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小儿进行性圆锥角膜的角膜胶原交联治疗结果

Outcome of corneal collagen crosslinking for progressive keratoconus in paediatric patients.

作者信息

Viswanathan Deepa, Kumar Nikhil L, Males John J

机构信息

Australian School of Advanced Medicine, Macquarie University, Sydney, NSW 2109, Australia.

Australian School of Advanced Medicine, Macquarie University, Sydney, NSW 2109, Australia ; Sydney Adventist Hospital Clinical School, The University of Sydney, Sydney, NSW 2076, Australia.

出版信息

Biomed Res Int. 2014;2014:140461. doi: 10.1155/2014/140461. Epub 2014 Jun 11.

Abstract

PURPOSE

To evaluate the efficacy of corneal collagen crosslinking for progressive keratoconus in paediatric patients.

METHODS

This prospective study included 25 eyes of 18 patients (aged 18 years or younger) who underwent collagen crosslinking performed using riboflavin and ultraviolet-A irradiation (370 nm, 3 mW/cm2, 30 min).

RESULTS

The mean patient age was 14.3±2.4 years (range 8-17) and mean followup duration was 20.1±14.25 months (range 6-48). Crosslinked eyes demonstrated a significant reduction of keratometry values. The mean baseline simulated keratometry values were 46.34 dioptres (D) in the flattest meridian and 50.06 D in the steepest meridian. At 20 months after crosslinking, the values were 45.67 D (P=0.03) and 49.34 D (P=0.005), respectively. The best spectacle corrected visual acuity (BSCVA) and topometric astigmatism improved after crosslinking. Mean logarithm of the minimum angle of resolution (logMAR) BSCVA decreased from 0.24 to 0.21 (P=0.89) and topometric astigmatism reduced from mean 3.50 D to 3.25 D (P=0.51).

CONCLUSIONS

Collagen crosslinking using riboflavin and ultraviolet-A is an effective treatment option for progressive keratoconus in paediatric patients. Crosslinking stabilises the condition and, thus, reduces the need for corneal grafting in these young patients.

摘要

目的

评估角膜胶原交联术治疗儿童进展性圆锥角膜的疗效。

方法

本前瞻性研究纳入了18例(年龄18岁及以下)患者的25只眼,这些患者接受了使用核黄素和紫外线A照射(370纳米,3毫瓦/平方厘米,30分钟)进行的胶原交联术。

结果

患者平均年龄为14.3±2.4岁(范围8 - 17岁),平均随访时间为20.1±14.25个月(范围6 - 48个月)。交联后的眼睛角膜曲率值显著降低。最平子午线方向的平均基线模拟角膜曲率值为46.34屈光度(D),最陡子午线方向为50.06 D。交联后20个月时,相应值分别为45.67 D(P = 0.03)和49.34 D(P = 0.005)。交联后最佳矫正视力(BSCVA)和角膜地形图散光得到改善。平均最小分辨角对数(logMAR)BSCVA从0.24降至0.21(P = 0.89),角膜地形图散光从平均3.50 D降至3.25 D(P = 0.51)。

结论

使用核黄素和紫外线A的胶原交联术是治疗儿童进展性圆锥角膜的有效选择。交联可稳定病情,从而减少这些年轻患者角膜移植的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fcf/4071785/24524cebe2e3/BMRI2014-140461.001.jpg

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