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核黄素和紫外线A光角膜交联治疗进展期圆锥角膜:十年结果

Corneal collagen crosslinking with riboflavin and ultraviolet-A light in progressive keratoconus: ten-year results.

作者信息

Raiskup Frederik, Theuring Anja, Pillunat Lutz E, Spoerl Eberhard

机构信息

From the Department of Ophthalmology (Raiskup, Theuring, Pillunat, Spoerl), C.G. Carus University Hospital, Dresden, Germany; the Department of Ophthalmology (Raiskup), Faculty of Medicine Hradec Králové, Charles University, Prague, Czech Republic.

From the Department of Ophthalmology (Raiskup, Theuring, Pillunat, Spoerl), C.G. Carus University Hospital, Dresden, Germany; the Department of Ophthalmology (Raiskup), Faculty of Medicine Hradec Králové, Charles University, Prague, Czech Republic.

出版信息

J Cataract Refract Surg. 2015 Jan;41(1):41-6. doi: 10.1016/j.jcrs.2014.09.033.

Abstract

PURPOSE

To analyze the 10-year results of corneal collagen crosslinking (CXL) for keratoconus.

SETTING

Department of Ophthalmology, University Hospital, Dresden, Germany.

DESIGN

Retrospective interventional case series.

METHODS

The study included eyes treated for progressive keratoconus from 2000 to 2004. Corneal collagen crosslinking was performed by applying riboflavin and ultraviolet-A. The corrected distance visual acuity (CDVA), corneal topography, and endothelial cell count (ECC) were recorded preoperatively and 10 years postoperatively.

RESULTS

The study enrolled 24 patients (34 eyes). The mean age of the 18 men and 6 women was 28.4 years ± 7.3 (SD) and the mean follow-up, 131.9 ± 20.1 months. The mean apical keratometry (K) value was 61.5 diopters (D) preoperatively and 55.3 D 10 years postoperatively; the decrease was statistically significant (P<.001). The mean values for maximum K (53.2 D and 49.56 D, respectively) and minimum K (47.5 D and 45.5 D, respectively) were also significantly lower (P<.001). The preoperative and postoperative CDVA were statistically significantly different (P=.002). The mean CDVA improved by 0.14 logMAR over preoperatively; the change was statistically significant (P=.002). The ECC was unchanged.

CONCLUSIONS

Corneal CXL was effective in treating progressive keratoconus, achieving long-term stabilization of the condition. It was easy to perform, had a good safety profile, and reduced the need for corneal transplantation.

FINANCIAL DISCLOSURE

No author has a financial or proprietary interest in any material or method mentioned.

摘要

目的

分析圆锥角膜角膜胶原交联术(CXL)的10年疗效。

机构

德国德累斯顿大学医院眼科。

设计

回顾性干预病例系列研究。

方法

本研究纳入2000年至2004年接受治疗的进展性圆锥角膜患者。通过应用核黄素和紫外线A进行角膜胶原交联。术前及术后10年记录矫正远视力(CDVA)、角膜地形图和内皮细胞计数(ECC)。

结果

本研究纳入24例患者(34只眼)。18例男性和6例女性的平均年龄为28.4岁±7.3(标准差),平均随访时间为131.9±20.1个月。术前平均角膜顶点曲率(K)值为61.5屈光度(D),术后10年为55.3 D;下降具有统计学意义(P<0.001)。最大K值(分别为53.2 D和49.56 D)和最小K值(分别为47.5 D和45.5 D)的平均值也显著降低(P<0.001)。术前和术后CDVA有统计学显著差异(P = 0.002)。平均CDVA较术前提高了0.14 logMAR;变化具有统计学意义(P = 0.002)。ECC未改变。

结论

角膜CXL在治疗进展性圆锥角膜方面有效,可实现病情的长期稳定。该手术操作简便,安全性良好,减少了角膜移植的需求。

财务披露

没有作者对文中提及的任何材料或方法有财务或专利权益。

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