Humanitas Clinical and Research Center, Rozzano, Italy.
Ophthalmology. 2013 May;120(5):908-16. doi: 10.1016/j.ophtha.2012.10.023. Epub 2013 Jan 3.
To report the 4-year outcomes of corneal cross-linking (CXL) for progressive keratoconus in a population of different age groups.
Retrospective, single-center, nonrandomized clinical study.
Four hundred consecutive eyes treated with corneal CXL for progressive keratoconus from April 2006 through April 2010.
After removal of the epithelium, the cornea was irrigated for 30 minutes with a solution of 0.1% riboflavin and 20% dextran, followed by irradiation with an ultraviolet A light of 3 mW/cm(2) for 30 minutes.
Best-corrected visual acuity (BCVA), sphere and cylinder refraction, corneal topography, Scheimpflug tomography, and aberrometry were assessed at baseline and at 1, 6, 12, 24, 36, and 48 months after corneal CXL treatment. The compiled data were stratified according to age (group A, younger than 18 years; group B, 18-29 years; group C, 30-39 years; and group D, older than 40 years).
Comparative analysis included 400 eyes of 301 patients. Functional results showed a significant increase in BCVA in group A by a mean reduction of -0.11 logarithm of the minimum angle of resolution (logMAR) after 12 months, in group B by a mean reduction of -0.31 logMAR after 36 months, in group C by a mean reduction of -0.33 logMAR after 36 months, and in group D by a mean reduction of -0.26 logMAR after 36 months. Morphologic results showed an analogous regularization of corneal shape with a significant reduction of opposite sector index by a mean value of -0.53 at 12 months in group A, -1.14 at 36 months in group B, -1.10 at 36 months in group C, and -0.55 at 12 months for group D. Optical quality improvement was demonstrated by a mean significant reduction of coma -1.52 μm after 12 months in group A, -1.58 μm after 24 months in group B, -2.57 μm after 36 months for group C, and -0.25 μm after 36 months in group D.
Outcomes stratified by age indicate the efficacy of corneal CXL in stabilizing the progression of ectatic disease in all age groups and improving the functional and morphologic parameters in select groups. Results indicated better functional and morphologic results in the population between 18 and 39 years of age.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
报告在不同年龄组的进行性圆锥角膜患者中，角膜交联术（CXL）治疗 4 年的结果。
回顾性、单中心、非随机临床研究。
2006 年 4 月至 2010 年 4 月期间，400 只连续接受 CXL 治疗进行性圆锥角膜的眼睛。
去除上皮后，用 0.1%核黄素和 20%葡聚糖溶液冲洗角膜 30 分钟，然后用 3mW/cm(2)的紫外线 A 光照射 30 分钟。
治疗后 1、6、12、24、36 和 48 个月时，采用最佳矫正视力（BCVA）、球镜和柱镜屈光、角膜地形图、Scheimpflug 断层扫描和像差仪评估。根据年龄（A 组：<18 岁；B 组：18-29 岁；C 组：30-39 岁；D 组：>40 岁）对汇总数据进行分层。
包括 301 名患者的 400 只眼的比较分析。功能结果显示，A 组在 12 个月时 BCVA 平均提高 -0.11 对数最小角分辨率（logMAR），B 组在 36 个月时平均提高 -0.31 logMAR，C 组在 36 个月时平均提高 -0.33 logMAR，D 组在 36 个月时平均提高 -0.26 logMAR。形态学结果显示，角膜形状的规则化相似，A 组在 12 个月时对面部指数的平均降低值为-0.53，B 组在 36 个月时为-1.14，C 组在 36 个月时为-1.10，D 组在 12 个月时为-0.55。光学质量改善表现为 A 组在 12 个月时平均降低彗差 -1.52 μm，B 组在 24 个月时平均降低 -1.58 μm，C 组在 36 个月时平均降低 -2.57 μm，D 组在 36 个月时平均降低 -0.25 μm。
按年龄分层的结果表明，角膜 CXL 能有效稳定所有年龄组的扩张性疾病进展，并改善特定组的功能和形态参数。结果表明，18 至 39 岁人群的功能和形态结果更好。
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