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圆锥角膜角膜交联术后的视力恢复:一项为期 1 年的随访研究。

Visual recovery after corneal crosslinking for keratoconus: a 1-year follow-up study.

机构信息

Eye Clinic, Cantonal Hospital of Lucerne, Lucerne, Switzerland.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2013 Mar;251(3):803-7. doi: 10.1007/s00417-012-2133-2. Epub 2012 Aug 16.

Abstract

PURPOSE

To evaluate visual recovery and intraocular straylight in keratoconus patients 3 months and 1 year after corneal crosslinking (CXL) PATIENTS AND METHODS: Thirty-three eyes of 28 consecutive patients with mild to moderate keratoconus were included. The following were assessed at baseline, 3 months and 1 year after CXL: corrected distance visual acuity (CDVA), intraocular straylight, spherical equivalent (SE), keratometry (Kmax and K min (Diopters D and axis), the regularity index and pachymetry. Changes from baseline were calculated using mixed linear regression models.

RESULTS

The CDVA remained unchanged 3 months after CXL (-0.003 (95 % CI: -0.038 to 0.044); p = 0.880) and improved after 1 year (-0.042 (95 % CI: -0.078 to -0.007; p = 0.021)). The mean straylight value increased significantly by 0.27 (95 % CI: 0.18 to 0.35; p < 0.001) 3 months after CX and normalized to preoperative values after 1 year (0.06 (95 % CI: -0.03 to 0.14; p = 0.215)). SE improved from the mean preoperative value of -2.61 D (95 % CI: -3.83 to -1.39) by 1.95 (95 % CI: 1.03 to 2.86; p < 0.001) at 3 months and remained stable at the 1-year follow-up visit (2.17 (95 % CI: 1.21 to 3.12; p < 0.001)). Parameters of of keratometry changed only minimally. The regularity index remained almost unchanged at 3 months (2.45 (95 % CI: -4.97 to 9.88; p = 0.503)) and decreased by 6.97 (95 % CI: -14.08 to 0.14; p = 0.054). Pachymetry decreased by 44.0 μm (95 % CI: 56.1 to 31.9; p < 0.001) at 3 months and almost returned to preoperative values at 12 months (-11.3 μm (95 % CI: -27.9 to 5.3; p = 0.175)).

CONCLUSIONS

In accordance with the decrease in CDVA and patients' complaints of disability due to glare, intraocular straylight increased 3 months after surgery. One year after CXL, there was an increase in CDVA due to an improved SE and regularity index, and intraocular straylight had normalized.

摘要

目的

评估角膜交联术(CXL)后 3 个月和 1 年时圆锥角膜患者的视力恢复和眼内杂散光情况。

患者和方法

纳入 28 例连续的 33 只轻中度圆锥角膜患者。在基线、CXL 后 3 个月和 1 年时评估以下内容:矫正远视力(CDVA)、眼内杂散光、等效球镜(SE)、角膜曲率(Kmax 和 Kmin(屈光度和轴位)、规则指数和角膜厚度。使用混合线性回归模型计算从基线的变化。

结果

CXL 后 3 个月时 CDVA 保持不变(-0.003(95%CI:-0.038 至 0.044);p=0.880),1 年后有所改善(-0.042(95%CI:-0.078 至 -0.007;p=0.021))。3 个月时,平均杂散光值显著增加 0.27(95%CI:0.18 至 0.35;p<0.001),并在 1 年后恢复到术前值(0.06(95%CI:-0.03 至 0.14;p=0.215))。SE 从术前平均-2.61 D(95%CI:-3.83 至 -1.39)增加了 1.95(95%CI:1.03 至 2.86;p<0.001),并在 1 年随访时保持稳定(2.17(95%CI:1.21 至 3.12;p<0.001))。角膜曲率参数仅略有变化。3 个月时规则指数几乎保持不变(2.45(95%CI:-4.97 至 9.88;p=0.503)),并下降了 6.97(95%CI:-14.08 至 0.14;p=0.054)。3 个月时角膜厚度下降 44.0 μm(95%CI:56.1 至 31.9;p<0.001),12 个月时几乎恢复到术前值(-11.3 μm(95%CI:-27.9 至 5.3;p=0.175))。

结论

与 CDVA 下降和患者因眩光导致的视力障碍相关,眼内杂散光在术后 3 个月增加。CXL 后 1 年,由于 SE 和规则指数的改善,CDVA 增加,眼内杂散光恢复正常。

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