Mencucci Rita, Mazzotta Cosimo, Corvi Andrea, Terracciano Luca, Rechichi Miguel, Matteoli Sara
*Department of Surgery and Translational Medicine, Eye Clinic, University of Florence, Florence, Italy; †Unità Operativa di Oculistica, Azienda Ospedaliero-Universitaria Senese, Siena, Italy; ‡Department of Industrial Engineering, University of Florence, Florence, Italy; and §Eye Center Ophthalmology Unit, Catanzaro, Italy.
Cornea. 2015 Mar;34(3):323-7. doi: 10.1097/ICO.0000000000000324.
To assess corneal thermal profile during combined riboflavin and accelerated UV corneal collagen cross-linking (A-CXL) using in vivo surface thermographic analysis.
In this open-label, nonrandomized, prospective pilot study, 28 eyes of 28 patients were included. The study was conduced at the Department of Surgery and Translational Medicine, University of Florence, Italy, in collaboration with the Ophthalmic Operative Unit of Siena University, Italy. All patients underwent high-fluence A-CXL in pulsed light and continuous light UV-A exposure at 30 and 18 mW/cm. Patients were divided into 4 groups: 7 for continuous light A-CXL, 7 for pulsed light A-CXL at 30 mW/cm with 7.2 J energy, 7 for continuous light A-CXL, and 7 for pulsed light A-CXL at 18 mW/cm with 5.4 J energy. Corneal surface temperature measurements were recorded using an infrared FLIR thermocamera (FLIR 320A; FLIR Systems). Corneal temperature values were detected in the surface area exposed to UV-A light irradiation, selecting it in the acquired thermographic image. The maximum temperature value detected in the area studied was recorded and considered for comparative analysis.
Infrared thermocamera measurements of the corneal surface during A-CXL treatments showed an average temperature of 31.5°C during the entire procedure in all groups and UV-A powers (30 mW/cm at 7.2 J/cm and 18 mW/cm at 5.4 J/cm) and light exposure modality remained under the threshold of collagen thermal injury.
Accelerated corneal collagen cross-linking did not cause thermal rise over the threshold of thermal injury to the corneal surface, demonstrating a safe thermal profile both at 30 mW/cm with 7.2 J and 18 mW/cm with 5.4 J energy dose.
使用活体表面热成像分析评估核黄素联合加速紫外线角膜胶原交联（A-CXL）过程中的角膜热分布情况。
在这项开放标签、非随机、前瞻性试点研究中，纳入了28例患者的28只眼。该研究在意大利佛罗伦萨大学外科与转化医学系与意大利锡耶纳大学眼科手术单元合作开展。所有患者均接受了高能量的A-CXL治疗，分别采用30 mW/cm和18 mW/cm的脉冲光和连续光紫外线A照射。患者被分为4组：7例接受连续光A-CXL治疗，7例接受30 mW/cm脉冲光A-CXL治疗（能量为7.2 J），7例接受连续光A-CXL治疗，7例接受18 mW/cm脉冲光A-CXL治疗（能量为5.4 J）。使用红外FLIR热成像仪（FLIR 320A；FLIR Systems）记录角膜表面温度测量值。在获取的热成像图像中选择暴露于紫外线A光照射的表面区域，检测该区域的角膜温度值。记录并考虑研究区域内检测到的最高温度值进行对比分析。
A-CXL治疗过程中角膜表面的红外热成像仪测量显示，在所有组以及紫外线A功率（30 mW/cm，7.2 J/cm和18 mW/cm，5.4 J/cm）和光照方式下，整个过程中的平均温度为31.5°C，均低于胶原热损伤阈值。
加速角膜胶原交联不会导致角膜表面热损伤阈值以上的温度升高，在30 mW/cm、7.2 J和18 mW/cm、5.4 J能量剂量下均显示出安全的热分布情况。
