薄圆锥角膜的加速角膜胶原交联

Accelerated Corneal Collagen Cross-Linking in Thin Keratoconic Corneas.

作者信息

Ozgurhan Engin Bilge, Akcay Betul Ilkay Sezgin, Kurt Tugba, Yildirim Yusuf, Demirok Ahmet

出版信息

J Refract Surg. 2015 Jun;31(6):386-90. doi: 10.3928/1081597X-20150521-11.

DOI:10.3928/1081597X-20150521-11

PMID:26046705

Abstract

PURPOSE

To report the outcomes of accelerated corneal collagen cross-linking in patients with thin corneas (minimum corneal thickness < 400 µm).

METHODS

Thirty-four eyes of 34 patients with a minimum corneal thickness less than 400 µm were included. All patients underwent accelerated corneal collagen cross-linking (irradiance power of 30 mW/cm² at 3 minutes with a total surface dose of 5.4 J/cm²). Uncorrected (UDVA) and corrected distance visual acuity (CDVA), manifest refraction (diopters [D]), and topography were evaluated at baseline and at the 1-, 6-, and 12-month follow-up visit. Endothelial cell density (cells/mm²) was calculated preoperatively and postoperatively at 12 months. The corneal stromal demarcation line was measured using anterior segment optical coherence tomography at 1 month postoperatively.

RESULTS

The mean age of all patients (14 women and 20 men) was 23.08 ± 3.90 years (range: 16 to 29 years). UDVA and CDVA increased but not significantly. UDVA improved from 0.67 ± 0.32 (20/93 ± 20/41 Snellen) to 0.56 ± 0.28 logMAR (20/72 ± 20/38 Snellen) (P = .033) and CDVA improved from 0.49 ± 0.19 (20/61 ± 20/30 Snellen) to 0.42 ± 0.19 logMAR (20/52 ± 20/30 Snellen) (P = .009) at the last follow-up visit. The mean spherical and cylindrical refractions did not significantly change (P = .100 and 0.139, respectively). At the last follow-up visit, the flat keratometry decreased from 47.40 ± 2.52 to 46.95 ± 2.48 D, steep keratometry decreased from 51.04 ± 3.71 to 50.62 ± 3.57 D, and apex keratometry decreased from 57.58 ± 4.49 to 56.26 ± 4.47 D (P = .001, = .0019, = .001, respectively) from baseline. The mean endothelial cell density changed from 2,726.02 ± 230.21 to 2,714.58 ± 218.26 cells/mm² at 12 months postoperatively (P =.086).

CONCLUSION

The results of this study revealed that accelerated corneal collagen cross-linking stabilized the progression of keratoconus without a significant endothelial cell density loss during the 12 months of follow-up.

摘要

目的

报告薄角膜（最小角膜厚度<400µm）患者行加速角膜胶原交联术的结果。

方法

纳入34例最小角膜厚度小于400µm患者的34只眼。所有患者均接受加速角膜胶原交联术（3分钟时辐照功率为30mW/cm²，总表面剂量为5.4J/cm²）。在基线以及1个月、6个月和12个月随访时评估未矫正远视力（UDVA）、矫正远视力（CDVA）、显验光（屈光度[D]）和角膜地形图。术前及术后12个月计算内皮细胞密度（细胞/mm²）。术后1个月使用眼前节光学相干断层扫描测量角膜基质分界线。

结果

所有患者（14名女性和20名男性）的平均年龄为23.08±3.90岁（范围：16至29岁）。UDVA和CDVA有所提高，但无显著差异。末次随访时，UDVA从0.67±0.32（20/93±20/41斯内伦）提高至0.56±0.28 logMAR（20/72±20/38斯内伦）（P = 0.033），CDVA从0.49±0.19（20/61±20/30斯内伦）提高至0.42±0.19 logMAR（20/52±20/30斯内伦）（P = 0.009）。平均球镜和柱镜屈光度无显著变化（分别为P = 0.100和0.139）。末次随访时，平坦角膜曲率从47.40±2.52 D降至46.95±2.48 D，陡峭角膜曲率从51.04±3.71 D降至50.62±3.57 D，顶点角膜曲率从57.58±4.49 D降至56.26±4.47 D（分别为P = 0.001、P = 0.0019、P = 0.001）。术后12个月平均内皮细胞密度从2726.02±230.21变为2714.58±218.26细胞/mm²（P = 0.086）。