From the Department of Ophthalmology (Lee), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, the Institute of Vision Research (Lee, Kim), Department of Ophthalmology, Yonsei University College of Medicine, and Eyereum Eye Clinic (Kang), Seoul, South Korea; the Department of Ophthalmology & Visual Science and Department of Biomedical Engineering (Roberts), Ohio State University, Columbus, Ohio, USA; the Rio de Janeiro Corneal Tomography and Biomechanics Study Group (Ambrósio), Rio de Janeiro, Brazil; the School of Engineering (Elsheikh), University of Liverpool, Liverpool, United Kingdom.
From the Department of Ophthalmology (Lee), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, the Institute of Vision Research (Lee, Kim), Department of Ophthalmology, Yonsei University College of Medicine, and Eyereum Eye Clinic (Kang), Seoul, South Korea; the Department of Ophthalmology & Visual Science and Department of Biomedical Engineering (Roberts), Ohio State University, Columbus, Ohio, USA; the Rio de Janeiro Corneal Tomography and Biomechanics Study Group (Ambrósio), Rio de Janeiro, Brazil; the School of Engineering (Elsheikh), University of Liverpool, Liverpool, United Kingdom.
J Cataract Refract Surg. 2017 Jul;43(7):937-945. doi: 10.1016/j.jcrs.2017.04.036.
To evaluate the effect of accelerated corneal crosslinking (CXL) combined with transepithelial photorefractive keratectomy (PRK) on changes in new dynamic corneal response parameters and the biomechanically corrected intraocular pressure (IOP) measured using a dynamic Scheimpflug analyzer (Corvis ST).
Yonsei University College of Medicine and Eyereum Eye Clinic, Seoul, South Korea.
Retrospective case series.
Medical records of eyes of healthy myopic patients having transepithelial PRK or transepithelial PRK with CXL were examined. Main outcome variables were the biomechanically corrected IOP and new dynamic corneal response parameters including the deformation amplitude ratio at 1.0 mm (DAR1) and at 2.0 mm (DAR2), stiffness at first applanation and at highest concavity, and the integrated inverse radius preoperatively and 6 months postoperatively.
The study comprised 69 eyes (69 patients); 35 had transepithelial PRK and 34, transepithelial PRK with CXL. The DAR1, DAR2, and integrated inverse radius significantly increased, while stiffness at first applanation and at highest concavity decreased postoperatively in both groups. Changes in the DAR2 and integrated inverse radius in the transepithelial PRK group were significantly larger than in the transepithelial PRK with CXL group without and with analysis of covariance with the spherical equivalent change or corneal thickness change as a covariate. No significant differences in the biomechanically corrected IOP occurred preoperatively or postoperatively in either group.
Results indicate that prophylactic CXL combined with transepithelial PRK has a role in reducing the change in corneal biomechanical properties. The dynamic Scheimpflug analyzer showed stable biomechanically corrected IOP measurements preoperatively and postoperatively.
评估加速角膜交联（CXL）联合经上皮准分子激光角膜切削术（PRK）对使用动态 Scheimpflug 分析仪（Corvis ST）测量的新动态角膜反应参数和生物力学校正眼压（IOP）变化的影响。
韩国首尔延世大学医学院和 Eyereum 眼科诊所。
回顾性病例系列。
检查了接受经上皮 PRK 或经上皮 PRK 联合 CXL 的健康近视患者的眼部病历。主要观察变量是生物力学校正的 IOP 和新的动态角膜反应参数，包括 1.0mm 处的变形幅度比（DAR1）和 2.0mm 处的变形幅度比（DAR2）、首次压平处和最高凹陷处的硬度以及术前和术后 6 个月的综合倒数半径。
本研究包括 69 只眼（69 例患者）；35 只眼行经上皮 PRK，34 只眼行经上皮 PRK 联合 CXL。两组术后 DAR1、DAR2 和综合倒数半径均显著增加，而首次压平处和最高凹陷处的硬度均降低。与分析协方差相比，在没有和考虑球镜等效变化或角膜厚度变化为协变量的情况下，经上皮 PRK 组的 DAR2 和综合倒数半径的变化明显大于经上皮 PRK 联合 CXL 组。两组术前和术后生物力学校正的 IOP 均无显著差异。
结果表明，预防性 CXL 联合经上皮 PRK 可减少角膜生物力学特性的变化。动态 Scheimpflug 分析仪术前和术后均可稳定测量生物力学校正的 IOP。
