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| Clinical Study of Photoshop Software Guided Femtosecond Laser Assisted DLK for the Treatment of Keratoconus |
| Xiaolin Qi, Miaolin Wang, Xiao Lin, Yanni Jia, Cixin Huang, Hua Gao |
| Eye Institute of Shandong First Medical University,Eye Hospital of Shandong First Medical University(Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250012, China |
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Abstract Objective: To observe the effectiveness and accuracy of femtosecond laser-assisted deep lamellar keratoplasty (DLK) for the treatment of keratoconus guided by Photoshop software personalized design.Methods: In this prospective, noncomparative and interventional study, patients with advanced keratoconus that were scheduled to undergo DLK at Eye Hospital of Shandong First Medical University from December 2016 to December 2018 were continuously enrolled and divided into the experimental group and the control group. For patients in the experimental group, the corneal diameter was measured with Photoshop software before surgery and then the diameter of the corneal implant bed/graft was designed individually, while in the control group, the diameter of the corneal implant bed/graft was uniformly set at 7.9/8.2 mm. Indicators including the best corrected visual acuity (BCVA), mean corneal curvature, spherical equivalent and average astigmatism were observed 12 months after surgery. Independent samples t-test was used for statistical analysis of the data. Results: A total of 72 patients (72 eyes) were included, including 40 cases in the experimental group and 32 patients in the control group. In the experimental group, 6 patients had a corneal implant bed/graft diameter of 7.9/8.2 mm, 18 patients had a diameter of 8.1/8.4 mm and 16 patients had a diameter of 8.3/8.6 mm. One week after the operation, the actual diameter of corneal graft measured by Photoshop software in the experimental group was 8.4±0.1 mm, with no significant difference compared with that personalized designed preoperatively (t=-0.47, P=0.710). Twelve months after the operation, the best corrected visual acuity (LogMAR) of the experimental group was 0.44卤0.24, which was better than that of the control group 0.58±0.30 (t=-2.19, P=0.030). The average astigmatism of the experimental group was 3.96±2.68 D, more stable than that of the control group 6.30±4.71 D (t=-2.65,P<0.001).Complications such as Descemet's membrane rupture, suture loosening, suture-induced corneal neovascularization and immune rejection did not occur in all the patients included. Conclusions: The method using Photoshop software to individually design the corneal bed/graft diameter achieves high accuracy and predictability and can significantly improve the refractive state of patients with keratoconus after DLK.
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Received: 07 April 2022
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| Fund:National Natural Science Foundation of China (81900907, 81870639); Taishan Scholar Program(201812150) |
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Corresponding Authors:
Hua Gao, Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base,Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Jinan 250012, China (Email: gaohua100@126.com)
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. [J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2023, 25(8): 0-. |
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