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首页> 外文期刊>Journal of Ophthalmology >Excimer versus Femtosecond Laser Assisted Penetrating Keratoplasty in Keratoconus and Fuchs Dystrophy: Intraoperative Pitfalls
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Excimer versus Femtosecond Laser Assisted Penetrating Keratoplasty in Keratoconus and Fuchs Dystrophy: Intraoperative Pitfalls

机译：准分子与飞秒激光辅助的圆锥角膜和Fuchs营养不良性穿透性角膜移植术：术中的陷阱

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Purpose. To assess the intraoperative results comparing two non-mechanical laser assisted penetrating keratoplasty approaches in keratoconus and Fuchs dystrophy.Patients and Methods. 68 patients (age 18 to 87 years) with keratoconus or Fuchs dystrophy were randomly distributed to 4 groups. 35 eyes with keratoconus and 33 eyes with Fuchs dystrophy were treated with either excimer laser ([Exc] groups I and II) or femtosecond laser-assisted ([FLAK] groups III and IV) penetrating keratoplasty. Main intraoperative outcome measures included intraoperative decentration, need for additional interrupted sutures, alignment of orientation markers, and intraocular positive pressure (vis a tergo).Results. Intraoperative recipient decentration occurred in 4 eyes of groups III/IV but in none of groups I/II. Additional interrupted sutures were not necessary in groups I/II but in 5 eyes of groups III/IV. Orientation markers were all aligned in groups I/II but were partly misaligned in 8 eyes of groups III/IV. Intraocular positive pressure grade was recognized in 12 eyes of groups I/II and in 19 eyes of groups III/IV. In particular, in group III, severe vis a tergo occurred in 8 eyes.Conclusions. Intraoperative decentration, misalignment of the donor in the recipient bed, and need for additional interrupted sutures as well as high percentage of severe intraocular positive pressure were predominantly present in the femtosecond laser in keratoconus eyes.
机译：目的。为了评估术中结果，比较两种非机械激光辅助穿透性角膜移植术治疗圆锥角膜和Fuchs营养不良的患者和方法。将68例圆锥角膜或Fuchs营养不良患者（年龄18至87岁）随机分为4组。用准分子激光（[Exc] I和II组）或飞秒激光辅助（[FLAK] III和IV组）穿透性角膜移植手术治疗35眼圆锥角膜和Fuchs营养不良。术中主要的结局指标包括术中偏心，是否需要额外打断缝线，对准方向标记以及眼内正压（相对于tergo）。术中接受者偏心发生在III / IV组的4只眼中，但在I / II组中均没有。在I / II组中不需要额外的间断缝合，而在III / IV组的5只眼中。方向标记在I / II组中全部对齐，但在III / IV组的8只眼中部分未对齐。在I / II组的12眼和III / IV组的19眼中识别出眼内正压等级。特别是在第三组中，有8只眼发生了严重的畸形。飞秒激光在圆锥角膜眼中主要存在术中偏心，供体床位供体未对准，需要额外打断缝线以及高百分比的严重眼内正压的情况。

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