Randleman J Bradley, Khandelwal Sumitra S, Hafezi Farhad
Department of Ophthalmology, Emory University, Atlanta, Georgia, USA; Emory Vision, Emory Eye Center, Atlanta, Georgia, USA.
Baylor College of Medicine, Cullen Eye Institute, Houston, Texas, USA.
Surv Ophthalmol. 2015 Nov-Dec;60(6):509-23. doi: 10.1016/j.survophthal.2015.04.002. Epub 2015 May 14.
Since its inception in the late 1990s, corneal cross-linking has grown from an interesting concept to a primary treatment for corneal ectatic disease worldwide. Using a combination of ultraviolet-A light and a chromophore (vitamin B2, riboflavin), the cornea can be stiffened, usually with a single application, and progressive thinning diseases such as keratoconus arrested. Despite being in clinical use for many years, some of the underlying processes, such as the role of oxygen and the optimal treatment times, are still being worked out. More than a treatment technique, corneal cross-links represent a physiological principle of connective tissue, which may explain the enormous versatility of the method. We highlight the history of corneal cross-linking, the scientific underpinnings of current techniques, evolving clinical treatment parameters, and the use of cross-linking in combination with refractive surgery and for the treatment of infectious keratitis.
自20世纪90年代末问世以来，角膜交联术已从一个有趣的概念发展成为全球范围内角膜扩张性疾病的主要治疗方法。通过结合紫外线A光和一种发色团（维生素B2，核黄素），通常单次应用就能使角膜变硬，并阻止诸如圆锥角膜等进行性变薄疾病的发展。尽管已临床应用多年，但一些潜在过程，如氧气的作用和最佳治疗时间，仍在研究之中。角膜交联术不仅仅是一种治疗技术，它代表了结缔组织的一种生理原理，这或许可以解释该方法的巨大通用性。我们重点介绍角膜交联术的历史、当前技术的科学基础、不断演变的临床治疗参数，以及交联术与屈光手术联合应用和用于治疗感染性角膜炎的情况。
