Sadoughi Mohammad Mehdi, Einollahi Bahram, Baradaran-Rafii Alireza, Roshandel Danial, Hasani Hamidreza, Nazeri Mehrdad
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int Ophthalmol. 2018 Feb;38(1):67-74. doi: 10.1007/s10792-016-0423-0. Epub 2016 Dec 29.
To compare the outcomes of the conventional and accelerated corneal collagen cross-linking (CXL) in patients with bilateral progressive keratoconus (KC).
Fifteen consecutive patients with bilateral progressive KC were enrolled. In each patient, the fellow eyes were randomly assigned to the conventional CXL (3 mW/cm for 30 min) or accelerated CXL (ACXL) (9 mW/cm for 10 min) groups. Manifest refraction; uncorrected and corrected distant visual acuity; maximum and mean keratometry; corneal hysteresis and corneal resistance factor; endothelial cell density and morphology; central corneal thickness; and wavefront aberrations were measured before and 12 months after the CXL.
Manifest refraction spherical equivalent and refractive cylinder improved significantly only in conventional group. Uncorrected and corrected distant visual acuity did not change significantly in either group. Also there was no significant change in the maximum and mean keratometry after 12 months. There was significant decrease in central corneal thickness in both groups which was more prominent in conventional group. Endothelial cell density reduced only in the conventional group which was not statistically significant (P = 0.147). CH, CRF, and wavefront aberrations did not change significantly in either group. We did not observe any significant difference in the changes of the variables between the two groups.
Accelerated CXL with 9 mW/cm irradiation for 10 min had similar refractive, visual, keratometric, and aberrometric results and less adverse effects on the corneal thickness and endothelial cells as compared with the conventional method after 12 months follow-up. However, randomized clinical trials with longer follow-ups and larger sample sizes are needed.
比较传统角膜胶原交联术（CXL）与加速角膜胶原交联术对双侧进行性圆锥角膜（KC）患者的治疗效果。
纳入15例双侧进行性KC患者。每位患者的双眼被随机分配至传统CXL组（3 mW/cm，持续30分钟）或加速CXL组（ACXL）（9 mW/cm，持续10分钟）。在CXL术前及术后12个月测量明显验光结果、未矫正和矫正远视力、最大和平均角膜曲率、角膜滞后和角膜阻力因子、内皮细胞密度和形态、中央角膜厚度以及波前像差。
仅传统组的明显验光球镜等效值和屈光柱镜值有显著改善。两组的未矫正和矫正远视力均无显著变化。12个月后最大和平均角膜曲率也无显著变化。两组中央角膜厚度均显著降低，传统组更明显。仅传统组的内皮细胞密度降低，但无统计学意义（P = 0.147）。两组的角膜滞后、角膜阻力因子和波前像差均无显著变化。我们未观察到两组间变量变化有任何显著差异。
随访12个月后，与传统方法相比，9 mW/cm照射10分钟的加速CXL在屈光、视力、角膜曲率和像差测量结果方面相似，且对角膜厚度和内皮细胞的不良影响较小。然而，需要进行更长随访期和更大样本量的随机临床试验。
