Cagil Nurullah, Sarac Ozge, Cakmak Hasan Basri, Can Gamze, Can Erol
From the Department of Ophthalmology, Yildirim Beyazit University, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
From the Department of Ophthalmology, Yildirim Beyazit University, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
J Cataract Refract Surg. 2015 Aug;41(8):1730-7. doi: 10.1016/j.jcrs.2014.12.058.
To compare the complications occurring within the first 3 months of corneal collagen crosslinking (CXL) performed with mechanical or transepithelial phototherapeutic keratectomy (PTK) epithelial removal in keratoconus patients.
Yildirim Beyazit University Ataturk Training and Research Hospital, Ankara, Turkey.
Nonrandomized retrospective clinical study.
Eyes of consecutive progressive keratoconus patients who had PTK or mechanical epithelial removal followed by CXL were included. All patients were examined regularly until epithelial healing. Detailed ophthalmologic examinations were performed preoperatively and 1 and 3 months postoperatively.
The study comprised 499 eyes (302 patients) that had transepithelial PTK (Group 1, 153 eyes) or mechanical epithelial removal (Group 2, 256 eyes) followed by CXL. Delayed epithelial healing occurred in 15.0% of eyes in Group 1 and 3.5% of eyes in Group 2 (P = .001). Epithelial hypertrophy occurred in 24.8% of eyes and 3.5% of eyes, respectively (P = .001). Salzmann-like epithelial nodules (2.6%), epithelial herpetic keratitis (1.9%), anterior uveitis (1.9%), and elevated intraocular pressure (1.9%) occurred in Group 1 only and infective keratitis (0.8%) in Group 2 only. Marked stromal edema and peripheral sterile infiltrates occurred at similar rates in both groups (P = .567 and P = .479, respectively). Grade 1+ corneal haze was significantly high in Group 2. Grade 2+ and 3+ haze was significantly high in Group 1 (P = .001).
Ocular surface healing disorders were the most common early complications of CXL. Short-term complications were higher with the transepithelial PTK epithelial removal technique than with mechanical epithelial removal.
No author has a financial or proprietary interest in any material or method mentioned.
比较圆锥角膜患者采用机械法或经上皮光治疗性角膜切削术（PTK）去除上皮后行角膜胶原交联术（CXL）在术后3个月内出现的并发症。
土耳其安卡拉的耶迪特佩大学阿塔图尔克培训与研究医院。
非随机回顾性临床研究。
纳入连续的圆锥角膜进展期患者，这些患者接受了PTK或机械法去除上皮后再行CXL。所有患者定期检查直至上皮愈合。术前及术后1个月和3个月进行详细的眼科检查。
该研究包括499只眼（302例患者），这些眼先接受经上皮PTK（第1组，153只眼）或机械法去除上皮（第2组，256只眼），然后行CXL。第1组15.0%的眼和第2组3.5%的眼出现上皮愈合延迟（P = 0.001）。上皮肥厚分别出现在24.8%的眼和3.5%的眼中（P = 0.001）。仅第1组出现了类萨尔茨曼上皮结节（2.6%）、上皮性疱疹性角膜炎（1.9%）、前葡萄膜炎（1.9%）和眼压升高（1.9%），仅第2组出现了感染性角膜炎（0.8%）。两组中明显的基质水肿和周边无菌性浸润发生率相似（分别为P = 0.567和P = 0.479）。第2组中1+级角膜 haze 显著更高。第1组中2+级和3+级 haze 显著更高（P = 0.001）。
眼表愈合障碍是CXL最常见的早期并发症。经上皮PTK去除上皮技术导致的短期并发症高于机械法去除上皮。
没有作者对文中提及的任何材料或方法拥有财务或专利权益。
