Kobashi Hidenaga, Rong Shi Song
Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Biomed Res Int. 2017;2017:8145651. doi: 10.1155/2017/8145651. Epub 2017 Jun 11.
To evaluate the efficacy of collagen cross-linking (CXL) one year after treatment for keratoconus compared to no treatment by summarizing randomized controlled trials (RCTs) using a systematic review.
Trials meeting the selection criteria were quality appraised, and the data were extracted by two independent authors. The outcome parameters included maximum keratometry (), corneal thickness at the thinnest point, best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), spherical equivalent (SE) refraction, and cylindrical refraction one year after CXL. We compared the changes in the above parameters with the control group.
We identified five RCTs involving 289 eyes that met the eligibility criteria for this systematic review. The changes in BSCVA from baseline to one year exhibited a significant difference between the two groups. There was no statistically significant difference between the two groups for changes in corneal thickness and cylindrical refraction. We did not conduct a meta-analysis in , UCVA, and SE refraction because their values were greater than 50%.
According to the systematic review, CXL may be effective in halting the progression of keratoconus for one year under certain conditions, although evidence is limited due to the significant heterogeneity and paucity of RCTs.
通过系统评价总结随机对照试验（RCT），比较圆锥角膜治疗一年后胶原交联（CXL）与未治疗的疗效。
对符合选择标准的试验进行质量评估，数据由两名独立作者提取。结果参数包括最大角膜曲率（）、最薄点处的角膜厚度、最佳眼镜矫正视力（BSCVA）、未矫正视力（UCVA）、等效球镜度（SE）屈光度和CXL术后一年的柱镜屈光度。我们将上述参数的变化与对照组进行了比较。
我们确定了五项RCT，涉及289只眼睛，符合本系统评价的纳入标准。两组之间从基线到一年的BSCVA变化存在显著差异。两组在角膜厚度和柱镜屈光度变化方面无统计学显著差异。我们未对UCVA和SE屈光度进行荟萃分析，因为它们的I²值大于50%。
根据系统评价，尽管由于显著的异质性和RCT的缺乏，证据有限，但在某些条件下，CXL可能有效地阻止圆锥角膜进展一年。
