Wu Huping, Luo Shunrong, Dong Nuo, Lin Zhirong, Liu Zhaosheng, Shang Xumin
Ocular Surface and Corneal Disease Department, the Affiliated Xiamen University, Xiamen 361001, China. Email:
Ocular Surface and Corneal Disease Department, the Affiliated Xiamen University, Xiamen 361001, China.
Zhonghua Yan Ke Za Zhi. 2014 Sep;50(9):681-6.
To evaluate the clinical results of keratoconic eyes with thin corneas that were treated by using corneal collagen cross-linking with hypo-osmolar riboflavin solution.
Retrospective, nonrandomized study. Fifteen eyes of 15 patients with progressive keratoconus and corneal thickness of less than 400 µm (without the epithelium) were included in this study. Application of hypo-osmolar riboflavin solution to the cornea for 30 minutes after its de-epithelialization was followed by ultraviolet A collagen cross-linking. Corneal thickness was measured with anterior segment OCT before surgery, after epithelial removal, and after hypotonic riboflavin solution application. Before the ultraviolet A application was started, we must be sure that the thinnest cornea was equal to or greater than 400 µm. Examinations comprised an evaluation of uncorrected distance visual acuity and best corrected visual acuity, slit-lamp microscopy, corneal topography, and endothelial cell counting after the procedure.
Before surgery, the mean corneal thickness (with the epithelium) was (399.27 ± 17.87) µm, and after the removal of epithelium, the thickness of the cornea was reduced to (354.00 ± 18.57) µm. After the application of the hypo-osmolar riboflavin solution, this value increased to (477.73 ± 20.87) µm. The improvements in visual acuity and keratometry readings occurred during the follow-up. No statistically signiflcant differences were found between preoperative and postoperative endothelial cell counts. No complications such as scarring lesions in the stroma and corneal endothelial damage were observed throughout the study period.
The results of our study, using hypo-osmolar riboflavin solution in a cross-linking procedure in thin corneas, show a stability of keratoconus 12 months after cross-linking.
评估使用低渗核黄素溶液进行角膜交联治疗薄角膜圆锥角膜眼的临床效果。
回顾性、非随机研究。本研究纳入了15例进行性圆锥角膜且角膜厚度小于400μm（无上皮）患者的15只眼。角膜上皮去除后，将低渗核黄素溶液应用于角膜30分钟，随后进行紫外线A胶原交联。术前、上皮去除后及低渗核黄素溶液应用后，使用眼前节光学相干断层扫描测量角膜厚度。在开始紫外线A照射前，我们必须确保最薄角膜等于或大于400μm。检查包括术后未矫正远视力和最佳矫正视力评估、裂隙灯显微镜检查、角膜地形图检查及内皮细胞计数。
术前，平均角膜厚度（有上皮）为（399.27±17.87）μm，上皮去除后，角膜厚度降至（354.00±18.57）μm。应用低渗核黄素溶液后，该值增至（477.73±20.87）μm。随访期间视力和角膜曲率读数有所改善。术前和术后内皮细胞计数无统计学显著差异。在整个研究期间，未观察到基质瘢痕病变和角膜内皮损伤等并发症。
我们使用低渗核黄素溶液对薄角膜进行交联手术的研究结果显示，交联后12个月圆锥角膜病情稳定。
