飞秒激光辅助的大气泡法深板层角膜移植治疗圆锥角膜

摘要

Objective To evaluate the clinical results and safety of big bubble deep anterior lamellar keratoplasty assisted by a femtosecond laser for keratoconus.Methods A case series of 11 eyes of 9 keratoconus patients were enrolled in the study.A 500 kHz VisuMax femtosecond laser (Carl Zeiss Meditec AG,Jena,Germany) was used to create a vertical side cut on both donor and recipient corneas.The mean thinnest corneal thickness measured with ultrasound corneal pachymetry,was 359.7±49.8 μm.Preoperative UCVA was counting fingers (CF) to-0.1 and preoperative BCVA was CF to-0.12.The mean donor diameter was 7.51±0.14 mm and mean recipient diameter was 7.38±0.10 mm.Mean follow-up was 7.70±2.88 months.Results All eyes were successfully treated without intraoperative complications.Early postoperative evaluation showed a clear graft in all cases.Mean corneal thickness was 481.4±51.3 μm.A normal corneal topographic pattern was restored.At the last postoperative examination,UCVA was 0.15 to 0.40 and the BCVA was 0.30 to 0.80.Conclusion Our early results indicate that femtosecond laser-assisted deep anterior lamellar keratoplasty using the big bubble technique shows promise as a safe and effective surgical choice in the treatment of keratoconus.%目的 评价飞秒激光辅助的大气泡法深板层角膜移植术治疗圆锥角膜临床效果及安全性.方法 系列病例研究.9例(11眼)圆锥角膜患者采用飞秒激光辅助进行大气泡法深板层角膜移植手术.供体及受体角膜均采用500 kHz VisuMax飞秒激光进行垂直边切,术前超声测量角膜最薄点厚度,角膜厚度为(359.7±49.8) μm,术前UCVA为指数～0.1,术前BCVA为指数～0.12,供体直径为(7.51±0.14)mm,受体直径为(7.38±0.10)mm,随访时间为(7.70±2.88)个月.结果 所有患者手术顺利,术中无并发症,术后早期所有角膜植片透明.角膜厚度为(481.4±51.3)μm,角膜地形图恢复正常形态.术后最后1次随访,UCVA为0.15～0.40,BCVA为0.30～0.80.结论 飞秒激光辅助的大气泡法深板层角膜移植对于圆锥角膜患者具有良好的临床效果及安全性.