飞秒激光辅助的大气泡法全板层角膜移植治疗圆锥角膜及角膜瘢痕临床疗效观察  

Clinical outcomes of femtosecond laser-assisted deep anterior lamellar keratoplasty by using big-bubble technique for keratoconus and corneal scar

作　　者：王振茂[1] 肖凯霖 陆妍 杨丽萍[2] 葛轶睿[2] 黄振平[2] 陆燕[2] Wang Zherunao;Xiao Kailin;Lu Yan;Yang Iuping;Ge Yirui;Huang Zhenping;Lu Yan(Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong,Shantou 515000,China;Department of Ophthalmology General Hospital of Eastern Theater Command,Nanjing 210002,China;Department of Ophthalmology,People's Hospital of Wuwei,Gansu,Wuwei 733000,China)

机构地区：[1]汕头大学·香港中文大学联合汕头国际眼科中心,广东汕头515000 [2]东部战区总医院(原南京军区南京总医院)眼科,江苏南京210002 [3]甘肃省武威市人民医院,甘肃武威733000

出　　处：《临床眼科杂志》2019年第3期193-196,共4页Journal of Clinical Ophthalmology

基　　金：国家自然科学基金项目(编号:81270979);江苏省青年医学人才项目(编号:QNRC2016905);广东省医学科学技术研究基金项目(编号:A2018478)

摘　　要：目的观察飞秒激光辅助的大气泡全板层角膜移植术治疗圆锥角膜及角膜瘢痕临床效果。方法系列病例研究。20例(23只眼)患者(圆锥角膜22只眼,角膜瘢痕1只眼)采用飞秒激光辅助的大气泡法全板层角膜移植手术。供体及受体角膜均采用500-kHz VisuMax飞秒激光进行垂直边切,平均随访时间为(53.6±5.5)个月(47~61个月)。结果术中大气泡成功形成及后弹力层清晰暴露的成功率为91.3%(21/23)。术后裸眼视力、最佳矫正视力、角膜曲率、角膜散光及角膜厚度均有改善,与术前相比差异显著(P<0.05)。结论飞秒激光辅助的大气泡法全板层角膜移植对于圆锥角膜和角膜瘢痕患者具有良好的临床效果及安全性。Objective To observe the clinical effect of deep anterior lamellar keratoplasty using big-bubble technique assisted by a femtosecond laser for patients with keratoconus or corneal scar.Methods This was a case-series study. 20 patients(23 eyes, 22 with keratoconus and 1 with corneal scar) were enrolled and underwent femtosecond laser-assisted deep anterior lamellar keratoplasty using big-bubble technique. A 500-kHz VisuMax femtosecond laser was used to create vertical side-cut on both the donor and recipient corneas. The mean follow-up period was 53.6±5.5 months(range from 47 to 61 months).Results Big-bubble and naked Descemet’s membrane(DM) were successfully achieved in twenty-one eyes(91.3%, 21/23). The mean uncorrected visual acuity, best-corrected visual acuity, keratometry, corneal astigmatism, and corneal thicknesses were all significantly improved(P<0.05) after the surgery.Conclusions The femtosecond laser-assisted deep anterior lamellar keratoplasty with big bubble technique is a safe and effective surgical treatment option for patients with keratoconus or corneal scar.

关 键 词：飞秒激光 大气泡全板层角膜移植 圆锥角膜 角膜瘢痕 临床疗效 

分 类 号：R779.65[医药卫生—眼科]