Knezović Igor, Višnjić Mirna Belovari, Raguž Hrvoje
Acta Clin Croat. 2015 Jun;54(2):193-200.
The aim was to assess the results achieved in keratoconic corneas submitted to the combined partial topography-guided photorefractive keratectomy (TG-PRK) and corneal cross linking (CXL) procedure performed on the same day. Four patients underwent this treatment of one eye. Corneal epithelium removal was performed by 50-micron phototherapeutic keratectomy. Then, partial TG-PRK laser treatment was applied (Wavelight Allegretto, Eye Q, 400Hz), followed by corneal collagen cross-linking (CXL, 3 mW/cm2) for 30 minutes using 0.1% topical riboflavin solution. Outcome measurements included uncorrected distance visual acuity (UCDVA), best spectacle corrected distance visual acuity (BSCDVA), manifest refraction spherical equivalent, keratometry, corneal high order aberration values, and corneal tomography. At the end of 10-month follow up, all eyes showed improvement in BSCDVA of 1-5 lines on Snellen chart. All other investigated parameters showed significant improvement as well. One eye showed some topographic improvement, but no improvement in UCDVA. No corneal haze, prolonged epithelial healing or endothelial cell loss occurred. During 10-month follow up, the same-day combined TG-PRK and CXL appeared to offer tomographic improvement and better visual acuity in keratoconus patients.
目的是评估同一天接受联合的部分地形图引导准分子原位角膜磨镶术（TG-PRK）和角膜交联（CXL）手术的圆锥角膜所取得的结果。4例患者一眼接受了该治疗。通过50微米的光治疗性角膜切削术去除角膜上皮。然后，应用部分TG-PRK激光治疗（Wavelight Allegretto，Eye Q，400Hz），接着使用0.1%的局部核黄素溶液进行30分钟的角膜胶原交联（CXL，3 mW/cm2）。结果测量包括未矫正远视力（UCDVA）、最佳矫正远视力（BSCDVA）、显验光球镜等效度、角膜曲率测量、角膜高阶像差值和角膜地形图。在10个月的随访结束时，所有术眼的BSCDVA在斯内伦视力表上提高了1-5行。所有其他研究参数也显示出显著改善。一只眼显示出一些地形图改善，但UCDVA没有改善。未发生角膜混浊、上皮愈合延迟或内皮细胞丢失。在10个月的随访期间，同一天联合TG-PRK和CXL似乎能改善圆锥角膜患者的地形图并提高视力。
