mm from the pupillary center with the depth of incision at 90% of corneal thickness. Angular length of the arcs ranged between 60° and 120° depending on the astig-matic power of the cornea. RESULTS： Astigmatism decreased in 87.5% of the 24 treated eyes, increased in 8.33% and did not change in 4.17%. Corneal volume increased in 91.66% of the 24 eyes and decreased in 8.34%. Visual acuity improved in 100% of the eyes; there was a mean improvement of 59% from preoperative visual acuity, 8.34% of the treated eyes reaching a visual acuity of 1.0 （20/20） with correction. No complications occurred during orafter surgery. No suturing was performed and there was no rupturing at incision sites. There was statistical significance difference between pre.sph against post.sph （ P = 0.001）. Also between pre.cyl against post.cyl （ P = 0.005）, there was no significance difference between pre.axis against post.axis （P = 0.05）.CONCLUSION： Paired arcuate keratotomy coupled with modified circular keratotomy should be considered as an intervention before performing keratoplasty.

关 键 词：Arcuate keratotomy Circular keratotomy KERATOCONUS ASTIGMATISM KERATOTOMY Bader procedure ECTASIA 

分 类 号：R77[医药卫生—眼科]