圆锥角膜防治现状及展望  

Current status and prospect of keratoconus prevention and treatment

作　　者：王一凡 杨凯丽 任胜卫 Wang Yifan;Yang Kaili;Ren Shengwei(Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Henan Eye Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学人民医院,河南省人民医院,河南省立眼科医院,郑州450003

出　　处：《中华实验眼科杂志》2025年第4期350-356,共7页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金青年科学基金(81200664);河南省自然科学基金面上项目(222300420536);河南省医学科技攻关计划省部共建重点项目(SBGJ202002028);河南省中青年卫生健康科技创新杰出青年人才培养项目(YXKC2020023);河南省立眼科医院基础研究重点专项(20JCZD003)。

摘　　要：圆锥角膜是一种以角膜中央或旁中央扩张变薄、向前呈锥形突起及高度近视伴有不规则散光为特征的致盲眼病。圆锥角膜尚无有效的根治手段,目前的临床防治方法主要包括危险因素防治、非手术光学矫正及手术治疗。危险因素防治主要措施包括干预揉眼行为、变应性疾病和系统性疾病的对症治疗以及纠正不良睡姿;非手术光学矫正通过配戴框架眼镜或角膜/巩膜接触镜提高矫正视力;手术治疗包括角膜基质环植入术提高矫正视力、角膜胶原交联术增加角膜生物力学硬度以及角膜移植治疗重度和角膜瘢痕患者。此外,飞秒激光辅助的角膜移植术、角膜基质透镜植入联合角膜胶原交联术逐渐应用于临床治疗,以生物合成替代物、3D打印技术为主的组织工程和以干细胞治疗为主的细胞工程的发展为圆锥角膜的治疗提供了研究前景。本文通过总结圆锥角膜临床危险因素的防治方法、非手术光学矫正及手术治疗方式并探讨创新性治疗研究进展,以期为圆锥角膜患者个性化治疗方案的选择提供参考。Keratoconus is a blinding eye disease characterized by central or paracentral corneal thinning,forward conical protrusion,and high myopia with irregular astigmatism.There are still no effective radical treatments for keratoconus.Current methods mainly include the prevention and treatment of risk factors,non-surgical optical correction and surgical treatment.The main risk factor prevention and treatment measures include intervention of eye rubbing behavior,symptomatic treatment of allergic diseases and systemic diseases,and correction of poor sleeping position.Non-surgical optical correction uses spectacles or corneal/scleral contact lenses to improve corrected vision.Surgical treatments include intracorneal ring segment implantation to improve corrected vision,corneal collagen cross-linking to increase the biomechanical stiffness of the cornea,and corneal transplantation to treat patients with severe keratoconus or corneal scarring.In addition,femtosecond laser-assisted keratoplasty,lenticule intrastromal keratoplasty combined with corneal collagen cross-linking have been gradually applied in clinical treatment,and tissue engineering based on biosynthetic substitutes,3D bioprinting technology and cell engineering based on stem cell therapy have provided research prospects for the treatment of keratoconus.This article summarizes the prevention and treatment of clinical risk factors,non-surgical optical correction and surgical treatment,and discusses the research perspective of innovative treatment,in order to provide personalized treatment for patients with keratoconus.

关 键 词：圆锥角膜 防治 非手术光学矫正 手术治疗 组织工程 细胞工程 

分 类 号：R772.2[医药卫生—眼科]