Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zürich, Switzerland.
J Cataract Refract Surg. 2011 Aug;37(8):1488-92. doi: 10.1016/j.jcrs.2011.03.041.
To identify preoperative parameters that may predict flattening of the keratoconic cornea after collagen crosslinking (CXL).
Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Zurich, Switzerland.
Cohort study.
Patients with verified progressive primary keratectasia received standard corneal CXL. Factors such as corrected distance visual acuity (CDVA) and Scheimpflug tomography (Pentacam) were used to follow the evolution from preoperatively to 12 months after CXL. Statistical analysis included U tests and Spearman rank correlation tests to detect risk factors for flattening of the keratoconus.
The study enrolled 151 eyes of 151 patients; more than 80% completed the 12-month follow-up. The flattening rate (flattening of the maximum curvature >1.00 diopter [D]) was 37.7%. A preoperative maximum keratometry (K) reading of more than 54.00 D was identified as the only significant risk factor for this effect (odds ratio, 1.88; 95% confidence interval, 1.01-3.51). A restriction to corneas with a maximum K value greater than 54.00 D would have resulted in a significant flattening in 51% of the cases.
Statistically significant flattening occurred during 1 year after CXL in more than 50% of cases when the preoperative maximum K reading was more than 54.00 D. None of the other preoperative parameters evaluated (eg, age, sex, diagnosis, CDVA, corneal shape factors) had a statistically significant impact on corneal flattening after CXL.
确定胶原交联（CXL）后可能预测圆锥角膜变平的术前参数。
瑞士苏黎世屈光与眼科手术研究所（IROC）。
队列研究。
患有已证实进展性原发性角膜扩张症的患者接受标准角膜 CXL。使用校正后的距离视力（CDVA）和Scheimpflug 断层扫描（Pentacam）等因素来随访 CXL 术前至术后 12 个月的演变。统计分析包括 U 检验和 Spearman 秩相关检验，以检测角膜变平的危险因素。
该研究共纳入 151 例 151 只眼患者；超过 80%的患者完成了 12 个月的随访。变平率（最大曲率变平>1.00 屈光度[D]）为 37.7%。术前最大角膜曲率计（K）读数>54.00 D 被确定为这种效应的唯一显著危险因素（优势比，1.88；95%置信区间，1.01-3.51）。如果将最大 K 值限制在>54.00 D 的角膜，则会导致 51%的病例出现明显变平。
当术前最大 K 值读数>54.00 D 时，CXL 后 1 年内超过 50%的病例会出现统计学上显著的变平。评估的其他术前参数（例如年龄、性别、诊断、CDVA、角膜形状因素）均未对 CXL 后角膜变平产生统计学上的显著影响。
