轻压式传导性角膜成形术治疗老视的疗效
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摘要
目的探讨轻压式传导性角膜成形术(CK)治疗老视的临床疗效和安全性。方法对7例(11只眼)屈光不正患者行CK手术。观察11只眼术前,术后1周、6个月,1、2年双眼裸眼远视力、近视力,术眼裸眼远视力、近视力,术眼等效球镜值、术眼眼压及术后6个月,1、2年屈光回退速度和患者满意度。结果 11只眼中,术后1周、6个月和1年术眼裸眼近视力、等效球镜值、眼压与术前比较差异均有统计学意义(均P<0.05)。术后6个月和1、2年屈光回退速度分别是0.01D·月~(-1)、0.03D·月~(-1)、0.06D·月~(-1)。术后眼压与性别、年龄均无相关性(r=-0.194、-0.229,均P>0.05),术后眼压与等效球镜值呈正相关(r=0.441,P<0.05)。11只眼中,4只眼(36.36%)在CK术后早期出现不同程度的异物感,术后1周症状基本缓解。术后未出现角膜炎、角膜穿孔、虹膜睫状体炎等并发症。术后2年患者满意度:1度5例(71.42%),2度1例(14.29%),3度1例(14.29%)。结论 CK能够安全和有效地治疗老视。
Objective To investigate the efficacy and safety of light-press conductive keratoplasty(CK)on presbyopia.Methods Seven patients with ametropia(11eyes)underwent CK.Uncorrected distance visual acuity,uncorrected near visual acuity,spherical equivalent and intraocular pressure were measured before and 1week,6months,1year and 2years after operation.Furthermore,refractive regression speed and patient satisfaction were determined 6 months,1year and 2years after operation.Results Uncorrected near visual acuity,spherical equivalent and intraocular pressure were significantly improved 1week,6months and 1year after operation(P<0.05).Refractive regression speed was 0.01,0.03 and 0.06D·month~(-1) at 6months,1year and 2years after operation,respectively.Postoperative intraocular pressure was not correlated with gender and age(r=-0.194and-0.229,respectively;P>0.05),but was positively correlated with spherical equivalent(r=0.441,P<0.05).Of the 11 eyes,different degrees of foreign body sensation occurred in 4(36.36%).The symptom was relieved 1week after operation.No keratitis,corneal perforation,iridocyclitis and other complications were found after operation.At 2years after operation,the satisfaction with treatment was grade 1in 5patients(71.42%),grade 2in 1patient(14.29%),and grade 3in 1patient(14.29%).Conclusion Light-press CK is effective and safe for treating presbyopia.
Objective To investigate the efficacy and safety of light-press conductive keratoplasty(CK)on presbyopia.Methods Seven patients with ametropia(11eyes)underwent CK.Uncorrected distance visual acuity,uncorrected near visual acuity,spherical equivalent and intraocular pressure were measured before and 1week,6months,1year and 2years after operation.Furthermore,refractive regression speed and patient satisfaction were determined 6 months,1year and 2years after operation.Results Uncorrected near visual acuity,spherical equivalent and intraocular pressure were significantly improved 1week,6months and 1year after operation(P<0.05).Refractive regression speed was 0.01,0.03 and 0.06D·month~(-1) at 6months,1year and 2years after operation,respectively.Postoperative intraocular pressure was not correlated with gender and age(r=-0.194and-0.229,respectively;P>0.05),but was positively correlated with spherical equivalent(r=0.441,P<0.05).Of the 11 eyes,different degrees of foreign body sensation occurred in 4(36.36%).The symptom was relieved 1week after operation.No keratitis,corneal perforation,iridocyclitis and other complications were found after operation.At 2years after operation,the satisfaction with treatment was grade 1in 5patients(71.42%),grade 2in 1patient(14.29%),and grade 3in 1patient(14.29%).Conclusion Light-press CK is effective and safe for treating presbyopia.
引文
[1]Asbell P A,Maloney R K,Davidorf J,et al.Conductive keratoplasty for the correction of hyperopia[J].Trans Am Ophthalmol Soc,2001,99:79-84.
[2]McDonald M B,Davidorf J,Maloney R K,et al.Conductive keratoplasty for the correction of low to moderate hyperopia:1-year results on the first 54eyes[J].Ophthalmology,2002,109(4):637-649.
[3]Soler Tomás J R,Fuentes Páez G,Burillo S.Symmetrical versus asymmetrical presbyLASIK:results after 18 months and patient satisfaction[J].Cornea,2015,34(6):651-657.
[4]Venter J A,Pelouskova M,Bull C E,et al.Visual outcomes and patient satisfaction with a rotational asymmetric refractive intraocular lens for emmetropic presbyopia[J].J Cataract Refract Surg,2015,41(3):585-593.
[5]徐婧,许烨,李莹,等.LaserACE激光巩膜手术矫正老视[J].中华眼视光学与视觉科学杂志,2015,17(9):518-522.
[6]McDonald M B.Conductive keratoplasty:a radiofrequency-based technique for the correction of hyperopia[J].Trans Am Ophthalmol Soc,2005,103:512-536.
[7]McDonald M B,Durrie D,Asbell P,et al.Treatment of presbyopia with conductive keratoplasty:six-month results of the1-year United States FDA clinical trial[J].Cornea,2004,23(7):661-668.
[8]徐雯,吴炜,姚克,等.传导性角膜成形术治疗老视的二年临床观察[J].中华眼科杂志,2011,47(7):611-617.
[9]张洪洋,曾锦,郭海科.传导性角膜热成形术治疗衍射型多焦点人工晶状体植入后的正性屈光不正[J].中华眼视光学与视觉科学杂志,2013,15(2):116-119.
[10]张扬,赵家良,卞爱玲,等.中央角膜厚度、角膜曲率对Goldmann压平眼压计和非接触眼压计测量结果的影响[J].中华眼科杂志,2009,45(8):713-718.
[2]McDonald M B,Davidorf J,Maloney R K,et al.Conductive keratoplasty for the correction of low to moderate hyperopia:1-year results on the first 54eyes[J].Ophthalmology,2002,109(4):637-649.
[3]Soler Tomás J R,Fuentes Páez G,Burillo S.Symmetrical versus asymmetrical presbyLASIK:results after 18 months and patient satisfaction[J].Cornea,2015,34(6):651-657.
[4]Venter J A,Pelouskova M,Bull C E,et al.Visual outcomes and patient satisfaction with a rotational asymmetric refractive intraocular lens for emmetropic presbyopia[J].J Cataract Refract Surg,2015,41(3):585-593.
[5]徐婧,许烨,李莹,等.LaserACE激光巩膜手术矫正老视[J].中华眼视光学与视觉科学杂志,2015,17(9):518-522.
[6]McDonald M B.Conductive keratoplasty:a radiofrequency-based technique for the correction of hyperopia[J].Trans Am Ophthalmol Soc,2005,103:512-536.
[7]McDonald M B,Durrie D,Asbell P,et al.Treatment of presbyopia with conductive keratoplasty:six-month results of the1-year United States FDA clinical trial[J].Cornea,2004,23(7):661-668.
[8]徐雯,吴炜,姚克,等.传导性角膜成形术治疗老视的二年临床观察[J].中华眼科杂志,2011,47(7):611-617.
[9]张洪洋,曾锦,郭海科.传导性角膜热成形术治疗衍射型多焦点人工晶状体植入后的正性屈光不正[J].中华眼视光学与视觉科学杂志,2013,15(2):116-119.
[10]张扬,赵家良,卞爱玲,等.中央角膜厚度、角膜曲率对Goldmann压平眼压计和非接触眼压计测量结果的影响[J].中华眼科杂志,2009,45(8):713-718.