科研之友
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摘要
Purpose.- To determine the value of wavefront analysis in the detection of keratoconus.
Patients and methods.- A prospective study was conducted from May 2008 to May 2010. Four groups were formed: patients with a "healthy'' cornea (group 0; n = 48), patients with keratoconus "suspect'' (group 1; n = 43), patients with keratoconus "forme fruste'' (group 2; n = 31), and patients with "beginning'' keratoconus (group 3; n = 47). Total and corneal aberrations were analysed. The Fisher test and Student t-test were used to compare the different groups. Receiver operating characteristic (ROC) curves were plotted when aberration differentiated groups 0 and 1.
Results.- Total and corneal coma (Z 3), the corneal trefoil, (Z 3) and the corneal secondary astigmatism (Z 4) differentiated groups 0 and 1. Sensitivities and specificities of total and corneal coma, corneal trefoil, and corneal secondary astigmatism were, respectively, 67.4%, 56.3% (Youden = 0.237), 60.5%, 72.9% (Youden = 0.334), 83.7%, 39.6% (Youden = 0.233), and 65.1%, 58.3% (Youden = 0.234). Total, corneal coma, and corneal trefoil differentiated all severity groups. The third high-order aberrations differentiated groups 1 and 2.
Discussion.- High-order aberrations are good indicators for grading keratoconus. Total high-order aberrations are less discriminating than corneal high-order aberrations. Corneal coma (Z 3) is the most discriminating aberration to differentiate the healthy cornea from the suspect cornea. Nevertheless, it does not optimally detect keratoconus suspect (Youden = 0.334 and sensitivity = 60.5%). The statistical analysis suggests that keratoconus suspect and forme fruste are different entities.
Conclusion.- Wavefront analysis can be used for the detection of keratoconus suspect, forme fruste, and beginning keratoconus but must be associated with videotopography and pachymetry during consultation of refractive surgery.
- 出版日期2011-10
