■圆锥角膜(KCN)是角膜的一种扩张性疾病,其特征是角膜的基质无力和顶端突出,并且与视力逐渐无痛降低有关。KCN在儿科患者中具有一定的重要特点,例如进步和侵略性。我们的目的是分析视觉,屈光,根据一种新颖的方法,植入单个210°弧长Keraring段的地形结果,目标,基于Q值的列线图(Q-N),用于治疗小儿与成人KCN。
■这个前景,多中心,非随机化,开放标签试验包括47例患者的47只眼睛,这些患者被分配到两组中的一组.成人组包括年龄≥18岁患者的33只眼,而儿科组包括14只眼,年龄为14-17岁的患者。所有患者均根据Q-N行飞秒激光辅助植入单个210°弧长角膜段,并随访6个月。所有的眼睛都接受了视力测量,睫状肌麻痹屈光,基线和术后6个月的角膜地形图。
■研究组在性别比例和KCN等级方面具有可比性(均P>0.05)。成年组患者术后平均未矫正远距视力(UDVA)显著改善,矫正视力(CDVA),球体,气缸,球形当量(SE),和Kmax(所有P<0.001),最小分辨率角(logMAR)的平均变化为-0.56对数,-0.40logMAR,3.07屈光度(D),0.70D,3.42D,和-5.26D,分别。小儿组表现出显著的术后平均UDVA改善,CDVA,球体,SE,和Kmax(所有P<0.05),平均变化为-0.62logMAR,-0.34logMAR,3.18D,3.67D,和-5.37D,分别。在视觉上的平均变化方面,两组之间没有显着差异,屈光,和地形变量(均P>0.05)。两组均无术后并发症发生。
■使用目标Q-N治疗小儿KCN是有效的,随着术后平均视力的改善,屈光,和地形参数,与成人圆锥角膜的结局相当。Q-N实现了良好的角膜重塑,随后在视觉上有所改善,屈光,成人和儿童圆锥角膜患者的地形结果。为了验证我们的初步发现,我们建议在使用KCN作为CXL前后辅助治疗的更大样本的儿科患者中使用Q-N列线图进行进一步的多中心随机临床试验.
UNASSIGNED: Keratoconus (KCN) is an ectatic disorder of the cornea characterized by stromal weakness and apical protrusion of the cornea, and is associated with a gradual and painless reduction in visual acuity. KCN in pediatric patients has certain important characteristics, such as a progressive and aggressive nature. We aimed to analyze the visual, refractive, and topographic outcomes of implanting a single 210° arc-length Keraring segment according to a novel, objective, Q value-based nomogram (Q-N) for the treatment of pediatric versus adult KCN.
UNASSIGNED: This prospective, multicenter, non-randomized, open-label trial included 47 eyes of 47 patients who were allocated to one of two groups. The adult group included 33 eyes of patients ≥ 18 years of age, whereas the pediatric group included 14 eyes of patients aged 14 - 17 years. All patients underwent femtosecond laser-assisted implantation of a single 210° arc-length Keraring segment according to the Q-N and were followed up for 6 months. All eyes underwent visual acuity measurement, cycloplegic refraction, and corneal topography at baseline and 6 months after surgery.
UNASSIGNED: The study groups were comparable in terms of sex proportions and KCN grades (both P > 0.05). The adult group exhibited significant postoperative improvements in mean uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), sphere, cylinder, spherical equivalent (SE), and Kmax (all P < 0.001) with a mean change of -0.56 logarithm of the minimal angle of resolution (logMAR), - 0.40 logMAR, 3.07 diopters (D), 0.70 D, 3.42 D, and - 5.26 D, respectively. The pediatric group exhibited significant postoperative improvements in mean UDVA, CDVA, sphere, SE, and Kmax (all P < 0.05) with a mean change of - 0.62 logMAR, - 0.34 logMAR, 3.18 D, 3.67 D, and - 5.37 D, respectively. There were no significant differences between the groups in terms of the mean change in visual, refractive, and topographic variables (all P > 0.05). No postoperative complications were observed in either group.
UNASSIGNED: Use of the objective Q-N was efficient in the treatment of pediatric KCN, with postoperative improvements in the mean visual, refractive, and topographic parameters, comparable to outcomes in adult keratoconus. Q-N achieved good corneal remodeling with subsequent improvements in visual, refractive, and topographic outcomes in both adult and pediatric patients with keratoconus. To verify our preliminary findings, we recommend further multicenter randomized clinical trials using the Q-N nomogram in a larger sample of pediatric patients with KCN as an adjunct treatment before or after CXL.