Lee Hun, Yong Kang David Sung, Ha Byoung Jin, Choi Jin Young, Kim Eung Kweon, Seo Kyoung Yul, Kim Tae-Im
*Department of Ophthalmology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea; †Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea; ‡Eyereum Eye Clinic, Seoul, South Korea; and §Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
Cornea. 2017 Oct;36(10):1213-1220. doi: 10.1097/ICO.0000000000001308.
To investigate the effects of combined transepithelial photorefractive keratectomy (tPRK) and accelerated corneal collagen cross-linking (CXL) on visual acuity and refractive outcomes.
The medical records of 89 eyes (89 patients) undergoing combined tPRK and CXL (tPRK-CXL group) or tPRK alone (tPRK group) were retrospectively analyzed. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity, and manifest refraction spherical equivalent (MRSE) were evaluated preoperatively and 2 weeks, 1, 3, 6, and 12 months after surgery.
At 2 weeks after surgery, the tPRK-CXL group had better UDVA than the tPRK group (0.97 ± 0.22 vs. 0.85 ± 0.22, P = 0.015). At 2 weeks and 1 month after surgery, the tPRK-CXL group had a significantly lower spherical error than the tPRK group (0.24 vs. 0.63 D, P = 0.017, for 2 weeks and 0.43 vs. 0.57 D, P = 0.019, for 1 month). At 12 months after surgery, the tPRK-CXL group had a lower spherical error and MRSE than the tPRK group (0.30 vs. 0.44 D, P < 0.001, for the spherical error and 0.17 vs. 0.31 D, P < 0.001, for the MRSE). Both groups had comparable predictability, efficacy, and safety indices at 12 months after surgery.
Combined tPRK and accelerated CXL demonstrated comparable predictability, efficacy, and safety compared with tPRK alone. Combined tPRK and CXL provides better UDVA in the early postoperative period and better refractive outcomes at 12 months postoperatively in terms of spherical error and MRSE.
研究经上皮准分子激光角膜切削术（tPRK）联合加速角膜胶原交联（CXL）对视力和屈光结果的影响。
回顾性分析89只眼（89例患者）接受tPRK联合CXL（tPRK-CXL组）或单纯tPRK（tPRK组）治疗的病历。术前以及术后2周、1个月、3个月、6个月和12个月评估未矫正远视力（UDVA）、矫正远视力和显验光球镜等效度（MRSE）。
术后2周，tPRK-CXL组的UDVA优于tPRK组（0.97±0.22对0.85±0.22，P = 0.015）。术后2周和1个月，tPRK-CXL组的球镜误差显著低于tPRK组（2周时为0.24对0.63 D，P = 0.017；1个月时为0.43对0.57 D，P = 0.019）。术后12个月，tPRK-CXL组的球镜误差和MRSE低于tPRK组（球镜误差为0.30对0.44 D，P < 0.001；MRSE为0.17对0.31 D，P < 0.001）。两组在术后12个月时的可预测性、有效性和安全性指标相当。
与单纯tPRK相比，tPRK联合加速CXL在可预测性、有效性和安全性方面相当。tPRK联合CXL在术后早期提供更好的UDVA，在术后12个月时在球镜误差和MRSE方面提供更好的屈光结果。
