Background:To evaluate the efficacy of manual mid-stromal dissection in stabilizing progressive keratoconus.Methods:Surgeries were performed in 16 eyes of 14 patients with progressive keratoconus.All eyes were examine...Background:To evaluate the efficacy of manual mid-stromal dissection in stabilizing progressive keratoconus.Methods:Surgeries were performed in 16 eyes of 14 patients with progressive keratoconus.All eyes were examined before and at 1 day,1 week,1,3,6 and 12 months after surgery,and every 6 months thereafter.Pentacam(simK,Kmax and pachymetry),best corrected visual acuity(BCVA)and subjective refraction were recorded up to the latest follow-up visit(mean follow-up time 6.6±2.4 years).Results:All surgeries were uneventful,and no postoperative complications occurred.Keratometry values(n=15)stabilized in 6/11 eyes(55%)with a preoperative Kmax<60.0 diopter(D),while all eyes>60 D showed continued progression.In 11/15 eyes(73%)pachymetry was unchanged.BCVA with spectacles remained stable in 7/12 eyes(58%)and improved≥2 Snellen lines in 5/12 eyes(42%).BCVA with a contact lens remained stable in 4/9 eyes(44%),improved≥2 Snellen lines in 3/9 eyes(33%)and deteriorated in 2/9 eyes(22%).Conclusions:Manual mid-stromal dissection was effective in 50%of keratoconic corneas with Kmax values<60 D and may be considered in cases ineligible for other interventions such as UV-crosslinking,stromal ring implantation or Bowman layer transplantation.An advantage of the procedure may be that the tissue is unaltered and that no synthetic or biological implant is required.展开更多
文摘Background:To evaluate the efficacy of manual mid-stromal dissection in stabilizing progressive keratoconus.Methods:Surgeries were performed in 16 eyes of 14 patients with progressive keratoconus.All eyes were examined before and at 1 day,1 week,1,3,6 and 12 months after surgery,and every 6 months thereafter.Pentacam(simK,Kmax and pachymetry),best corrected visual acuity(BCVA)and subjective refraction were recorded up to the latest follow-up visit(mean follow-up time 6.6±2.4 years).Results:All surgeries were uneventful,and no postoperative complications occurred.Keratometry values(n=15)stabilized in 6/11 eyes(55%)with a preoperative Kmax<60.0 diopter(D),while all eyes>60 D showed continued progression.In 11/15 eyes(73%)pachymetry was unchanged.BCVA with spectacles remained stable in 7/12 eyes(58%)and improved≥2 Snellen lines in 5/12 eyes(42%).BCVA with a contact lens remained stable in 4/9 eyes(44%),improved≥2 Snellen lines in 3/9 eyes(33%)and deteriorated in 2/9 eyes(22%).Conclusions:Manual mid-stromal dissection was effective in 50%of keratoconic corneas with Kmax values<60 D and may be considered in cases ineligible for other interventions such as UV-crosslinking,stromal ring implantation or Bowman layer transplantation.An advantage of the procedure may be that the tissue is unaltered and that no synthetic or biological implant is required.
