Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2022
Impact of cone base diameter on outcomes of deep anterior lamellar keratoplasty in keratoconus.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Zheng Qinxiang, Li Saiqing, Ren Yueping, Chen Yunyun, Wang Haiou, Zhao Jiawei, Chen Jiaojie, Jhanji Vishal, Chen Wei
Аннотация
PURPOSE: To evaluate the outcomes of deep anterior lamellar keratoplasty (DALK) in treating keratoconus in relation to cone base diameter (CBD).
METHODS: A retrospective study. Sixty-one eyes of 49 keratoconus patients who underwent DALK between 2009 and 2018 were enrolled. Preoperative and postoperative uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical equivalent, and astigmatism were measured. Scheimpflug tomography (Pentacam) was used to measure the cone base area (CBA) and CBD using MATLAB software.
RESULTS: The mean age of the patients was 20.8 ± 6.1 years old, and the mean follow-up time was 27.3 ± 15.2 months. Mean UCVA improved from 1.23 ± 0.48 to 0.57 ± 0.27 (LogMAR, 95% CI [0.52, 0.80]; P < 0.001), whereas mean BCVA improved from 0.98 ± 0.55 to 0.18 ± 0.13 (95% CI [0.66, 0.94]; P < 0.001). The mean spherical equivalent decreased by 4.53 ± 5.65 D (95% CI [- 6.25, - 2.82]; P < 0.001), with little change in astigmatism (95% CI [- 1.39, 0.64]; P = 0.457). The postoperative BCVA in the patients with CBD < 5.07 mm and corneal curvature ≥ 55D was significantly better than those whose CBD ≥ 5.07 mm (0.14 ± 0.09 vs 0.25 ± 0.15, P = 0.001). The follow-up time was negatively correlated with the BCVA (P = 0.004).
CONCLUSIONS: In this study, outcomes of DALK in keratoconus were related to CBD and corneal curvature. Patients with large CBD (≥ 5.07 mm) where the corneal curvature ≥ 55D are more likely to have poor visual outcomes after DALK.
METHODS: A retrospective study. Sixty-one eyes of 49 keratoconus patients who underwent DALK between 2009 and 2018 were enrolled. Preoperative and postoperative uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical equivalent, and astigmatism were measured. Scheimpflug tomography (Pentacam) was used to measure the cone base area (CBA) and CBD using MATLAB software.
RESULTS: The mean age of the patients was 20.8 ± 6.1 years old, and the mean follow-up time was 27.3 ± 15.2 months. Mean UCVA improved from 1.23 ± 0.48 to 0.57 ± 0.27 (LogMAR, 95% CI [0.52, 0.80]; P < 0.001), whereas mean BCVA improved from 0.98 ± 0.55 to 0.18 ± 0.13 (95% CI [0.66, 0.94]; P < 0.001). The mean spherical equivalent decreased by 4.53 ± 5.65 D (95% CI [- 6.25, - 2.82]; P < 0.001), with little change in astigmatism (95% CI [- 1.39, 0.64]; P = 0.457). The postoperative BCVA in the patients with CBD < 5.07 mm and corneal curvature ≥ 55D was significantly better than those whose CBD ≥ 5.07 mm (0.14 ± 0.09 vs 0.25 ± 0.15, P = 0.001). The follow-up time was negatively correlated with the BCVA (P = 0.004).
CONCLUSIONS: In this study, outcomes of DALK in keratoconus were related to CBD and corneal curvature. Patients with large CBD (≥ 5.07 mm) where the corneal curvature ≥ 55D are more likely to have poor visual outcomes after DALK.