Kymionis George D, Grentzelos Michael A, Portaliou Dimitra M, Kankariya Vardhaman P, Randleman J Bradley
J Refract Surg. 2014 Aug;30(8):566-76. doi: 10.3928/1081597X-20140711-10.
To discuss current combined corneal collagen cross-linking (CXL) and refractive surgical techniques (herein termed "CXL plus") for the treatment of corneal ectatic disorders to improve functional visual acuity in addition to corneal stability from CXL alone.
Literature review.
Efficacious combined treatments with CXL include: photorefractive keratectomy, transepithelial phototherapeutic keratectomy, intrastromal corneal ring segments implantation, phakic intraocular lens implantation, and multiple combined procedures. Some uncertainty remains as to the optimal strategies for each patient. A decision tree is proposed to facilitate optimal patient management.
With multiple adjuvant techniques, CXL plus is likely to benefit many patients with corneal ectatic disorders. The appropriate combined procedure will depend on multiple factors, such as refraction, corneal thickness, and degree of irregular astigmatism.
探讨当前联合角膜胶原交联（CXL）和屈光手术技术（以下称为“CXL 联合术”）治疗角膜扩张性疾病，以在单纯 CXL 提供角膜稳定性的基础上提高功能性视力。
文献综述。
与 CXL 联合有效的治疗方法包括：准分子激光角膜原位磨镶术、经上皮光疗性角膜切削术、角膜基质内环形片段植入术、有晶状体眼人工晶状体植入术以及多种联合手术。对于每位患者的最佳治疗策略仍存在一些不确定性。提出了一个决策树以促进最佳的患者管理。
通过多种辅助技术，CXL 联合术可能使许多角膜扩张性疾病患者受益。合适的联合手术将取决于多种因素，如屈光、角膜厚度和不规则散光程度。
