Caporossi Aldo, Baiocchi Stefano, Mazzotta Cosimo, Traversi Claudio, Caporossi Tomaso
Department of Ophthalmological and Neurosurgical Sciences, Siena University, Siena, Italy.
J Cataract Refract Surg. 2006 May;32(5):837-45. doi: 10.1016/j.jcrs.2006.01.091.
To assess the effectiveness of riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen in reducing progression of keratoconus and in improving visual acuity in patients with progressive keratoconus.
Department of Ophthalmology, Siena University, Siena, Italy.
This was a second-phase prospective nonrandomized open study. Starting in September 2004, 10 eyes of 10 patients (mean age 31.4 years) with bilateral keratoconus were treated by combined riboflavin-ultraviolet type A rays (UVA) collagen cross-linking. Radiant energy was 3 mW/cm2 or 5.4 joule/cm2 for a 30-minute exposure at 1 cm from the corneal apex. A complete ophthalmologic examination (uncorrected visual acuity [UCVA], sphere spectacles corrected visual acuity (SSCVA), best spectacle-corrected visual acuity [BSCVA]) was performed. Patients had corneal computerized topographic examination, linear scan optical tomography, endothelial cell count, ultrasound pachometry, intraocular pressure (IOP) evaluation, and HRT II system confocal microscopy at 1, 2, 3, and 6 months. After treatment, eyes were medicated and dressed with a soft contact lens.
Comparative preoperative and postoperative results showed increases of 3.6 lines for UCVA (P = .0000112), 1.85 lines for SSCVA (P = .00065), and 1.66 lines for BSCVA (P = .00071). Topographic analysis showed a mean K reduction of 2.1 +/- 0.13 diopters (D) in the central 3.0 mm. Statistical analysis of IOP and endothelial cell count did not show significant differences. Topo-aberrometric analysis findings of corneal symmetry showed a trend toward increasing corneal symmetry with a major reduction in asymmetry between vertical hemimeridians.
Refractive results showed a reduction of about 2.5 D in the mean spherical equivalent, topographically confirmed by the reduction in mean K. Results of surface aberrometric analysis showed improvement in morphologic symmetry with a significant reduction in comatic aberrations.
评估核黄素 - A型紫外线诱导角膜胶原交联在减缓圆锥角膜进展及提高进行性圆锥角膜患者视力方面的有效性。
意大利锡耶纳锡耶纳大学眼科。
这是一项二期前瞻性非随机开放研究。从2004年9月开始，对10例双侧圆锥角膜患者（平均年龄31.4岁）的10只眼睛进行核黄素 - A型紫外线（UVA）联合胶原交联治疗。在距离角膜顶点1 cm处进行30分钟的照射，辐射能量为3 mW/cm²或5.4焦耳/cm²。进行了全面的眼科检查（未矫正视力[UCVA]、球镜矫正视力[SSCVA]、最佳眼镜矫正视力[BSCVA]）。患者在1、2、3和6个月时进行角膜计算机化地形图检查、线性扫描光学断层扫描、内皮细胞计数、超声角膜测厚、眼压（IOP）评估以及HRT II系统共焦显微镜检查。治疗后，眼睛用药并佩戴软性接触镜。
术前与术后结果对比显示，UCVA提高了3.6行（P = .0000112），SSCVA提高了1.85行（P = .00065），BSCVA提高了1.66行（P = .00071）。地形图分析显示，中央3.0 mm区域平均角膜曲率（K）降低了2.1±0.13屈光度（D）。眼压和内皮细胞计数的统计分析未显示出显著差异。角膜对称性的地形图像差分析结果显示，角膜对称性有增加的趋势，垂直半子午线之间的不对称性明显降低。
屈光结果显示平均球镜等效度降低约2.5 D，地形图检查通过平均角膜曲率的降低得到证实。表面像差分析结果显示形态对称性有所改善，彗差显著降低。
