Doors Muriël, Tahzib Nayyirih G, Eggink Fred A, Berendschot Tos T J M, Webers Carroll A B, Nuijts Rudy M M A
Department of Ophthalmology, University Medical Center Maastricht, Maastricht, The Netherlands.
Am J Ophthalmol. 2009 Dec;148(6):844-51.e2. doi: 10.1016/j.ajo.2009.06.031. Epub 2009 Sep 24.
To investigate the stromal demarcation line after corneal cross-linking using anterior segment optical coherence tomography (AS-OCT) and its influence on the short-term results of cross-linking in patients with progressive keratoconus.
Prospective, nonrandomized study.
Twenty-nine eyes of 29 patients with progressive keratoconus (n = 28) or after laser in situ keratomileusis ectasia (n = 1) were included and treated with corneal cross-linking at our institution. Measurements at 1, 3, 6, and 12 months after corneal cross-linking were: refraction, best-corrected visual acuity (BCVA), tonometry, corneal topography, AS-OCT, specular microscopy, and aberrometry. Demarcation line depth was measured centrally, 2 mm temporally, and 2 mm nasally by two independent observers using AS-OCT and was correlated with clinical parameters.
The stromal demarcation line was visible with AS-OCT at 1 month after surgery in 28 of 29 eyes. Pairwise comparisons between the two observers of the AS-OCT measurements did not show a statistically significant difference. After an initial steepening of maximal keratometry values and a decrease in BCVA at 1 month after surgery (both with P < .012), no significant changes were found at 3, 6, and 12 months after surgery compared with before surgery. Refractive cylinder, topographic astigmatism, aberration values, endothelial cell density, and intraocular pressure remained stable during all postoperative visits. A deeper demarcation line depth was associated with a larger decrease in corneal thickness (r = -0.506; P = .012).
AS-OCT is a useful device to detect the stromal demarcation line after corneal cross-linking. At 3 to 12 months follow-up, all clinical parameters remained stable, indicating stabilization of the keratoconic disease.
使用眼前节光学相干断层扫描（AS-OCT）研究角膜交联术后的基质分界线及其对圆锥角膜患者交联短期结果的影响。
前瞻性、非随机研究。
纳入29例圆锥角膜患者（n = 28）或准分子原位角膜磨镶术（LASIK）后角膜扩张患者（n = 1）的29只眼，在我们机构接受角膜交联治疗。角膜交联术后1、3、6和12个月的测量指标包括：验光、最佳矫正视力（BCVA）、眼压测量、角膜地形图、AS-OCT、镜面显微镜检查和像差测量。两名独立观察者使用AS-OCT在中央、颞侧2 mm和鼻侧2 mm处测量分界线深度，并将其与临床参数相关联。
29只眼中的28只在术后1个月时通过AS-OCT可见基质分界线。两位观察者对AS-OCT测量值的两两比较未显示出统计学上的显著差异。术后1个月时最大角膜曲率值最初变陡，BCVA下降（均P < .012），与术前相比，术后3、6和12个月未发现显著变化。在所有术后随访中，屈光柱镜、地形散光、像差值、内皮细胞密度和眼压均保持稳定。更深的分界线深度与角膜厚度更大的降低相关（r = -0.506；P = .012）。
AS-OCT是检测角膜交联术后基质分界线的有用设备。在3至12个月的随访中，所有临床参数均保持稳定，表明圆锥角膜病情稳定。
