圆锥角膜基质环植入手术前后人工晶状体度数的比较

Comparison of preoperative and postoperative intraocular lens power values in eyes with Keraring implantation

摘要:

目的：评估圆锥角膜基质环(keraring 355°)(ICRS)植入术前术后3mo人工晶状体(IOL)度数的计算和生物学特征。

方法：队列研究。收集18例(19眼)圆锥角膜接受角膜基质环植入术患者术前及术后3mo数据。分析裸眼视力(UCVA)， 最佳矫正视力(BCVA)，屈光度，人工晶体度数计算公式，眼轴长度(AL)和角膜曲率。

结果：患者平均年龄为29.58±0.6y。裸眼视力由0.84(0.35)LogMAR 显著提高到0.43(0.31)LogMAR(P<0.001)。3mo后，最佳矫正视力和眼轴长度无明显变化。球镜度数，柱镜度数和等效球镜(SE)均显著提高(P<0.001)。另一方面，角膜曲率1(K1)和角膜曲率2(K2)显著下降。3mo后， SRK/II(P<0.001)， Hoffer Q(P<0.001)and Holladay I(P<0.001)发生显著变化。

结论：角膜基质环植入术后，视力，屈光率和角膜曲率均有所提高，此外，人工晶状体计算公式度数明显改变。然而，角膜基质环植入术过程没有过度干预眼轴长，但降低角膜曲率值使得人工晶状体度数计算更加精确，所有公式得出同一晶状体度数。

Abstract:

AIM: To evaluate intraocular lens power(IOL)calculation and biometry before and 3mo after implantation of Keraring 355° intrastromal corneal ring segment(ICRS; Mediphacos, Belo Horizonte, Brazil)in keratoconic eyes.

METHODS: In this cohort study, data of 19 keratoconus eyes of 18 patients which undergone ICRS implantations were gathered before and 3mo after surgery. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), manifest refraction, IOL power calculation formulas, axial lenght(AL)and keratometry were analayzed.

RESULTS: Mean age of participants was 29.58±0.6. UCVA improved from 0.84(0.35)logMAR to 0.43(0.31)logMAR significantly(P<0.001). BCVA and AL didn't change significantly after 3mo. All Sphere, cylinder and spherical equivalent(SE)were improved significantly(P<0.001). On the other hand, keratometry 1(K1)and keratometry 2(K2)decreased significantly. It was a considerable change in SRK/Ⅱ(P<0.001), Hoffer Q(P<0.001)and Holladay Ⅰ(P<0.001)after 3-month's follow-up. Among this formula SRK/II had the lowest change.

CONCLUSION: In addition to improvement in visual, refractive, and keratometry outcomes after Keraring implantation, there was a significantly changes in IOL calculation formulas values. However, ICRS procedure doesn't interfere considerably AL in eyes, but it seems reduced keratometric values lead to IOL power calculations more accurately and all formulas suggested same IOL power.