From Georgetown University Medical Center (Rubinfeld) and Washington Hospital Center (Rubinfeld), Washington, DC, Re: Vision (Rubinfeld, Kim, Choi), Rockville, Maryland, and Fairfax, Virginia, Department of Ophthalmology (R.H. Epstein, Majmudar, R.J. Epstein), Rush University Medical Center, and Chicago Cornea Consultants, Ltd. (Majmudar, R.J. Epstein), Chicago, Illinois, USA.
From Georgetown University Medical Center (Rubinfeld) and Washington Hospital Center (Rubinfeld), Washington, DC, Re: Vision (Rubinfeld, Kim, Choi), Rockville, Maryland, and Fairfax, Virginia, Department of Ophthalmology (R.H. Epstein, Majmudar, R.J. Epstein), Rush University Medical Center, and Chicago Cornea Consultants, Ltd. (Majmudar, R.J. Epstein), Chicago, Illinois, USA.
J Cataract Refract Surg. 2017 Jan;43(1):131-135. doi: 10.1016/j.jcrs.2016.11.038.
A 41-year-old man presented 10 years after uneventful laser in situ keratomileusis (LASIK) with symptomatic post-LASIK ectasia. He had treatment with the classic Dresden epithelium-off technique and presented 4 years later with progression of the ectasia. He was subsequently retreated with conductive keratoplasty (CK) followed by a new proprietary epithelium-on corneal collagen crosslinking (CXL) procedure using a proprietary transepithelial riboflavin formulation and delivery system on the following day. One year after retreatment, the patient noted stable vision in the treated eye with a corrected distance visual acuity (CDVA) of 20/60. Thus, epithelium-on CXL, if performed with appropriate formulations and delivery technology as well as careful attention to appropriate riboflavin loading of the stroma, can stabilize an ectatic cornea. In addition, when performed prior to CXL, CK can induce a significant, lasting improvement in corneal shape and CDVA. This technique merits further study.
一位 41 岁男性在 LASIK 手术后 10 年出现 LASIK 后扩张性角膜病变，当时 LASIK 手术过程顺利。他接受了经典的德累斯顿上皮下切削技术治疗，4 年后出现了扩张性病变进展。随后他接受了传导性角膜成形术（CK）治疗，接着在第二天使用一种专有的经上皮 Riboflavin 制剂和输送系统进行了新的专有上皮下角膜胶原交联（CXL）治疗。在再次治疗 1 年后，患者在治疗眼的视力稳定，矫正远视力（CDVA）为 20/60。因此，如果使用适当的制剂和输送技术以及仔细注意基质中适当的 Riboflavin 加载，上皮下 CXL 可以稳定扩张性角膜。此外，在 CXL 之前进行 CK 可以显著改善角膜形态和 CDVA，且效果持久。这种技术值得进一步研究。
