PURPOSE: To assess the diagnosis-based spontaneous lon-gterm changes in corneal power and refraction with a regression model in the all-sutures-out time period following non-mechanical penetrating keratoplasty (PK). D...PURPOSE: To assess the diagnosis-based spontaneous lon-gterm changes in corneal power and refraction with a regression model in the all-sutures-out time period following non-mechanical penetrating keratoplasty (PK). DESIGN: Retrospective non-randomized clinical trial. METHODS: setting: Clinical practice. study population: 147 eyes [47 Fuchs dystrophy (FD); 100 keratoconus (KC)] were studied after suture removal in this retrospective longitudinal study. MAIN OUTCOME MEASURES: Zeiss keratometry [equivalent power (KEQ) and astigmatism (KAST)], corneal topography analysis [equivalent power (TEQ) and astigmatism (TAST)], and subjective refractometry [spherical equivalent (SEQ) and refractive cylinder (RAST)]were assessed in at least three up to 16 ophthalmologic examinations in the all-sutures-out time period. observation procedure: The time course of each target variable was analyzed in a longitudinal manner (time interval < 12 months) separately for each patient with a linear regression model. RESULTS: Post-keratoplasty follow-up ranged from 31 months to 10.3 years. In the linear regression model, the annual change in FD/KC showed an increase/a decrease in KEQ (0.29 ± 0.50/- 0.63± 0.46 diopters, P=.02) and an increase/a decrease in TEQ (0.37 ± 0.54/- 0.69 ± 0.49 diopters, P=.04) corresponding to a decrease/an increase in SEQ (- 0.31 ± 0.47/0.63 ± 0.43 diopters, P=.02). KAST/TAST/RAST showed a minimal annual decrease (- 0.06 ± 0.41/- 0.05 ± 0.45/- 0.06 ± 0.41 diopters) in FD but an increase in KC(0.46± 0.41/0.51± 0.43/0.46± 0.38 diopters) (P=.05/0.06/0.12). CONCLUSIONS: In the followup after post- keratoplasty suture removal, patients with FD/KC tend to develop a spontaneous myopic shift (steepening of the cornea)/hyperopic shift (flattening of the cornea). In contrast with those with FD, patients with KC should be counseled on the fact that astigmatism may increase again over time after suture removal.展开更多
Aims: To characterise changes in ocular dimensions after combined cataract ope ration and trabeculectomy with mitomycin C using separate incisions (combined op eration). Methods: 24 consecutive eyes that had combined ...Aims: To characterise changes in ocular dimensions after combined cataract ope ration and trabeculectomy with mitomycin C using separate incisions (combined op eration). Methods: 24 consecutive eyes that had combined operation and 16 eyes t hat had cataract operation alone were enrolled. The axial lengths before and aft er operations were determined with non-contact optical coherence biometry. The intraocular pressures (IOP), axial lengths, corneal curvatures, and the expected and observed refractive errors before and after operations were compared. Resul ts: After a combined operation, mean IOP was significantly reduced from 16.6 (SD 5.8) mm Hg to 10.9 (4.1)mm Hg (p < 0.00001), and mean axial lengthwas significa ntly shortened from 24.10 (0.98) mm to 23.98 (0.96) mm (p < 0.00001). The mean a xial length reduction after combined operation (117 (57)-μm) was significantly larger than the reduction after cataract operation alone (75 (38) p< 0.02), and correlated significantly with the postoperative IOP (p< 0.002). There was a mea n with the rule surgically induced corneal astigmatism of 0.44 (0.83)-dioptre b y vector analysis, and a significant increase of mean keratometry reading of 0.2 3 (0.46) dioptre after a combined operation. However, there was no significant d ifference between the expected and observed refractive errors. Conclusions: Desp ite an alteration of the axial length and corneal curvature, the refractive outc ome after a combined operation did not differ significantly from the predicted r efraction.展开更多
文摘PURPOSE: To assess the diagnosis-based spontaneous lon-gterm changes in corneal power and refraction with a regression model in the all-sutures-out time period following non-mechanical penetrating keratoplasty (PK). DESIGN: Retrospective non-randomized clinical trial. METHODS: setting: Clinical practice. study population: 147 eyes [47 Fuchs dystrophy (FD); 100 keratoconus (KC)] were studied after suture removal in this retrospective longitudinal study. MAIN OUTCOME MEASURES: Zeiss keratometry [equivalent power (KEQ) and astigmatism (KAST)], corneal topography analysis [equivalent power (TEQ) and astigmatism (TAST)], and subjective refractometry [spherical equivalent (SEQ) and refractive cylinder (RAST)]were assessed in at least three up to 16 ophthalmologic examinations in the all-sutures-out time period. observation procedure: The time course of each target variable was analyzed in a longitudinal manner (time interval < 12 months) separately for each patient with a linear regression model. RESULTS: Post-keratoplasty follow-up ranged from 31 months to 10.3 years. In the linear regression model, the annual change in FD/KC showed an increase/a decrease in KEQ (0.29 ± 0.50/- 0.63± 0.46 diopters, P=.02) and an increase/a decrease in TEQ (0.37 ± 0.54/- 0.69 ± 0.49 diopters, P=.04) corresponding to a decrease/an increase in SEQ (- 0.31 ± 0.47/0.63 ± 0.43 diopters, P=.02). KAST/TAST/RAST showed a minimal annual decrease (- 0.06 ± 0.41/- 0.05 ± 0.45/- 0.06 ± 0.41 diopters) in FD but an increase in KC(0.46± 0.41/0.51± 0.43/0.46± 0.38 diopters) (P=.05/0.06/0.12). CONCLUSIONS: In the followup after post- keratoplasty suture removal, patients with FD/KC tend to develop a spontaneous myopic shift (steepening of the cornea)/hyperopic shift (flattening of the cornea). In contrast with those with FD, patients with KC should be counseled on the fact that astigmatism may increase again over time after suture removal.
文摘Aims: To characterise changes in ocular dimensions after combined cataract ope ration and trabeculectomy with mitomycin C using separate incisions (combined op eration). Methods: 24 consecutive eyes that had combined operation and 16 eyes t hat had cataract operation alone were enrolled. The axial lengths before and aft er operations were determined with non-contact optical coherence biometry. The intraocular pressures (IOP), axial lengths, corneal curvatures, and the expected and observed refractive errors before and after operations were compared. Resul ts: After a combined operation, mean IOP was significantly reduced from 16.6 (SD 5.8) mm Hg to 10.9 (4.1)mm Hg (p < 0.00001), and mean axial lengthwas significa ntly shortened from 24.10 (0.98) mm to 23.98 (0.96) mm (p < 0.00001). The mean a xial length reduction after combined operation (117 (57)-μm) was significantly larger than the reduction after cataract operation alone (75 (38) p< 0.02), and correlated significantly with the postoperative IOP (p< 0.002). There was a mea n with the rule surgically induced corneal astigmatism of 0.44 (0.83)-dioptre b y vector analysis, and a significant increase of mean keratometry reading of 0.2 3 (0.46) dioptre after a combined operation. However, there was no significant d ifference between the expected and observed refractive errors. Conclusions: Desp ite an alteration of the axial length and corneal curvature, the refractive outc ome after a combined operation did not differ significantly from the predicted r efraction.
