Интрастромальная кератопластика с имплантацией роговичных сегментов в коррекции астигматизма после сквозной кератопластики по поводу кератоконуса

Oftal mokhirurgiya

З. И. Мороз¹  О. С. Волкова¹  А. Н. Токмакова¹ 

[1] ФГАУ «МНТК «Микрохирургия глаза» им. акад. С.Н. Федорова» Минздрава России Адрес: 127486, Москва, ул. Бескудниковский бульвар, 59а

关键词: keratoconus;    astigmatism correction after penetrating keratoplasty;    intrastromal keratoplasty;    intracorneal ring segments implantation;    femtosecond assistance;    кератоконус;    коррекция астигматизма после сквозной кератопластики;    интрастромальная кератопластика;    имплантация интрастромальных роговичных сегментов;    фемтосекундное сопровождение;   

DOI  :  10.25276/0235-4160-2015-4-70-77

学科分类：眼科学

来源: M H T K Mikrokhirurgiya Glaza

【 摘 要 】

Purpose . To evaluate the clinical outcomes of intracorneal ring segments (ICRS) implantation and femtosecond laserassisted ICRS implantation to correct the residual astigmatism in post-PKP patients with keratoconus. Material and methods.The study evaluated 28 eyes with residual astigmatism in post-PKP patients with keratoconus. Preop and post-op examination included: refractometry, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA), corneal topography, pachymetry, con-focal microscopy. The ICRS was performed in 15 cases (group 1), femtosecond laser-assisted ICRS was performed in 13 cases (group 2). Results.Patients were examined 1, 3 and 6 month after the surgery. The results 3 month after the surgery in the group 1: the mean UCVA improved from 0.13±0.14 to 0.39±0.14, the mean BCVA – from 0.49±0.28 to 0.68±0.1, the mean astigmatism decreased from 8.21±2.21D to 3.20±0.74D, the mean maximum K value decreased from 49.00±2.30D to 44.38±1.90D, the mean minimum K value was 40.82±2.42D preoperatively and 41.18±2.06D postoperatively. The results 3 month after the surgery in the group 2: the mean UCVA improved from 0.09±0.05 to 0.44±0.17, the mean BCVA – from 0.42±0.30 to 0.64±0.17, the mean astigmatism decreased from 7.50±2.47D to 3.16±1.53D, the mean maximum K value decreased from 47.71±2.39D to 43.83±2.73D, the mean minimum K value was 40.29±2.68D preoperatively and 40.67±2.10D postoperatively. At 6 months postoperatively there was no significant difference in relation to the 3-month outcomes. Conclusion.The implantation of ICRS may be an effective procedure for the residual astigmatism correction in post- PKP patients with keratoconus with good visual, refractive and topographic outcomes. The use of the femtosecond laserassistance may provide the ICRS implantation more safe and accurate.

【 授权许可】

CC BY