Research progress of early keratoconus screening before refractive surgery

doi:10.3877/cma.j.issn.2095-2007.2021.06.010

Abstract

Abstract:

Refractive surgery is the choice of many myopia patients. However, secondary keratoconus, a postoperative complication, has the great harm to the visual acuity of patients. The one of the important means to prevent it is to screen preoperatively. Therefore, the examination of keratoconus before corneal refractive surgery was summarized, and the parameters of corneal topographic map and corneal biomechanical examination was compared, which to provide a reference for clinical choice.

Key words: Early keratoconus screening, Pentacam anterior segment analysis system, Corneal topographic map, Corneal biomechanics

Jia Liu, Rui He, Xiaona Li, Yan Gao. Research progress of early keratoconus screening before refractive surgery[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2021, 11(06): 375-379.

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References 56

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类别	临床表现及辅助检查结果
临床期圆锥角膜	有近视眼和(或)散光病史；视力下降，矫正视力<1.0；裂隙灯显微镜检查角膜基质变薄、锥状向前膨隆、Fleischer环、Vogt线、上皮或上皮下瘢痕。以上体征至少1项阳性；角膜地形图检查示角膜前表面中央屈光度>47.00 D；角膜中心下方3 mm处与上方3 mm处屈光度差值>3.00 D；双眼角膜中央前表面屈光度差值>1.00 D
亚临床期圆锥角膜	不满足临床期圆锥角膜的诊断标准；角膜中央的屈光度>46.50 D；下方与上方3 mm角膜屈光度差值>1.26 D；同一患者双眼角膜屈光度差值>0.92 D；一眼确诊为临床期圆锥角膜，而按照目前诊断标准仍属正常范围的对侧眼

类别	临床表现及辅助检查结果
临床期圆锥角膜	有近视眼和(或)散光病史；视力下降，矫正视力<1.0；裂隙灯显微镜检查角膜基质变薄、锥状向前膨隆、Fleischer环、Vogt线、上皮或上皮下瘢痕。以上体征至少1项阳性；角膜地形图检查示角膜前表面中央屈光度>47.00 D；角膜中心下方3 mm处与上方3 mm处屈光度差值>3.00 D；双眼角膜中央前表面屈光度差值>1.00 D
亚临床期圆锥角膜	不满足临床期圆锥角膜的诊断标准；角膜中央的屈光度>46.50 D；下方与上方3 mm角膜屈光度差值>1.26 D；同一患者双眼角膜屈光度差值>0.92 D；一眼确诊为临床期圆锥角膜，而按照目前诊断标准仍属正常范围的对侧眼

序号	重复性较好	准确性较好	参考文献
1	CCT、角膜变形幅度、A₁T及IOP	角膜变形幅度	[36]
2	CCT和IOP	CCT和IOP	[41]
3	IOP、CCT、最大压陷时的角膜变形幅度及A₁T		[42]
4	IOP、角膜厚度、最大压陷时的角膜变形幅度及A₁T	最大压陷时的角膜曲率半径	[48]
5	CCT	CCT	[49]
6	IOP	IOP	[50]

序号	重复性较好	准确性较好	参考文献
1	CCT、角膜变形幅度、A₁T及IOP	角膜变形幅度	[36]
2	CCT和IOP	CCT和IOP	[41]
3	IOP、CCT、最大压陷时的角膜变形幅度及A₁T		[42]
4	IOP、角膜厚度、最大压陷时的角膜变形幅度及A₁T	最大压陷时的角膜曲率半径	[48]
5	CCT	CCT	[49]
6	IOP	IOP	[50]

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