Raiskup F, Veliká V, Veselá M, Spörl E
Klinik für Augenheilkunde, Universitätsklinikum Carl Gustav Carus, Dresden.
Klinik für Augenheilkunde, Universitätsklinikum, Hradec Králové, Tschechische Republik.
Klin Monbl Augenheilkd. 2015 Dec;232(12):1392-6. doi: 10.1055/s-0035-1546155. Epub 2015 Dec 17.
Corneal cross-linking can halt the progression of keratoconus, but what is the best approach for treatment? There are a number of treatment options for keratoconus, but only corneal cross-linking (CXL) appears to halt the progression of the disease. To guarantee effective cross-linking, CXL treatment involves removal of the corneal epithelium prior to riboflavin application and ultraviolet light illumination - "epi-off" CXL. Several methods of "epi-on" (transepithelial) CXL have been proposed, such as keeping the corneal epithelium intact which should be less painful and help avoid other CXL-associated adverse events. The evidence so far is that epi-off CXL remains the most effective method of strengthening the cornea and slowing keratoconus progression - but transepithelial methods are gaining ground.
角膜交联术可以阻止圆锥角膜的进展，但最佳治疗方法是什么呢？圆锥角膜有多种治疗选择，但只有角膜交联术（CXL）似乎能阻止该病的进展。为确保有效的交联，CXL治疗在应用核黄素和紫外线照射之前需要去除角膜上皮——“去上皮”CXL。已经提出了几种“上皮在位”（经上皮）CXL方法，比如保持角膜上皮完整，这样应该会减轻疼痛，并有助于避免其他与CXL相关的不良事件。目前的证据表明，去上皮CXL仍然是强化角膜和减缓圆锥角膜进展的最有效方法——但经上皮方法正在逐渐流行。
