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准分子激光角膜原位磨镶术后角膜扩张的角膜胶原交联术。

Corneal collagen crosslinking in post-LASIK keratectasia.

机构信息

Augenklinik, Technische Universität München, Ismaningerstr 22, 81675, Munich, Germany.

出版信息

Br J Ophthalmol. 2011 Apr;95(4):493-7. doi: 10.1136/bjo.2010.179424. Epub 2010 Aug 1.

DOI:10.1136/bjo.2010.179424
PMID:20679077
Abstract

BACKGROUND/AIMS: To evaluate the effect of corneal collagen crosslinking with riboflavin and UV-A as a treatment option for postlaser in situ keratomileusis keratectasia.

METHODS

Crosslinking was carried out in 22 eyes of 15 patients with iatrogenic keratectasia. Follow-up, according to a standardised protocol (uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), slit-lamp examination, pachymetry and topography), was performed preoperatively 1, 3, 6 and 12 months after crosslinking.

RESULTS

The mean BCVA was 0.19 (SD ± 0.21) logMAR preoperatively, 0.25 (SD ± 0.17) 1 month, 0.20 (SD ± 0.20) 3 months, 0.18 (SD ± 0.21) 6 months and 0.15 (SD ± 0.14) 12 months postoperatively (statistically significant postop1-postop6, p=0.0335). The maximum k-readings were 44.12 (SD ± 3.97) preoperatively, 46.23 (SD ± 4.14) 1 month, 43.88 (SD ± 4.25) 3 months, 45.06 (SD ± 5.07) 6 months and 44.43 (SD ± 4.06) 12 months postoperatively (statistically significant preop-postop1, p=0.0281).

CONCLUSION

Crosslinking in patients with iatrogenic keratectasia stabilised the UCVA and BCVA as well as the maximum k-readings in our cohort. It seems to be a safe and promising procedure to stabilise the refraction and the corneal topography, and thus to stop the progression of visual loss, thereby avoiding or delaying disease progression and keratoplasty.

摘要

背景/目的:评估使用核黄素和 UV-A 进行角膜胶原交联作为治疗激光原位角膜磨镶术后角膜扩张症的一种选择的效果。

方法

对 15 例 22 只眼的医源性角膜扩张症患者进行交联治疗。根据标准方案(未矫正视力(UCVA)、最佳矫正视力(BCVA)、裂隙灯检查、角膜厚度和地形图)进行术前 1、3、6 和 12 个月的随访。

结果

术前平均 BCVA 为 0.19(SD ± 0.21)logMAR,术后 1 个月为 0.25(SD ± 0.17),3 个月为 0.20(SD ± 0.20),6 个月为 0.18(SD ± 0.21),术后 12 个月为 0.15(SD ± 0.14)(术后 1 个月与术后 6 个月差异有统计学意义,p=0.0335)。最大 k 值读数术前为 44.12(SD ± 3.97),术后 1 个月为 46.23(SD ± 4.14),3 个月为 43.88(SD ± 4.25),6 个月为 45.06(SD ± 5.07),术后 12 个月为 44.43(SD ± 4.06)(术前与术后 1 个月差异有统计学意义,p=0.0281)。

结论

在我们的研究队列中,交联治疗使医源性角膜扩张症患者的 UCVA 和 BCVA 以及最大 k 值读数稳定。交联似乎是一种安全且有前途的稳定屈光不正和角膜地形图的方法,从而阻止视力丧失的进展,从而避免或延迟疾病进展和角膜移植。

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