Li Jingjing, Ji Peng, Lin Xiaoti
Department of Ophthalmology, Xiangyang Central Hospital, Teaching Hospital of Medical College of Hubei University of arts and science, Xiangyang, Hubei Province, China.
Department of Operating Theatre, Xiangyang Hospital of Traditional Chinese Medicine, Teaching Hospital of Hubei University of Chinese Medicine, Xiangyang, Hubei Province, China.
PLoS One. 2015 May 18;10(5):e0127079. doi: 10.1371/journal.pone.0127079. eCollection 2015.
To evaluate the efficacy of corneal collagen cross-linking (CXL) for the treatment of keratoconus.
We performed a literature search for randomized controlled trials that assessed the effect of CXL in slowing progression of keratoconus. The primary outcome measures included changes of topographic parameters, visual acuity, and refraction. Efficacy estimates were evaluated by weighted mean difference (WMD) and 95% confidence interval (CI) for absolute changes of the interested outcomes.
Significant decrease in mean keratometry value, maximum keratometry value and minimum keratometry value were demonstrated in the CXL group compared with the control group (WMD = -1.65; 95% CI: -2.51 to -0.80; P < 0.00001; WMD = -2.05; 95% CI: -3.10 to -1.00; P < 0.00001; WMD = -1.94; 95% CI: -2.63 to -1.26; P < 0.00001; respectively). Best spectacle-corrected visual acuity improved significantly in CXL group (WMD = -0.10; 95% CI: -0.15 to -0.05; P < 0.00001), whereas uncorrected visual acuity did not differ statistically. Manifest cylinder error decreased significantly in patients undergoing CXL procedure compared with control patients in sensitivity analysis (WMD = -0.388; 95% CI: -0.757 to -0. 019; P = 0.04). The changes in central corneal thickness and intraocular pressure were not statistically significant.
CXL may be an effective option in stabilizing keratoconus. Further long-term follow-up studies will be necessary to assess the persistence of CXL.
评估角膜胶原交联术（CXL）治疗圆锥角膜的疗效。
我们进行了一项文献检索，查找评估CXL延缓圆锥角膜进展效果的随机对照试验。主要结局指标包括地形学参数、视力和屈光的变化。通过加权均数差（WMD）和95%置信区间（CI）对感兴趣结局的绝对变化进行疗效估计。
与对照组相比，CXL组的平均角膜曲率值、最大角膜曲率值和最小角膜曲率值均显著降低（WMD = -1.65；95%CI：-2.51至-0.80；P < 0.00001；WMD = -2.05；95%CI：-3.10至-1.00；P < 0.00001；WMD = -1.94；95%CI：-2.63至-1.26；P < 0.00001）。CXL组最佳矫正视力显著提高（WMD = -0.10；95%CI：-0.15至-0.05；P < 0.00001），而裸眼视力无统计学差异。在敏感性分析中，与对照患者相比，接受CXL手术的患者显性柱镜误差显著降低（WMD = -0.388；95%CI：-0.757至-0.019；P = 0.04）。中央角膜厚度和眼压的变化无统计学意义。
CXL可能是稳定圆锥角膜的有效选择。需要进一步的长期随访研究来评估CXL的持久性。
