目的:比较MyoRing植入前后圆锥角膜(KCN)患者角膜前后表面散光和全屈光散光。方法:历史队列研究。比较植入360度全环植入物(MyoRing)的KCN患者的术前和术后全屈光、角膜前后表面散光,术后3、6、9、12 mo连续随访四次。结果:共纳入KCN患...目的:比较MyoRing植入前后圆锥角膜(KCN)患者角膜前后表面散光和全屈光散光。方法:历史队列研究。比较植入360度全环植入物(MyoRing)的KCN患者的术前和术后全屈光、角膜前后表面散光,术后3、6、9、12 mo连续随访四次。结果:共纳入KCN患者79例85眼,其中男43例,女36例,平均年龄29±7.41(17-48)岁。随访期间,全屈光散光、角膜前后表面散光呈减少趋势。MyoRing植入后12 mo,总屈光散光测量值显著下降2.09 D (4.27±3.15 vs2.18±1.63 D,P<0.001)。此外,术后测量显示,角膜前表面和后表面散光分别改善约3.20 D和0.59 D[6.40±1.90 vs 3.20±1.75 D(P<0.001)和1.30±0.55 vs 0.71±0.35(P<0.001)]结论:MyoRing植入可显著改善散光参数,包括全屈光散光以及角膜前后表面散光。展开更多
AIM:To evaluate the efficacy of femtosecond laser assisted MyoRing intrastromal corneal implant and deep anterior lamellar keratoplasty (DALK) for management of moderate to advanced keratoconus regarding the degree...AIM:To evaluate the efficacy of femtosecond laser assisted MyoRing intrastromal corneal implant and deep anterior lamellar keratoplasty (DALK) for management of moderate to advanced keratoconus regarding the degree of changes in visual acuity, refraction, corneal asphericity and aberrations.METHODS:A prospective non comparative interventional case study was conducted in Ophthalmology Department,Ain Shams University Hospital in the period from January 2015 to February 2017. The study included 30 eyes of moderate to advanced keratoconus. MyoRing was implanted in one eye (Group Ⅰ) and DALK operation was performed in the contralateral eye of the same patient (Group Ⅱ).Preoperative and 6mo post-operative uncorrected visual acuity(UCVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), corneal and refractive astigmatisms,keratometry and Q-value using topography images were acquired. Quality of vision was assessed in all eyes including total corneal, anterior corneal high order aberrations analysis at 5 mm pupil size and the Strehl ratio of point spread function (PSF) as an objective measure of glare.RESULTS:Mean postoperative UCVA, CDVA, SE, refractive astigmatism,keratometryreadingsandasphericity were statistically improved compared to preoperative parameters in both groups (P〈0.05). Significant reduction of all corneal aberrations following both techniques(P〈0.05) was achieved except mean trefoil and mean PSF in Group Ⅰ (P〉0.05). Postoperative corneal aberrations were significantly lower in Group Ⅱ compared to Group Ⅰ.A statistically significant negative correlation was found in Group Ⅰ between the mean change in CDVA (logMAR)and the mean preoperative and mean postoperative total corneal aberrations root mean square (RMS; r=-0.78,P=0.04). Also a statistically significant negative correlation was found between mean preoperative coma RMS and mean post PSF (r=-0.86, P=0.01). In Group Ⅱ, there was a statistically significant positive correlation between mean change in CDVA (logMAR) and mean change in Kmax(r=0.87, P=0.01) and between mean change in refractive cylinder and mean postoperative PSF (r=0.76, P=0.05).CONCLUSION:Femtosecond laser assisted MyoRing and DALK are effective in improving visual acuities, refraction,corneal asphericity and aberrations. MyoRing reduced spherical error more than the corneal cylinder. Post operative homogenous corneal surface and good image quality were achieved following both techniques compared to the preoperative state. However, DALK results in better image quality and lower corneal aberrations.展开更多
文摘目的:比较MyoRing植入前后圆锥角膜(KCN)患者角膜前后表面散光和全屈光散光。方法:历史队列研究。比较植入360度全环植入物(MyoRing)的KCN患者的术前和术后全屈光、角膜前后表面散光,术后3、6、9、12 mo连续随访四次。结果:共纳入KCN患者79例85眼,其中男43例,女36例,平均年龄29±7.41(17-48)岁。随访期间,全屈光散光、角膜前后表面散光呈减少趋势。MyoRing植入后12 mo,总屈光散光测量值显著下降2.09 D (4.27±3.15 vs2.18±1.63 D,P<0.001)。此外,术后测量显示,角膜前表面和后表面散光分别改善约3.20 D和0.59 D[6.40±1.90 vs 3.20±1.75 D(P<0.001)和1.30±0.55 vs 0.71±0.35(P<0.001)]结论:MyoRing植入可显著改善散光参数,包括全屈光散光以及角膜前后表面散光。
文摘AIM:To evaluate the efficacy of femtosecond laser assisted MyoRing intrastromal corneal implant and deep anterior lamellar keratoplasty (DALK) for management of moderate to advanced keratoconus regarding the degree of changes in visual acuity, refraction, corneal asphericity and aberrations.METHODS:A prospective non comparative interventional case study was conducted in Ophthalmology Department,Ain Shams University Hospital in the period from January 2015 to February 2017. The study included 30 eyes of moderate to advanced keratoconus. MyoRing was implanted in one eye (Group Ⅰ) and DALK operation was performed in the contralateral eye of the same patient (Group Ⅱ).Preoperative and 6mo post-operative uncorrected visual acuity(UCVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), corneal and refractive astigmatisms,keratometry and Q-value using topography images were acquired. Quality of vision was assessed in all eyes including total corneal, anterior corneal high order aberrations analysis at 5 mm pupil size and the Strehl ratio of point spread function (PSF) as an objective measure of glare.RESULTS:Mean postoperative UCVA, CDVA, SE, refractive astigmatism,keratometryreadingsandasphericity were statistically improved compared to preoperative parameters in both groups (P〈0.05). Significant reduction of all corneal aberrations following both techniques(P〈0.05) was achieved except mean trefoil and mean PSF in Group Ⅰ (P〉0.05). Postoperative corneal aberrations were significantly lower in Group Ⅱ compared to Group Ⅰ.A statistically significant negative correlation was found in Group Ⅰ between the mean change in CDVA (logMAR)and the mean preoperative and mean postoperative total corneal aberrations root mean square (RMS; r=-0.78,P=0.04). Also a statistically significant negative correlation was found between mean preoperative coma RMS and mean post PSF (r=-0.86, P=0.01). In Group Ⅱ, there was a statistically significant positive correlation between mean change in CDVA (logMAR) and mean change in Kmax(r=0.87, P=0.01) and between mean change in refractive cylinder and mean postoperative PSF (r=0.76, P=0.05).CONCLUSION:Femtosecond laser assisted MyoRing and DALK are effective in improving visual acuities, refraction,corneal asphericity and aberrations. MyoRing reduced spherical error more than the corneal cylinder. Post operative homogenous corneal surface and good image quality were achieved following both techniques compared to the preoperative state. However, DALK results in better image quality and lower corneal aberrations.