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圆锥角膜治疗算法

Keratoconus Treatment Algorithm.

作者信息

Andreanos Konstantinos D, Hashemi Kate, Petrelli Myrsini, Droutsas Konstantinos, Georgalas Ilias, Kymionis George D

机构信息

1st Department of Ophthalmology, 'G. Gennimatas Hospital', National and Kapodistrian University of Athens, Athens, Greece.

Faculty of Biology and Medicine, Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland.

出版信息

Ophthalmol Ther. 2017 Dec;6(2):245-262. doi: 10.1007/s40123-017-0099-1. Epub 2017 Jul 28.

DOI:10.1007/s40123-017-0099-1
PMID:28755306
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5693837/
Abstract

Keratoconus management has significantly changed over the last two decades. The advent of new interventions such as cornea cross-linking, intrastromal corneal ring segments, and combined treatments provide corneal clinicians a variety of treatment options for the visual rehabilitation of keratoconus patients. This review summarizes current evidence for these treatments and highlights their place in keratoconus management while new promising emerging therapies are being investigated.

摘要

在过去二十年中,圆锥角膜的治疗方法发生了显著变化。诸如角膜交联、角膜基质内环植入术等新干预措施以及联合治疗的出现,为角膜病临床医生提供了多种治疗选择,用于圆锥角膜患者的视力康复。本综述总结了这些治疗方法的现有证据,并强调了它们在圆锥角膜治疗中的地位,同时也在探索新的有前景的新兴疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eb1/5693837/41ecd6a3e33d/40123_2017_99_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eb1/5693837/41ecd6a3e33d/40123_2017_99_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eb1/5693837/41ecd6a3e33d/40123_2017_99_Fig1_HTML.jpg

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Keratoconus Treatment Algorithm.圆锥角膜治疗算法
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2
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Cross-linking in progressive keratoconus using an epithelial debridement or intrastromal pocket technique after previous corneal ring segment implantation.经角膜环段植入术后,采用上皮清创或基质内囊技术治疗进行性圆锥角膜的交联。
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[Cross-Linking in Keratoconus: "Epi-off" or "Epi-on"?].[圆锥角膜中的交联:“上皮下”还是“上皮在位”?]
Klin Monbl Augenheilkd. 2015 Dec;232(12):1392-6. doi: 10.1055/s-0035-1546155. Epub 2015 Dec 17.
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Int Ophthalmol. 2018 Jun;38(3):1285-1293. doi: 10.1007/s10792-017-0593-4. Epub 2017 Jun 15.

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Keratoconus: Diagnosis and Management by Family Physicians.圆锥角膜:家庭医生的诊断与管理
Cureus. 2025 Jun 24;17(6):e86668. doi: 10.7759/cureus.86668. eCollection 2025 Jun.
2
Individual Risk Assessment and Prognostication of Outcomes After Corneal Cross-Linking.角膜交联术后个体风险评估及预后预测
J Ophthalmol. 2025 Jul 1;2025:3678453. doi: 10.1155/joph/3678453. eCollection 2025.
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Intrastromal graft of anterior lens capsule. A substitute for Bowman layer graft transplantation for keratoconus.前晶状体囊内基质移植物。圆锥角膜 Bowman 层移植物移植的替代品。

本文引用的文献

1
Scleral topography analysed by optical coherence tomography.通过光学相干断层扫描分析巩膜地形图。
Cont Lens Anterior Eye. 2017 Aug;40(4):242-247. doi: 10.1016/j.clae.2017.04.006. Epub 2017 May 8.
2
Comparison of 2 Different Methods of Transepithelial Corneal Collagen Cross-Linking: Analysis of Corneal Histology and Hysteresis.两种不同的经上皮角膜胶原交联方法的比较:角膜组织学与滞后现象分析
Cornea. 2017 Jul;36(7):860-865. doi: 10.1097/ICO.0000000000001229.
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Comparison of Accelerated Corneal Collagen Cross-linking Types for Treating Keratoconus.
PLoS One. 2024 Nov 19;19(11):e0306015. doi: 10.1371/journal.pone.0306015. eCollection 2024.
4
Impact of Scleral Lenses on Visual Acuity and Ocular Aberrations in Corneal Ectasia: A Comprehensive Review.巩膜镜对圆锥角膜视力和眼像差的影响:一项综述
J Pers Med. 2024 Oct 11;14(10):1051. doi: 10.3390/jpm14101051.
5
Harnessing Corneal Stromal Regeneration for Vision Restoration: A Comprehensive Review of the Emerging Treatment Techniques for Keratoconus.利用角膜基质再生恢复视力:圆锥角膜新兴治疗技术的综合综述
Cureus. 2024 Sep 21;16(9):e69835. doi: 10.7759/cureus.69835. eCollection 2024 Sep.
6
Efficacy of customized corneal crosslinking versus standard corneal crosslinking in patients with progressive keratoconus (C-CROSS study): study protocol for a randomized controlled trial.渐进性圆锥角膜患者行定制化角膜交联术与标准角膜交联术的疗效比较(C-CROSS 研究):一项随机对照试验的研究方案。
BMC Ophthalmol. 2023 May 19;23(1):224. doi: 10.1186/s12886-023-02976-4.
7
Determination of efficacy of repeated CXL and probable risk factors in patients with progressive keratoconus.评估重复交联术治疗进展性圆锥角膜的疗效及可能的危险因素。
Int Ophthalmol. 2023 Sep;43(9):3157-3164. doi: 10.1007/s10792-023-02715-0. Epub 2023 May 17.
8
Detecting True Change in Keratoconus after Intracorneal Ring Segment Implantation.检测角膜内环植入术后圆锥角膜的真实变化
Life (Basel). 2023 Apr 10;13(4):978. doi: 10.3390/life13040978.
9
Measuring the agreement of keratometry readings of four devices in eyes with keratoconus.测量四个设备在圆锥角膜眼中的角膜曲率读数的一致性。
Int Ophthalmol. 2023 Aug;43(8):2897-2915. doi: 10.1007/s10792-023-02693-3. Epub 2023 Apr 15.
10
Awareness About Keratoconus and Its Relation With Eye Rubbing: A Cross-Sectional Study in Medina.关于圆锥角膜及其与揉眼关系的认识:麦地那的一项横断面研究。
Cureus. 2022 Nov 29;14(11):e32030. doi: 10.7759/cureus.32030. eCollection 2022 Nov.
用于治疗圆锥角膜的加速角膜胶原交联类型的比较
Curr Eye Res. 2017 Jul;42(7):971-975. doi: 10.1080/02713683.2017.1284241. Epub 2017 Mar 30.
4
Comparison of femtosecond laser-assisted descemetic and predescemetic lamellar keratoplasty for keratoconus.飞秒激光辅助深板层角膜移植术与前板层角膜移植术治疗圆锥角膜的比较。
Indian J Ophthalmol. 2017 Jan;65(1):19-23. doi: 10.4103/ijo.IJO_688_16.
5
Cornea Collagen Cross-linking for Keratoconus: A Comparison between Accelerated and Conventional Methods.圆锥角膜的角膜胶原交联:加速法与传统方法的比较
Adv Biomed Res. 2017 Feb 22;6:10. doi: 10.4103/2277-9175.200785. eCollection 2017.
6
Randomized Controlled Trial Comparing Transepithelial Corneal Cross-linking Using Iontophoresis with the Dresden Protocol in Progressive Keratoconus.离子导入诱导交联与 Dresden 方案治疗进展性圆锥角膜的随机对照临床试验
Ophthalmology. 2017 Jun;124(6):804-812. doi: 10.1016/j.ophtha.2017.01.040. Epub 2017 Mar 7.
7
Comparison of the Conventional Dresden Protocol and Accelerated Protocol With Higher Ultraviolet Intensity in Corneal Collagen Cross-Linking for Keratoconus.圆锥角膜角膜胶原交联中传统德累斯顿方案与高紫外线强度加速方案的比较。
Cornea. 2017 May;36(5):523-529. doi: 10.1097/ICO.0000000000001165.
8
Refractive and visual outcomes after Keraring intrastromal corneal ring segment implantation for keratoconus assisted by femtosecond laser at 6 months follow-up.飞秒激光辅助下Keraring基质内角膜环植入术治疗圆锥角膜6个月随访时的屈光和视觉效果
Clin Ophthalmol. 2016 Dec 23;11:81-86. doi: 10.2147/OPTH.S120267. eCollection 2017.
9
Conventional and Iontophoresis Corneal Cross-Linking for Keratoconus: Efficacy and Assessment by Optical Coherence Tomography and Confocal Microscopy.圆锥角膜的传统及离子导入角膜交联术:光学相干断层扫描和共聚焦显微镜的疗效及评估
Cornea. 2017 Feb;36(2):153-162. doi: 10.1097/ICO.0000000000001062.
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Age-specific Incidence and Prevalence of Keratoconus: A Nationwide Registration Study.圆锥角膜的年龄特异性发病率和患病率:一项全国性登记研究。
Am J Ophthalmol. 2017 Mar;175:169-172. doi: 10.1016/j.ajo.2016.12.015. Epub 2016 Dec 28.