角膜屈光手术术前的筛查要点

doi:10.6040/j.issn.1673-3770.1.2020.014

摘要/Abstract

摘要： 安全性、有效性、可预测性和远期稳定性是角膜屈光手术取得良好效果的前提,其中最重要的因素就是术前严格筛查和合理选择手术适应证。本文就角膜屈光手术术前的筛查要点做一阐述,目的在于合理地选择手术适应证,有效规避医疗隐患和风险,使得接受角膜屈光手术的患者获得安全、有效及满意的术后效果,进一步提升术后的视觉质量。

关键词: 角膜屈光手术, 医疗隐患,眼科, 术前筛查, 适应证, 视觉质量

Abstract: Safety, efficacy, predictability, and long-term stability are the prerequisites for satisfied outcomes after corneal refractive surgery. The most important factors are strict pre-operative screening and reasonable selection for surgical indications. This article put forward the main criteria for screening before corneal refractive surgery, which purpose is to select surgical indications rationally and avoid medical pitfalls and risks effectively. And make sure the patients could achieve the safe, effective, and stable results as well as high visual quality after corneal refractive surgery.

Key words: Corneal refractive surgery, Hidden medical risk, Ophthalmology, Preoperative screening, Indications, Visual quality

中图分类号:

R778.1

张丰菊,李玉. 角膜屈光手术术前的筛查要点[J]. 山东大学耳鼻喉眼学报, 2020, 34(2): 7-12.

ZHANG Fengju, LI Yu. Key criteria for screening before corneal refractive surgery[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(2): 7-12.

参考文献

[1] Wen DZ, McAlinden C, Flitcroft I, et al. Postoperative efficacy, predictability, safety, and visual quality of laser corneal refractive surgery: a network meta-analysis[J]. Am J Ophthalmol, 2017, 178: 65-78. doi:10.1016/j.ajo.2017.03.013.
[2] 李莹. 重视激光角膜屈光手术快速发展中的手术并发症问题[J]. 中华眼科杂志, 2018,54(10): 721-725. doi:10.3760/cma.j.issn.0412-4081.2018.10.001. LI Ying. Keep an eye on standardized management of laser refractive surgery under its rapid development[J]. Chinese Journal of Ophthalmology, 2018,54(10): 721-725. doi:10.3760/cma.j.issn.0412-4081.2018.10.001.
[3] Bohac M, Koncarevic M, Pasalic A, et al.Incidence and Clinical Characteristics of Post LASIK Ectasia: A Review of over 30,000 LASIK Cases[J]. Semin Ophthalmol, 2018, 33(7-8): 869-877. doi: 10.1080/08820538.2018.1539183. Epub 2018 Oct 25.
[4] 中华医学会眼科学分会角膜病学组. 激光角膜屈光手术临床诊疗专家共识(2015年)[J]. 中华眼科杂志, 2015, 51(4): 249-254. doi:10.3760/cma.j.issn.0412-4081.2015.04.003.
[5] 中华医学会眼科学分会眼视光学组. 我国飞秒激光小切口角膜基质透镜取出手术规范专家共识(2016年)[J]. 中华眼科杂志, 2016, 52(1): 15-21. doi:10.3760/cma.j.issn.0412-4081.2016.01.007.
[6] 中华医学会眼科学分会眼视光学组. 我国角膜地形图引导个性化激光角膜屈光手术专家共识(2018年)[J]. 中华眼科杂志, 2018, 54(1): 23-26. doi:10.3760/cma.j.issn.0412-4081.2018.01.005.
[7] 周行涛, 李美燕. 解读新版美国眼科临床指南(PPP): 角膜屈光手术更安全[J]. 中国眼耳鼻喉科杂志, 2018, 18(6): 371-373. doi:10.14166/j.issn.1671-2420.2018.06.001. ZHOU Xingtao, LI Meiyan. Interpretation of Preferred Practice Pattern: safer for corneal refractive surgery[J]. Chinese Journal of Ophthalmology and Otorhinolaryngology, 2018, 18(6): 371-373. doi:10.14166/j.issn.1671-2420.2018.06.001.
[8] Santhiago MR, Smadja D, Wilson SE, et al. Role of percent tissue altered on ectasia after LASIK in eyes with suspicious topography[J]. J Refract Surg, 2015, 31(4): 258-265. doi:10.3928/1081597X-20150319-05.
[9] Meyer JJ, Gokul A, Vellara HR, et al. Repeatability and agreement of orbscan II, pentacam HR, and Galilei tomography systems in corneas with keratoconus[J]. Am J Ophthalmol, 2017, 175: 122-128. doi:10.1016/j.ajo.2016.12.003.
[10] Shetty R, Rao H, Khamar P, et al. Keratoconus screening indices and their diagnostic ability to distinguish normal from ectatic corneas[J]. Am J Ophthalmol, 2017, 181: 140-148. doi:10.1016/j.ajo.2017.06.031.
[11] Golan O, Piccinini AL, Hwang ES, et al. Distinguishing highly asymmetric keratoconus eyes using dual scheimpflug/placido analysis[J]. Am J Ophthalmol, 2019, 201: 46-53. doi:10.1016/j.ajo.2019.01.023.
[12] Lopes BT, Ramos IC, Salomão MQ, et al. Enhanced tomographic assessment to detect corneal ectasia based on artificial intelligence[J]. Am J Ophthalmol, 2018, 195: 223-232. doi:10.1016/j.ajo.2018.08.005.
[13] Gomes JA, Tan D, Rapuano CJ, et al. Global consensus on keratoconus and ectatic diseases[J]. Cornea, 2015, 34(4): 359-369. doi:10.1097/ICO.0000000000000408.
[14] Vinciguerra R, Ambrósio R Jr, Roberts CJ, et al. Biomechanical characterization of subclinical keratoconus without topographic or tomographic abnormalities[J]. J Refract Surg, 2017, 33(6): 399-407. doi:10.3928/1081597X-20170213-01.
[15] Ambrósio R Jr, Lopes BT, Faria-Correia F, et al. Integration of scheimpflug-based corneal tomography and biomechanical assessments for enhancing ectasia detection[J]. J Refract Surg, 2017, 33(7): 434-443. doi:10.3928/1081597X-20170426-02.
[16] Zhang MY, Zhang FJ, Li Y, et al. Early diagnosis of keratoconus in Chinese myopic eyes by combining corvis ST with pentacam[J]. Curr Eye Res, 2020, 45(2): 118-123. doi:10.1080/02713683.2019.1658787.
[17] Wheeler J, Hauser MA, Afshari NA,et al. The genetics of keratoconus: a review[J]. Reprod Syst Sex Disord, 2012, 3(Suppl 6). pii: 001.
[18] Kim TI, Roh MI, Grossniklaus HE, et al. Deposits of transforming growth factor-beta-induced protein in granular corneal dystrophy type II after LASIK[J]. Cornea, 2008, 27(1): 28-32. doi:10.1097/ICO.0b013e318156d36d.
[19] Chao-Shern C, Me R, DeDionisio LA, et al. Post-LASIK exacerbation of granular corneal dystrophy type 2 in members of a Chinese family[J]. Eye(Lond), 2018, 32(1): 39-43. doi:10.1038/eye.2017.265.
[20] 张小艳, 侯文博, 张丰菊, 等. 颗粒状角膜营养不良患者准分子激光原位角膜磨镶术后角膜混浊加重一例[J]. 中华眼科杂志, 2011, 47(8): 754-755. doi:10.3760/cma.j.issn.0412-4081.2011.08.021.
[21] Song YZ, Sun MS, Wang NL, et al. Prevalence of transforming growth factor β-induced gene corneal dystrophies in Chinese refractive surgery candidates[J]. J Cataract Refract Surg, 2017, 43(12): 1489-1494. doi:10.1016/j.jcrs.2017.07.038.
[22] Zeng L, Zhao J, Chen YJ, et al. TGFBI gene mutation analysis of clinically diagnosed granular corneal dystrophy patients prior to PTK: a pilot study from Eastern China[J]. Sci Rep, 2017, 7(1): 596. doi:10.1038/s41598-017-00716-5.
[23] 张丰菊, 孙旭光. 角膜颗粒状营养不良是否适合做准分子激光角膜切削术[J]. 中华眼科杂志, 2011, 47(7): 580-583. doi:10.3760/cma.j.issn.0412-4081.2011.07.002. ZHANG Fengju, SUN Xuguang. Whether does the granular corneal dystrophy indicate for the excimer laser ablation surgery or not[J]. Chinese Journal of Ophthalmology, 2011, 47(7): 580-583. doi:10.3760/cma.j.issn.0412-4081.2011.07.002.
[24] Hori-Komai Y, Toda I, Asano-Kato N, et al. Reasons for not performing refractive surgery[J]. J Cataract Refract Surg, 2002, 28(5): 795-797. doi:10.1016/s0886-3350(01)01321-9.
[25] 吴玲玲. 如何诊断近视眼准分子激光角膜屈光手术后的开角型青光眼[J]. 中华眼科杂志, 2013, 49(11): 965-967. doi:10.3760/cma.j.issn.0412-4081.2013.11.003. WU Lingling. Diagnosis of open-angle Glaucoma after myopic excimer laser corneal refractive surgery[J]. Chinese Journal of Ophthalmology, 2013, 49(11): 965-967. doi:10.3760/cma.j.issn.0412-4081.2013.11.003.
[26] Weiss HS, Rubinfeld RS, Anderschat JF. Case reports and small case series: LASIK-associated visual field loss in a Glaucoma suspect[J]. Arch Ophthalmol, 2001, 119(5): 774-775.
[27] Hwang ES, Perez-Straziota CE, Kim SW, et al. Distinguishing highly asymmetric keratoconus eyes using combined scheimpflug and spectral-domain OCT analysis[J]. Ophthalmology, 2018, 125(12): 1862-1871. doi:10.1016/j.ophtha.2018.06.020.
[28] Savini G, Schiano-Lomoriello D, Hoffer KJ. Repeatability of automatic measurements by a new anterior segment optical coherence tomographer combined with Placido topography and agreement with 2 Scheimpflug cameras[J]. J Cataract Refract Surg, 2018, 44(4): 471-478. doi:10.1016/j.jcrs.2018.02.015.
[29] Lu NJ, Chen D, Cui LL, et al. Repeatability of cornea and sublayer thickness measurements using optical coherence tomography in corneas of anomalous refractive status[J]. J Refract Surg, 2019, 35(9): 600-605. doi:10.3928/1081597X-20190806-03.
[30] Meyer JJ, Gokul A, Vellara HR, et al. Repeatability and agreement of orbscan II, pentacam HR, and Galilei tomography systems in corneas with keratoconus[J]. Am J Ophthalmol, 2017, 175: 122-128. doi:10.1016/j.ajo.2016.12.003.
[31] Schallhorn JM, Seifert S, Schallhorn SC. SMILE, topography-guided LASIK, and wavefront-guided LASIK: review of clinical outcomes in premarket approval FDA studies[J]. J Refract Surg, 2019, 35(11): 690-698. doi:10.3928/1081597X-20190930-02.
[32] Wallerstein A, Caron-Cantin M, Gauvin M, et al. Primary topography-guided LASIK: refractive, visual, and subjective quality of vision outcomes for astigmatism ≥2.00 diopters[J]. J Refract Surg, 2019, 35(2): 78-86. doi:10.3928/1081597X-20181210-01.
[33] Wallerstein A, Gauvin M, Cohen M. Effect of anterior corneal higher-order aberration ablation depth on primary topography-guided LASIK outcomes[J]. J Refract Surg, 2019, 35(12): 754-762. doi:10.3928/1081597X-20191021-02.
[34] de Ortueta D, Arba-Mosquera S. Laser in situ keratomileusis for high hyperopia with corneal vertex centration and asymmetric offset[J]. Eur J Ophthalmol, 2017, 27(2): 141-152. doi:10.5301/ejo.5000835.
[35] Khakshoor H, McCaughey MV, Vejdani AH, et al. Use of angle kappa in myopic photorefractive keratectomy[J]. Clin Ophthalmol, 2015, 9: 193-195. doi:10.2147/OPTH.S70690.
[36] Liu ML, Sun Y, Wang DY, et al. Decentration of optical zone center and its impact on visual outcomes following SMILE[J]. Cornea, 2015, 34(4): 392-397. doi:10.1097/ICO.0000000000000383.
[37] 梁刚, 查旭, 张丰菊. Q值引导及Kappa角调整后SBK和飞秒LASIK术后高阶象差的对比[J]. 中华眼视光学与视觉科学杂志, 2014, 16(1): 25-29. LIANG Gang, ZHA Xu, ZHANG Fengju. A clinical study comparing the changes in higher-order aberrations following SBK and femtosecond laser LASIK with a customized Q-factor and Kappa adjustment[J]. Chinese Journal of Optometry & Ophthalmology, 2014, 16(1): 25-29.
[38] Peng MY, Hannan S, Teenan D, et al. Monovision LASIK in emmetropic presbyopic patients[J]. Clin Ophthalmol, 2018, 12: 1665-1671. doi:10.2147/OPTH.S170759.
[39] Zhang T, Sun Y, Weng SB, et al. Aspheric micro-monovision LASIK in correction of presbyopia and myopic astigmatism: early clinical outcomes in a Chinese population[J]. J Refract Surg, 2016, 32(10): 680-685. doi:10.3928/1081597X-20160628-01.
[40] 黄鹤, 安阳, 何伟, 等. 睑板腺功能障碍患者IntraLase-LASIK术前睑板腺处理的临床观察[J]. 国际眼科杂志, 2016, 16(4): 788-790. HUANG He, AN Yang, HE Wei, et al. Clinical observation on treatment of Meibomian gland before Intra Lase LASIK in patients with Meibomian gland dysfunction[J]. International Eye Science, 2016, 16(4): 788-790.
[41] Diez-Feijóo E, Grau AE, Abusleme EI, et al. Clinical presentation and causes of recurrent corneal erosion syndrome: review of 100 patients[J]. Cornea, 2014, 33(6): 571-575. doi:10.1097/ICO.0000000000000111.
[42] Shi MH, Jiang HX, Niu XG, et al. Hyperopic corneal refractive surgery in patients with accommodative esotropia and amblyopia[J]. J AAPOS, 2014, 18(4): 316-320. doi:10.1016/j.jaapos.2014.02.015.
[43] Kushner BJ, Kowal L. Diplopia after refractive surgery: occurrence and prevention[J]. Arch Ophthalmol, 2003, 121(3): 315-321. doi:10.1001/archopht.121.3.315.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed