Hafezi Farhad, Mrochen Michael, Iseli Hans Peter, Seiler Theo
Institute for Refractive and Ophthalmic Surgery, Zurich, Switzerland.
J Cataract Refract Surg. 2009 Apr;35(4):621-4. doi: 10.1016/j.jcrs.2008.10.060.
Corneal collagen crosslinking (CXL) with riboflavin and ultraviolet-A light is a method for treating progressive keratectasia. The currently accepted treatment parameters induce collagen crosslinking in the anterior 250 to 350 microm of corneal stroma. To protect the endothelium, CXL inclusion criteria require a minimum corneal thickness of 400 microm after removal of the epithelium. In advanced keratoconus, however, progressive corneal thinning often leads to a remaining stromal thickness of less than 400 microm. We have therefore modified the current treatment protocol by preoperatively swelling thin corneas to a stromal thickness of at least 400 microm using hypoosmolar riboflavin solution. This treatment protocol was performed in a case series of 20 patients, and no complications were observed. Preoperative swelling of the cornea safely broadens the spectrum of CXL indications to thin corneas that would otherwise not be eligible for treatment.
核黄素与紫外线A光交联角膜（CXL）是一种治疗进行性圆锥角膜的方法。目前公认的治疗参数可诱导角膜基质前250至350微米处的胶原交联。为保护内皮细胞，CXL纳入标准要求去除上皮后角膜厚度至少为400微米。然而，在晚期圆锥角膜中，角膜进行性变薄常导致剩余基质厚度小于400微米。因此，我们修改了当前的治疗方案，术前使用低渗核黄素溶液将薄角膜肿胀至基质厚度至少为400微米。该治疗方案在20例患者的病例系列中实施，未观察到并发症。术前角膜肿胀安全地拓宽了CXL适应症范围，使其适用于那些原本不符合治疗条件的薄角膜。
