Ring-shaped corneoscleral lamellar keratoplasty guided by high-definition optical coherence tomography and Scheimpflug imaging for severe Terrien’s marginal corneal degeneration

详细信息    查看全文

• 作者：Ting Wang (1) (2)
  Weiyun Shi (2)
  Gang Ding (2)
  Suxia Li (2)
  Mingna Liu (2)
  Hua Gao (2)
  
• 关键词：Terrien’s marginal corneal degeneration ; Lamellar keratoplasty ; Astigmatism ; Perforation
• 刊名：Graefe's Archive for Clinical and Experimental Ophthalmology
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：250
• 期：12
• 页码：1795-1801
• 全文大小：753KB
• 参考文献：1. Oleynikov YS, Onclinx TM, Faktorovich EG, Mondino BJ (2009) Peripheral corneal disease with thinning. In: Brightbill FS, McDonnell PJ, McGhee CNJ, eds. Corneal surgery. 4th ed. Mosby: Elsevier: 229-40
  2. Guyer DR, Barraquer J, McDonnell PJ, Green WR (1987) Terrien's marginal degeneration: clinicopathologic case reports. Graefes Arch Clin Exp Ophthalmol 225:19-7 CrossRef
  3. Austin P, Brown SI (1981) Inflammatory Terrien’s marginal corneal disease. Am J Ophthalmol 92:189-92
  4. Beauchamp GR (1982) Terrien's marginal corneal degeneration. J Pediatr Ophthalmol Strabismus 19:97-9
  5. Berrocal AM, Chen PC, Soukiasian SH (2002) Ultrasound biomicroscopy of corneal hydrops in Terrien's marginal degeneration. Ophthalmic Surg Lasers 33:228-30
  6. Haller JA, Stark WJ, Azab A, Thomsen RW, Gottsch JD (2002) Surgical approaches to the management of epithelial cysts. Trans Am Ophthalmol Soc 100:79-4
  7. Varley GA, Macsai MS, Krachmer JH (1990) The results of penetrating keratoplasty for pellucid marginal corneal degeneration. Am J Ophthalmol 110:149-52
  8. Cameron JA (1992) Results of lamellar crescentic resection for pellucid marginal corneal degeneration. Am J Ophthalmol 113:296-02
  9. Dubroff S (1989) Pellucid marginal corneal degeneration: report on corrective surgery. J Cataract Refract Surg 15:89-3
  10. Brown AC, Rao GN, Aquavella JV (1983) Peripheral corneal grafts in Terrien's marginal degeneration. Ophthalmic Surg 14:931-34
  11. Caldwell DR, Insler MS, Boutros G, Hawk T (1984) Primary surgical repair of severe peripheral marginal ectasia in Terrien’s marginal degeneration. Am J Ophthalmol 97:332-36
  12. Lampé Z, Békési L, Csutak A, Berta A (2003) Two cases of Terrien's marginal degeneration treated with peripheral full thickness keratectomy, and followed-up by computer-assisted corneal topography. Klin Monbl Augenheilkd 220:404-10 CrossRef
  13. Cheng CL, Theng JT, Tan DT (2005) Compressive C-shaped lamellar keratoplasty: a surgical alternative for the management of severe astigmatism from peripheral corneal degeneration. Ophthalmology 112:425-30 CrossRef
  14. Shi W, Li S, Gao H, Wang T, Xie L (2010) Modified deep lamellar keratoplasty for the treatment of advanced-stage keratoconus with steep curvature. Ophthalmology 117:226-31 CrossRef
  15. Hashemi H, Mehravaran S (2007) Central corneal thickness measurement with Pentacam, Orbscan II, and ultrasound devices before and after laser refractive surgery for myopia. J Cataract Refract Surg 33:1701-707 CrossRef
  16. Swartz T, Marten L, Wang M (2007) Measuring the cornea: the latest developments in corneal topography. Curr Opin Ophthalmol 18:325-33 CrossRef
  
• 作者单位：Ting Wang (1) (2)
  Weiyun Shi (2)
  Gang Ding (2)
  Suxia Li (2)
  Mingna Liu (2)
  Hua Gao (2)
  
  1. Qingdao University Medical College, Qingdao, China
  2. Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 5 Yanerdao Road, Qingdao, 266071, People’s Republic of China
  
• ISSN：1435-702X

文摘

Background To evaluate the clinical efficacy of ring-shaped corneoscleral lamellar keratoplasty under guidance of high-definition optical coherence tomography (HD-OCT) and Scheimpflug imaging for severe Terrien’s marginal corneal degeneration. Methods Twenty-five patients (25 eyes) with Terrien's marginal corneal degeneration and?≥- diopters of astigmatism were treated at the Shandong Eye Institute from January 2008 through December 2010. In these patients, the diseased area was-gt;- quarter of the cornea, and the thickness at the thinnest corneal area was-lt;-50?μm with residual corneal stroma. Ring-shaped corneoscleral lamellar keratoplasty was performed, and the depth and width of dissection was set according to the HD-OCT and Pentacam examinations. Data of complications, surgical effects, visual acuity, and astigmatism were collected. Results No intraoperative corneal perforation occurred. No patients had liquid accumulation between the graft and the recipient. At 1?year after surgery, the average best-corrected visual acuity improved to 6/9 from preoperative 6/36, and the average astigmatism reduced to 4.37 (2.04) diopters from preoperative 13.39 (7.52) diopters. There was no recurrence of the disease or corneal graft rejection in the follow-up period. Conclusions Ring-shaped corneoscleral lamellar keratoplasty guided by HD-OCT and Pentacam imaging appears to be effective in the treatment of severe Terrien’s marginal corneal degeneration. Surgical perforation can be significantly reduced.