摘要
目的回顾性研究圆锥角膜患者的就诊及确诊过程。方法对2009年6月至2012年12月在郑州大学第一附属医院眼科就诊的74例圆锥角膜患者的病历资料进行回顾性分析，统计患者的基本资料、就诊原因和确诊过程。结果男性55例，女性19例；确诊年龄10～42岁，平均（20．5±4．3）岁。根据角膜地形图分为四组：可疑组18例（24％），轻度组29例（39％），中度组14例（19％），重度组13例（18％）。就诊原因分为9类：配戴框架眼镜视力未能矫正至正常27例（36％），初诊验光散光度数较大或复诊验光散光度数增加较大12例（16％），配戴框架眼镜单眼视物重影9例（12％），近视度数增长过快8例（11％），准分子激光角膜屈光手术术前检查发现5例（7％），验配硬镜前检查发现5例（7％），准分子术后近视反弹用框架眼镜无法矫正视力3例（4％），眼痒等不适3例（4％），角膜移植后视力渐下降2例（3％）。根据常规眼科检查，首次确诊63例（85％），多次检查误诊11例（15％）。结论圆锥角膜多见于20岁左右的男性，初诊为轻度的圆锥角膜患者稍多。就诊的主要原因是视力下降而戴框架眼镜不能矫正至正常或有重影、散光较大、近视度数增加过快。应综合评估，警惕误诊的蕞≮、
Objective Retrospective study the treatment reasons and diagnosis process of patients with keratoconus. Methods The basic information, treatment reasons and diagnosis process of 74 pa-tients with keratoconus were investigated. Results There were 55 males and 19 females. The treat-ment age was an average of （20.5 ± 4.3 ） years old （range from 12 to 42 years）. It was divided in-to four groups based on corneal topography： suspicious group （18 patients, 24%）; mild group （29 pa-tients, 39%）; moderate group （14 patients, 19%）; severe group （13 patients, 18%）. Nine categories treatment reasons were divided. Twenty-seven patients （36%） had an abnormal spectacle corrected vi-sion. Twelve patients （16%） had high astigmatism in the first diagnosed optometry or increased astig-matism quickly in the short term. Nine patients （12%） wearing glasses were monocular depending on the material ghosting. Eight patients （11%） had a rapid growth of myopia diopter. Five patients （7%） were found preoperative examination of the excimer laser corneal refractive surgery. Five pa-tients （7%） were revealed before the rigid contact lens fitting examination. Three patients （4%） had not a spectacle corrected vision postoperative myopic itching and other discomfort. Two patients （3%） had excimer surgery. Three spectacle （4%） felt eye a bad vision gradually after corneal transplanta-tion. There were 63 cases （85%） first diagnosed based on routine eye examination and 11 cases （15%） misdiagnosed with multiple inspections. Conclusions Keratoconus most appear in male pa-tients around 20 years old and mild patients are slightly more. The main reason for treatment is de-creased vision but can not be corrected to normal by glasses or ghosting, astigmatism, myopia diop-ter increased too fast. We should assess comprehensively, alert to the occurrence of misdiagnosis.
出处
《中国实用眼科杂志》
CSCD
北大核心
2013年第10期1297-1300,共4页
Chinese Journal of Practical Ophthalmology
关键词
圆锥角膜
就诊原因
确诊
角膜地形图
Keratoconus
Clinic reason
Diagnosed
Corneal topography
