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作者

DEWEI LI LE TIAN XIAOCHUAN WANG FEIFEI ZHANG TING LIU YANLING DONG PING LIN DONGFANG LI DAPENG SUN MIN CHEN

作者单位

³School of Ophthalmology (D.L., L.T., X.W., T.L., Y.D., D.L., M.C.), Shandong First Medical University, Qingdao, China ²State Key Laboratory Cultivation Base (D.L., T.L., Y.D., P.L., D.L., M.C.), Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China ¹From the Qingdao Eye Hospital (D.L., L.T., X.W., F.Z., T.L., Y.D., P.L., D.L., D.S., M.C.), Shandong First Medical University, Qingdao, China

刊名

American Journal of Ophthalmology

年份

2024

卷号

Vol.266

页码

37-45

ISSN

0002-9394

摘要

Purpose To evaluate the recurrence characteristics on optical coherence tomography and clinical outcomes after phototherapeutic keratectomy or penetrating keratoplasty in patients with Reis-Bücklers corneal dystrophy . Design Retrospective interventional case series. Methods Seventeen patients with RBCD received 44 surgical interventions from 1996 through 2022. PTK or PKP was performed as the initial surgical procedure. Significant recurrence was determined when best spectacle-corrected visua...更多

Purpose To evaluate the recurrence characteristics on optical coherence tomography and clinical outcomes after phototherapeutic keratectomy or penetrating keratoplasty in patients with Reis-Bücklers corneal dystrophy . Design Retrospective interventional case series. Methods Seventeen patients with RBCD received 44 surgical interventions from 1996 through 2022. PTK or PKP was performed as the initial surgical procedure. Significant recurrence was determined when best spectacle-corrected visual acuity decreased at least 2 lines with increased opacity in the superficial cornea. Repeated PTK or PTK on the corneal graft was considered if patients could not endure poor vision due to significant recurrence. Recurrence depth and annual increase in thickness of the central cornea and subepithelial deposits were assessed by anterior segment optical coherence tomography. Results The mean follow-up time was 12.8 ± 8.5 years . The mean logMAR best spectacle-corrected visual acuity improved from 1.24 ± 0.48 preoperatively to 0.27 ± 0.09 postoperatively in the initial PTK group , from 1.84 ± 0.69 to 0.40 ± 0.13 in the PKP group , from 1.04 ± 0.46 to 0.30 ± 0.07 in the repeated PTK group , and from 1.29 ± 0.43 to 0.39 ± 0.11 in the CG-PTK group . The median significant recurrence time was 27 months , 96 months , 31 months , and 24 months , respectively . The depth of superficial deposits located between the epithelium and the anterior stroma was approximately 115 µm . The annual thickening of subepithelial deposits was 14 ± 2 µm after initial PTK, 7 ± 3 µm after PKP, 14 ± 3 µm after repeated PTK, and 30 ± 11 µm after CG-PTK, compared to 4 ± 2 µm in surgery-naïve eyes . The thickness of the central cornea increased by 15 ± 2 µm, 7 ± 2 µm, 15 ± 3 µm, and 31 ± 10 µm per year in the 4 surgery groups, respectively, compared to 5 ± 2 µm in surgery-naïve eyes . Conclusions Better visual acuity can be achieved after PTK than PKP for treatment of RBCD. The annual thickening of subepithelial deposits may approximate an increase in central corneal thickness. The superficial distribution of subepithelial deposits makes it feasible to perform repeated PTK, even on the corneal allograft, for recurrent RBCD.收起

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