Photoshop软件设计指导的飞秒激光辅助DLK治疗圆锥角膜  

Clinical Study of Photoshop Software Guided Femtosecond Laser Assisted DLK for the Treatment of Keratoconus

作　　者：亓晓琳 王妙霖 林潇 贾艳妮 黄慈欣 高华 Xiaolin Qi;Miaolin Wang;Xiao Lin;Yanni Jia;Cixin Huang;Hua Gao(Eye Institute of Shandong First Medical University,Eye Hospital of Shandong First Medical University(Shandong Eye Hospital),State Key Laboratory Cultivation Base,Shandong Provincial Key Laboratory of Ophthalmology,School of Ophthalmology,Shandong First Medical University,Jinan 250012,China)

机构地区：[1]山东第一医科大学附属眼科研究所、山东第一医科大学附属眼科医院(山东省眼科医院)、山东省眼科学重点实验室-省部共建国家重点实验室培育基地、山东第一医科大学眼科学院,济南250012

出　　处：《中华眼视光学与视觉科学杂志》2022年第12期888-893,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：国家自然科学基金项目(81900907、81870639);泰山学者计划(201812150)。

摘　　要：目的:观察Photoshop软件个性化设计指导的飞秒激光辅助深板层角膜移植术(DLK)治疗圆锥角膜的有效性和准确性。方法:前瞻性干预性非随机对照研究。连续收集山东第一医科大学附属眼科医院2016年12月至2018年12月因圆锥角膜完成期拟行飞秒激光辅助DLK的患者,分为研究组和对照组。研究组术前应用Photoshop软件测量患者角膜直径,然后个性化设计角膜植床/植片的直径;而对照组植床/植片直径统一设定为7.9/8.2 mm。观察患者术后12个月最佳矫正视力(BCVA)、平均角膜曲率、等效球镜度、平均散光等指标。采用独立样本t检验对数据进行统计学分析。结果:共纳入72例(72眼)患者,其中研究组40例,植床/植片的直径分别为7.9/8.2 mm 6例、8.1/8.4 mm 18例、8.3/8.6 mm 16例;对照组32例,植床/植片直径均为7.9/8.2 mm。术后1周,研究组应用Photoshop软件实际测量的角膜植片直径为(8.4±0.1)mm,与术前个性化设计的植片直径进行对比,二者之间的差异无统计学意义(t=-0.47,P=0.710)。术后12个月,研究组BCVA(LogMAR)为0.44±0.24,较对照组(0.58±0.30)视力更好(t=-2.19,P=0.030);研究组散光为(3.96±2.68)D,相比对照组的(6.30±4.71)D,其散光更小(t=-2.65,P<0.001)。所有患者中均未出现后弹力层破裂、缝线松动、缝线新生血管化、植片免疫排斥反应等并发症。结论:应用Photoshop软件个性化设计角膜植床/植片直径的方法具有较高的准确性和可预测性,可以显著改善圆锥角膜患者DLK后的屈光状态。Objective::To observe the effectiveness and accuracy of femtosecond laser-assisted deep lamellar keratoplasty(DLK)for the treatment of keratoconus guided by Photoshop software personalized design.Methods::In this prospective,noncomparative and interventional study,patients with advanced keratoconus that were scheduled to undergo DLK at Eye Hospital of Shandong First Medical University from December 2016 to December 2018 were continuously enrolled and divided into the experimental group and the control group.For patients in the experimental group,the corneal diameter was measured with Photoshop software before surgery and then the diameter of the corneal implant bed/graft was designed individually,while in the control group,the diameter of the corneal implant bed/graft was uniformly set at 7.9/8.2 mm.Indicators including the best corrected visual acuity(BCVA),mean corneal curvature,spherical equivalent and average astigmatism were observed 12 months after surgery.Independent samples t-test was used for statistical analysis of the data.Results::A total of 72 patients(72 eyes)were included,including 40 cases in the experimental group and 32 patients in the control group.In the experimental group,6 patients had a corneal implant bed/graft diameter of 7.9/8.2 mm,18 patients had a diameter of 8.1/8.4 mm and 16 patients had a diameter of 8.3/8.6 mm.One week after the operation,the actual diameter of corneal graft measured by Photoshop software in the experimental group was 8.4±0.1 mm,with no significant difference compared with that personalized designed preoperatively(t=-0.47,P=0.710).Twelve months after the operation,the best corrected visual acuity(LogMAR)of the experimental group was 0.44±0.24,which was better than that of the control group 0.58±0.30(t=-2.19,P=0.030).The average astigmatism of the experimental group was 3.96±2.68 D,more stable than that of the control group 6.30±4.71 D(t=-2.65,P<0.001).Complications such as Descemet's membrane rupture,suture loosening,suture-induced corneal neovascularization a

关 键 词：飞秒激光 PHOTOSHOP软件 深板层角膜移植术 圆锥角膜 

分 类 号：R779.63[医药卫生—眼科]