放射状角膜切开术在轻中度圆锥角膜病例中视觉康复的疗效

摘要

目的：探讨放射状角膜切开术在轻中度圆锥角膜治疗中光学和视力康复的效果。　　方法：回顾性分析应用放射状角膜切开术治疗圆锥角膜的病例22例31眼并进行了至少12 mo的随访。测量并分析术前术后裸眼视力,最佳矫正视力,自动屈光计值,角膜曲率,角膜不规则指数以及并发症。　　结果：在最后一次随访中,平均裸眼视力( logMAR)由0.86±0.34显著提升至0.30±0.29(P<0.0001),平均最佳矫正视力由0.47±0.21提升至0.17±0.23(P<0.0001)。平均角膜曲率由48.69±3.68 D 降低至44.33±3.09 D ( P<0.0001)。自动屈光计测得平均等效球镜值由-5.61±2.85D显著提升至-2.29±1.95D(P<0.0001)。在整个随访过程中,中央角膜厚度和3mm,5mm区域的角膜不规则指数均无变化。术中和术后没有观察到严重并发症。　　结论：在本组病例中,放射状角膜切开术是轻中度圆锥角膜视觉康复的有效治疗方法。%AIM: To investigate the efficacy of radial keratotomy ( RK ) for the optical and visual rehabilitation of mild to moderate keratoconus. METHODS: Thirty-one eyes of 22 keratoconus patients with at least 12mo follow-up were recruited and reviewed retrospectively. Uncorrected visual acuity ( UCVA ) , best spectacle corrected visual acuity (BSCVA), autorefractometer values, keratometric values, corneal irregularity indexes, and complications were analyzed pre- and post-operatively.RESULTS: At the last follow-up visit, mean UVCA (logMAR) improved significantly from 0. 86±0. 34 to 0. 30±0.29 (P<0.0001), and mean BSCVA (logMAR) improved from 0. 47±0. 21 to 0. 17±0. 23, ( P<0. 0001 ). Mean keratometric values decreased from 48. 69±3. 68 to 44. 33±3. 09 diopters (P<0. 0001). Mean spherical equivalent measured by autorefractometer was also improved significantly from -5. 61±2. 85 to -2. 29±1. 95 at the last follow-up visit (P<0. 0001). Central corneal thickness and corneal irregularity index of 3mm and 5mm zones did not change during the overall follow-up time. No serious intraoperative or postoperative complication was observed. CONCLUSION:RK is assessed as an effective treatment method for the optical and visual rehabilitation of mild to moderate keratoconus cases, according to our results in a selected group of keratoconus patients.