Raiskup-Wolf Frederik, Hoyer Anne, Spoerl Eberhard, Pillunat Lutz E
Department of Ophthalmology, C.G. Carus University Hospital, Dresden, Germany.
J Cataract Refract Surg. 2008 May;34(5):796-801. doi: 10.1016/j.jcrs.2007.12.039.
To prove the long-term dampening effect of riboflavin- and ultraviolet-A-induced collagen crosslinking on progressive keratoconus.
Department of Ophthalmology, C.G. Carus University Hospital, Dresden, Germany.
Four hundred eighty eyes of 272 patients with progressive keratoconus were included in this long-term retrospective study. The maximum follow-up was 6 years. At the first and all follow-up examinations, refraction, best corrected visual acuity (BCVA), corneal topography, corneal thickness, and intraocular pressure were recorded.
The analysis included 241 eyes with a minimum follow-up of 6 months. The steepening decreased significantly by 2.68 diopters (D) in the first year, 2.21 D in the second year, and 4.84 D in the third year. The BCVA improved significantly (> or = 1 line) in 53% of 142 eyes in the first year, 57% of 66 eyes in the second year, and 58% of 33 eyes in the first year or remained stable (no lines lost) in 20%, 24%, and 29%, respectively. Two patients had continuous progression of keratoconus and had repeat crosslinking procedures.
Despite the low number of patients with a follow-up longer than 3 years, results indicate long-term stabilization and improvement after collagen crosslinking. Thus, collagen crosslinking is an effective therapeutical option for progressive keratoconus.
证实核黄素与紫外线A诱导的胶原交联对圆锥角膜进展的长期抑制作用。
德国德累斯顿C.G.卡鲁斯大学医院眼科。
本长期回顾性研究纳入了272例圆锥角膜进展期患者的480只眼。最长随访时间为6年。在首次及所有随访检查中，记录屈光、最佳矫正视力（BCVA）、角膜地形图、角膜厚度及眼压。
分析纳入了241只眼，最短随访时间为6个月。第一年陡峭度显著降低2.68屈光度（D），第二年降低2.21 D，第三年降低4.84 D。142只眼中53%在第一年BCVA显著提高（≥1行），66只眼中57%在第二年提高，33只眼中58%在第一年提高或保持稳定（未丢失行数），分别为20%、24%和29%。2例患者圆锥角膜持续进展并接受了重复交联手术。
尽管随访时间超过3年的患者数量较少，但结果表明胶原交联后可实现长期稳定和改善。因此，胶原交联是圆锥角膜进展期的一种有效治疗选择。
