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儿童圆锥角膜的加速角膜胶原交联:一年研究

Accelerated corneal collagen cross-linking in pediatric keratoconus: One year study.

作者信息

Badawi Amani E

机构信息

Department of Ophthalmology, Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Egypt.

出版信息

Saudi J Ophthalmol. 2017 Jan-Mar;31(1):11-18. doi: 10.1016/j.sjopt.2017.01.002. Epub 2017 Jan 25.

Abstract

PURPOSE

To evaluate the safety and effectiveness of accelerated corneal collagen crosslinking (CXL) in pediatric keratoconus.

DESIGN

Prospective non-randomized observational study.

METHODS

33 eyes of 25 children with keratoconus were included. The corneal epithelium was mechanically removed. Next, riboflavin/hydroxypropyl methylcellulose solution) was applied for 10 min. Accelerated CXL (10 mW/cm for 9 min), was accomplished. Visual acuity, slit lamp examination, refraction, keratometry readings, pachymetry, anterior and posterior elevations, average progression indices, and Q values were recorded. The follow-up visits were scheduled on one day, 3 days, 7 days, one month and then on 3, 6, 12 months after the procedure.

RESULTS

It was statistically significant improvement of the mean UAVA, AVA, and the mean corneal astigmatism ( < .0001). The mean corneal thickness showed a significant reduction. The preoperative mean max reading was reduced from 49.12 ± 3.7 D preoperatively to 47.9 ± 3.7 D at 12 months. The mean max anterior elevation, average progression index and Q value showed statistically significant improvement. No significant impact on posterior elevation was recorded. Serious complications were not encountered in this study.

CONCLUSION

Accelerated CXL shows a stabilization and beneficial clinical outcomes in pediatric keratoconus. It seems an effective and safe procedure in this age group. Effects of accelerated CXL on the posterior corneal surface will need further evaluation.

摘要

目的

评估加速角膜胶原交联(CXL)治疗儿童圆锥角膜的安全性和有效性。

设计

前瞻性非随机观察性研究。

方法

纳入25例圆锥角膜患儿的33只眼。机械去除角膜上皮。接下来,应用核黄素/羟丙基甲基纤维素溶液10分钟。完成加速CXL(10毫瓦/平方厘米,持续9分钟)。记录视力、裂隙灯检查、验光、角膜曲率读数、角膜厚度测量、前后表面高度、平均进展指数和Q值。术后1天、3天、7天、1个月,然后在3、6、12个月安排随访。

结果

平均未矫正视力、矫正视力和平均角膜散光有统计学意义的改善(P<0.0001)。平均角膜厚度有显著降低。术前平均最大读数从术前的49.12±3.7D降至12个月时的47.9±3.7D。平均最大前表面高度、平均进展指数和Q值有统计学意义的改善。未记录到对后表面高度有显著影响。本研究未遇到严重并发症。

结论

加速CXL在儿童圆锥角膜中显示出稳定且有益的临床结果。在这个年龄组中,它似乎是一种有效且安全的手术。加速CXL对角膜后表面的影响需要进一步评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcb4/5352941/f5d9375b25d9/gr1ab.jpg

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