屈光术后角膜扩张的诊断算法

H. M. Kamilov, M. S. Kasymova, G. Khamraeva, D.F. Ismailova
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摘要

目的。在现代临床检查方法的基础上,发展出早期发现角膜扩张症的最佳诊断算法。材料和方法。我们观察了73例(110只眼)屈光手术后发生的角膜扩张。患者年龄22 ~ 64岁,其中女性36例,男性37例。所有患者均行普通眼科学和特殊研究方法。结果。角膜扩张患者的角膜地形图显示角膜中部变薄,角膜后立面图显示角膜后表面增加,角膜曲率平均42.8 dpt。在角膜扩张症中,内皮细胞的平均损失为正常值的65%,内皮细胞的平均密度为1189±91.9个细胞/mm²,正常值为2863.7±54.29个细胞/mm²。这比正常情况低58.5%。结论。早期应用内皮显微镜、角膜地形学、光学相干断层扫描可以评估角膜状况,并在屈光手术后发生的角膜扩张的早期阶段采取必要的措施。关键词:角膜,医源性角膜扩张,圆锥角膜,内皮显微镜,角膜地形图,光学相干断层扫描
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Algorithm for the diagnosis of keratoectasias developed after refractive surgery
Purpose. On the basis of modern methods of clinical examination to develop an optimal diagnostic algorithm for early detection of keratoectasia. Material and methods. We observed 73 patients (110 eyes) with keratoectasia developed after refractive surgery. The age of the patients ranged from 22 to 64 years, of which 36 were women and 37 were men. All patients underwent general ophthalmological and special research methods. Results. Keratotopography of patients with keratectasia revealed thinning in the central part of the cornea, an increase in the posterior surface of the cornea was found in the posterior elevation map, and the curvature of the cornea averaged 42.8 dpt. In keratoectasia, the average loss of endothelial cells was 65 % of the norm, while the average density of endothelial cells was 1189 ± 91.9 cells/mm², with a norm of 2863.7 ± 54.29 cells/ mm². This is 58.5 % lower than normal. Conclusions. Early application of endothelial microscopy, keratotopography, optical coherence tomography allows to assess the condition of the cornea and take the necessary measures in the early stages of keratectasia developed after refractive surgery. Keywords: cornea, iatrogenic keratoectasia, keratoconus, endothelial microscopy, keratotopography, optical coherence tomography
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