Ehlers Niels, Hjortdal Jesper, Nielsen Kim, Søndergaard Anders
Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark.
J Refract Surg. 2009 Sep;25(9):S803-6. doi: 10.3928/1081597X-20090813-08. Epub 2009 Sep 11.
Riboflavin-ultraviolet A (UVA) treatment induces cross-linking and stiffens the corneal stroma. A parallel reduction in stromal swelling and increased resistance to microbial and enzymatic degradation has been suggested. The purpose of this study was to evaluate the potential of riboflavin-UVA treatment in the management of corneal disorders, in particular edema due to endothelial decompensation and non-healing ulcers.
Two clinical series are reported, 11 eyes with endothelial decompensation and 14 eyes with non-healing ulcers. Treatment comprised a) abrasion of epithelium (if present), b) instillation of 0.1% riboflavin in saline, and c) irradiation at 365 nm UVA light over approximately 30 minutes (3 mW/cm(2)). Four eyes in the first group were treated twice. Postoperatively, all eyes were followed for at least 3 months.
Reduction in corneal thickness was observed in 10 of 11 eyes with stromal edema and the majority also experienced improvement in vision. The effect occurred over weeks and lasted for months. Fourteen patients with non-healing ulceration were similarly treated; 6 healed, 8 showed no clear effect.
In addition to the stiffening of keratoconic and ectatic cornea, riboflavin-UVA treatment is effective in reducing corneal edema and has the potential to heal corneal ulcers.
核黄素 - 紫外线A（UVA）治疗可诱导角膜基质交联并使其变硬。有人提出，这会使基质肿胀程度相应降低，并增强对微生物和酶降解的抵抗力。本研究的目的是评估核黄素 - UVA治疗在角膜疾病管理中的潜力，特别是在内皮失代偿引起的水肿和不愈合溃疡方面。
报告了两个临床系列，11只患有内皮失代偿的眼睛和14只患有不愈合溃疡的眼睛。治疗包括：a）（如有）上皮擦伤；b）在盐水中滴注0.1%核黄素；c）用365nm的UVA光照射约30分钟（3mW/cm²）。第一组中有4只眼睛接受了两次治疗。术后，所有眼睛均随访至少3个月。
11只患有基质水肿的眼睛中有10只角膜厚度减小，大多数患者视力也有所改善。这种效果在数周内出现并持续数月。14例不愈合溃疡患者接受了类似治疗；6例愈合，8例无明显效果。
除了对圆锥角膜和扩张性角膜有变硬作用外，核黄素 - UVA治疗在减轻角膜水肿方面有效，并且有治愈角膜溃疡的潜力。
