ABSTRACT
AIM: To investigate the difference, correlation, and consistency of corneal thickness and the thinnest point position detected by Pentacam HR corneal topography map and RTVue optical coherence tomography(OCT)in patients with keratoconus.METHODS: Cross-sectional comparative study. The corneal curvature map, corneal thickness map, thinnest point position, and thinnest point thickness were detected by Pentacam HR and RTVue OCT. Paired sample t-test was used for data consistent with normal distribution, and paired sample rank sum test was used for data inconsistent with normal distribution. Spearman correlation analysis and Bland-Altman analysis were used for the correlation and consistency of the two measurement methods.RESULTS: A total of 63 patients(105 eyes)with keratoconus were included in this study, including 49 males(77.8%)and 14 females(22.2%), aged 22.24±6.19 years; among them, relevant data of Pentacam HR topographic map: Km was 47.85±4.73D and Kmax was 55.43±8.72D. In measuring central corneal thickness and the thinnest point thickness of keratoconus, the Pentacam HR was 4.70μm and 19.46μm thicker than the mean value measured by RTVue OCT(P<0.05). There was no significant difference between the horizontal and vertical coordinates of the thinnest points measured by the two devices(P>0.05). The central corneal thickness and the thinnest point thickness measured by the two devices were highly correlated, the horizontal coordinate of the thinnest point was moderately correlated, and the vertical coordinate of the thinnest point was weakly correlated. Bland-Altman analysis showed that the central corneal thickness, the thinnest point thickness, the horizontal coordinate of the thinnest point, and the vertical coordinate of the thinnest point were 95.2%(100/105)and 93.3%(98/105), 95.2%(100/105), 95.2%(100/105)respectively, which were within the 95% consistency limit, while the consistency ranges were -36.00～+26.62μm, -42.27～+3.36μm, -0.80～+0.84mm, and -1.95～+1.06mm, respectively.CONCLUSION: In keratoconus, the central corneal thickness and the thinnest point thickness measured by Pentacam HR were higher than those measured by RTVue OCT. It is not recommended that the central corneal thickness and the thinnest point thickness measured by the two instruments be interchangeable in clinical use because of the wide range of consistency between the two instruments' results. The position of the thinnest corneal point measured by the two instruments is similar and consistent, so it could be considered to replace the measured values of the two instruments in clinical use.
ABSTRACT
@#【Objective】To evaluate the efficacy of early filtering surgery in newborns with primary congenital glaucoma（NPCG）.【Methods】A total of 70 eyes of 39 patients with NPCG，who underwent trabeculotomy or combined trabeculotomy-trabeculectomy within 3 years old were retrospectively studied. Preoperative and postoperative intraocular pressure（IOP），corneal clarity and diameter，optic disc cupping and visual acuity were evaluated. Kaplan-Meier survival analysis of the success rates were studied. Success rates of the patients who underwent surgery within 1 month old（22 eyes）and older than 1 month old（48 eyes）were compared by Log- Rank.【Results】The postoperative IOP（mmHg；16.9 ± 5.2） were significantly lower than the preoperative IOP（28.7±5.8 ，P<0.001）. At the last visit ，the cornea became clearer ， C/D（cup/disc）ratio decreased significantly，while the horizontal corneal diameter did not change significantly in all the children. The success rates for all eyes at 1，2，3，6 and 9 years after operation were 94.3%（63 eyes），90.6%（52 eyes），85.9%（40 eyes），85.9%（23 eyes），and 85.9%（15 eyes），respectively. The success rates and visual acuity at last visit of patients who underwent surgery within 1 month old were better than those older than 1 month old（P=0.033； P=0.01）. There were no severe intraoperative or postoperative complications.【Conclusions】Early surgery such as trabeculotomy or combined trabeculotomy-trabeculectomy is a safe and effective treatment for NPCG.
ABSTRACT
<p><b>BACKGROUND</b>Early surgical intervention is required for the primary congenital glaucoma (PCG). There are currently few reports on the surgical outcomes in infants with PCG. This study aimed to evaluate the efficacy and safety of trabeculotomy and the postoperative visual outcomes in Chinese newborns with PCG within 4 weeks of birth.</p><p><b>METHODS</b>A total of 21 eyes of 12 patients with PCG who underwent primary trabeculotomy within 4 weeks of birth were retrospectively studied. Preoperative and postoperative intraocular pressure (IOP), corneal clarity and diameter, axial length and optic disc cupping, visual acuity and postoperative refractive error, success rates, and complications were evaluated. Kaplan-Meier survival analysis was applied to evaluate the success rates.</p><p><b>RESULTS</b>The mean follow-up time was 46.9 ± 34.4 months (range: 12-122 months). The postoperative IOP was significantly lower than the preoperative IOP at all of the follow-up visits (P < 0.001). The complete success rates for all eyes at 1, 2, 3, and 5 years postoperatively were 90.5%, 85.7%, 85.7%, and 85.7%, respectively. The IOPs of the three patients who needed antiglaucomatous medications postoperatively were also well controlled. At the last visit, the cornea became clear, and the cup-to-disc ratio decreased significantly (P = 0.01) although the horizontal corneal diameter did not change significantly (P = 0.11). Visual acuities were able to be recorded in eight eyes at the last visit, among which six eyes had a best-corrected visual acuity of 20/40 or better. There were no severe intraoperative or postoperative complications.</p><p><b>CONCLUSIONS</b>Trabeculotomy proves to be a safe and effective treatment in reducing IOP in this group of Chinese newborns with PCG. The outcomes of vision function were satisfactory in most of the patients.</p>