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Assessments of tear meniscus height, tear film thickness, and corneal epithelial thickness after deep anterior lamellar keratoplasty

前部深板层角膜移植术后泪新月高度、泪膜厚度及角膜上皮厚度的评估

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Abstract

Objective

To assess the lower tear meniscus height (LTMH), central tear film thickness (CTFT), and central corneal epithelial thickness (CCET) after deep anterior lamellar keratoplasty (DALK).

Methods

This was a retrospective cross-sectional study of 20 patients who had DALK in one eye over a three-month period. LTMH, CTFT, and CCET of the operated eyes and the unoperated fellow eyes were measured using high-definition optical coherence tomography (HD-OCT). Correlations between three OCT assessments and age, time following surgery, graft size, bed size, and the number of residual sutures were analyzed.

Results

Compared to patients with keratoconus, patients with other corneal conditions had significantly higher CCET in the fellow eye (P=0.024). For all patients, CCET in the operated eye was significantly negatively correlated with the number of residual sutures (R=−0.579, P=0.008), and was significantly positively correlated with time following surgery (R=0.636, P=0.003). In the fellow eye, a significant positive correlation was found between age and CCET (R=0.551, P=0.012), and a significant negative correlation between age and CTFT (R=−0.491, P=0.028). LTMH was found to be significantly correlated between operated and fellow eyes (R=0.554, P=0.011). There was no significant correlation between LTMH and age, bed/graft size, time following surgery, or residual sutures (all possible correlations, P>0.05).

Conclusions

Patients with keratoconus tend to have a thinner central corneal epithelium. Corneal epithelium keeps regenerating over time after DALK. DALK did not induce a significant change in tear volume compared with the fellow eye. Postoperative tear function might depend on an individual’s general condition, rather than on age, gender, bed/graft size, time following surgery, or residual sutures.

概要

目的

评估前部深板层角膜移植(DALK)术后的下泪 新月高度(LTMH)、中央泪膜厚度(CTFT)及 中央角膜上皮厚度(CCET)

创新点

首次利用高清光学相干断层扫描成像技术 (HD-OCT)定量测量DALK术后的CCET、CTFT 和LTMH,并发现各个参数之间及与其他临床数 据的相关性。

方法

回顾性横断面分析20 例单眼DALK 术后3 月以 上的患者。使用HD-OCT 定量分析并比较术眼和 对侧未手术眼的LTMH、CTFT 和CCET。对各个 OCT 参数之间及与年龄、术后时间、植片直径、 植床直径和残余缝线数量进行相关性分析。

结论

本研究显示,圆锥角膜患者的中央角膜上皮倾向 变薄;DALK 术后角膜上皮随着时间推移而持续 再生;与对侧未手术眼相比,DALK 并不引起显 著的泪液量变化。因此,术后的泪液功能可能取 决于患者的整体状况而非年龄、性别、植片/植床 直径、术后时间或残余缝线。

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Authors and Affiliations

  1. Department of Ophthalmology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China

    Wen-jia Xie, Ye-sheng Xu, Xia Zhang & Yu-feng Yao

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  1. Wen-jia Xie
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  2. Ye-sheng Xu
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  3. Xia Zhang
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Correspondence to Yu-feng Yao.

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Project supported by the Zhejiang Provincial Natural Science Foundation of China (No. LQ16H120002)

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Xie, Wj., Xu, Ys., Zhang, X. et al. Assessments of tear meniscus height, tear film thickness, and corneal epithelial thickness after deep anterior lamellar keratoplasty. J. Zhejiang Univ. Sci. B 19, 218–226 (2018). https://doi.org/10.1631/jzus.B1700095

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  • DOI: https://doi.org/10.1631/jzus.B1700095

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