Baenninger Philipp B, Bachmann Lucas M, Wienecke Ludmilla, Thiel Michael A, Kaufmann Claude
Department of Ophthalmology, Cantonal Hospital of Lucerne, Lucerne, Switzerland.
medignition Inc Healthcare Innovations, Zurich, Zurich, Switzerland.
Am J Ophthalmol. 2017 Nov;183:11-16. doi: 10.1016/j.ajo.2017.08.015. Epub 2017 Aug 31.
To compare visual and topographic outcomes 1 year after conventional (C-CXL) vs accelerated corneal cross-linking (A-CXL) in pediatric keratoconus (KC).
Comparative, retrospective, consecutive case series.
Patients with topography-confirmed, progressive KC and a corneal thickness of ≥400 μm at the time of surgery were enrolled. Uncorrected (UCVA) and best phoropter-corrected visual acuity (BCVA) and normal maximum keratometry reading (Kmax) were measured at study entry and at the 12-month follow-up. Treatment failure rate was defined as the percentage of eyes with an increase in Kmax of more than 1.0 diopter during follow-up. The adverse event rate was the percentage of eyes with a loss of ≥2 Snellen lines of BCVA from baseline. This was a single-center analysis of 78 eyes of 58 patients that underwent C-CXL (39 eyes) and A-CXL (39 eyes). No eyes were lost to follow-up after 12 months.
No significant difference between changes in 12 months after as compared to the time before CXL for UCVA (0.01 log MAR; 95% confidence interval -0.14 to 0.15, P = .944), BCVA (0.05 log MAR; 95% confidence interval -0.05 to 0.15, P = .310), and Kmax (-0.77 diopters; 95% confidence interval -2.20 to 0.65, P = .282) between the C-CXL and A-CXL group were observed. Treatment failure rate was observed in 9 of 39 eyes (23.1%) in C-CXL and in 6 of 39 eyes (15.4%) in A-CXL (P = .389). Adverse events were seen only in 1 eye in the C-CXL group.
In this retrospective comparison, the accelerated approach was equally as effective as the conventional protocol to treat pediatric keratoconus.
比较传统角膜交联术（C-CXL）与加速角膜交联术（A-CXL）治疗儿童圆锥角膜（KC）1年后的视力和地形图结果。
比较性、回顾性、连续病例系列研究。
纳入手术时地形图确诊为进行性KC且角膜厚度≥400μm的患者。在研究开始时和12个月随访时测量未矫正视力（UCVA）、最佳综合验光仪矫正视力（BCVA）和正常最大角膜曲率读数（Kmax）。治疗失败率定义为随访期间Kmax增加超过1.0屈光度的眼的百分比。不良事件发生率是指BCVA较基线下降≥2行Snellen视力表视力的眼的百分比。这是一项对58例患者的78只眼进行的单中心分析，其中39只眼接受了C-CXL，39只眼接受了A-CXL。12个月后无失访病例。
C-CXL组和A-CXL组之间，CXL术后12个月与术前相比，UCVA（0.01 log MAR；95%置信区间-0.14至0.15，P = 0.944）、BCVA（0.05 log MAR；95%置信区间-0.05至0.15，P = 0.310）和Kmax（-0.77屈光度；95%置信区间-2.20至0.65，P = 0.282）的变化无显著差异。C-CXL组39只眼中有9只（23.1%）出现治疗失败，A-CXL组39只眼中有6只（15.4%）出现治疗失败（P = 0.389）。不良事件仅在C-CXL组的1只眼中出现。
在这项回顾性比较中，加速治疗方法在治疗儿童圆锥角膜方面与传统方案同样有效。
