Sandvik Gunhild Falleth, Thorsrud Andreas, Råen Marianne, Østern Atle E, Sæthre Marit, Drolsum Liv
*Department of Ophthalmology, Oslo University Hospital, Ullevaal, Oslo, Norway; and †Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Cornea. 2015 Sep;34(9):991-5. doi: 10.1097/ICO.0000000000000460.
To investigate whether the introduction of corneal collagen cross-linking (CXL) influences the frequency of keratoplasties in patients with keratoconus.
Data were obtained from a cohort of patients from our corneal transplant registry. Two different periods were compared, 2005 to 2006 (period 1) and 2013 to 2014 (period 2). Patients during period 1 had surgery before the introduction of CXL treatment, and patients in period 2 had surgery after this treatment was well established in our department. Age and gender were registered, and the Amsler-Krumeich classification system was applied to grade the degree of keratoconus.
The total number of keratoplasties performed during period 1 was 137, and keratoconus was the cause of surgery in 55 eyes (55 patients). The corresponding numbers in period 2 were 231 and 26 eyes (26 patients), respectively. The difference in the number of keratoplasties for keratoconus in both periods was statistically significant (P = 0.003). There were no significant differences in the distributions of age and gender between both periods. In period 1, 63.6% of the eyes were graded as stage 4 in the Amsler-Krumeich classification, compared with 96.2% in period 2 (P = 0.001).
The frequency of keratoplasty for keratoconus has been more than halved in our department over the last decade. There is reason to believe that this reduction is for a great part caused by the introduction of CXL treatment.
研究角膜胶原交联术（CXL）的引入是否会影响圆锥角膜患者角膜移植术的频率。
数据来自我们角膜移植登记处的一组患者。比较了两个不同时期，2005年至2006年（时期1）和2013年至2014年（时期2）。时期1的患者在CXL治疗引入之前接受手术，时期2的患者在该治疗在我们科室广泛应用之后接受手术。记录年龄和性别，并应用Amsler-Krumeich分类系统对圆锥角膜的程度进行分级。
时期1进行的角膜移植术总数为137例，圆锥角膜是55只眼（55例患者）的手术原因。时期2的相应数字分别为231例和26只眼（26例患者）。两个时期圆锥角膜角膜移植术数量的差异具有统计学意义（P = 0.003）。两个时期的年龄和性别分布没有显著差异。在时期1，63.6%的眼睛在Amsler-Krumeich分类中被评为4期，而在时期2为96.2%（P = 0.001）。
在过去十年中，我们科室圆锥角膜角膜移植术的频率减少了一半以上。有理由相信这种减少很大程度上是由于引入了CXL治疗。
