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成人圆锥角膜标准交联结果的预测因素:一年随访

Predictive Factors of the Standard Cross-linking Outcomes in Adult Keratoconus: One-Year Follow-Up.

作者信息

Badawi Amani E, Abou Samra Waleed Ali, El Ghafar Ayman Abd

机构信息

Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

出版信息

J Ophthalmol. 2017;2017:4109208. doi: 10.1155/2017/4109208. Epub 2017 Aug 29.

Abstract

PURPOSE

To evaluate the effects of preoperative presumed predictor factors on clinical and topographic outcomes in adult keratoconus (KC) 1 year after the standard corneal cross-linking (CXL).

DESIGN

Retrospective cohort study.

METHODS

The study included 84 KC patients (136 eyes) who were treated with conventional CXL. Postoperative best-corrected visual acuity (BCVA) and K max were considered the main predicted variables. The entire participants were divided into subgroups with cutoff values in accordance with the predictive variables. The predicted postoperative outcomes at one year were compared between the subgroups. Next, the predictive variables were analyzed by univariate and multivariate linear regression.

RESULTS

In respect to the BCVA, univariate analysis showed that the worse BCVA, the higher K max, and the relative thinner corneas were relatively good predictors of improvement, while multivariate evaluation revealed a strong interrelation with preoperative BCVA only. Regarding the postoperative flattening, univariate analysis found that the cone location and worse preoperative BCVA were the pronounced predictors, whereas the multivariate evaluation focused on the impact of the cone location only.

CONCLUSIONS

The multivariate analysis disclosed a significant negative association between the baseline BCVA and postoperative BCVA and a positive relationship between the cone eccentricity and postoperative K max.

摘要

目的

评估术前假定的预测因素对成人圆锥角膜(KC)患者在标准角膜交联术(CXL)后1年的临床和地形图结果的影响。

设计

回顾性队列研究。

方法

该研究纳入了84例接受传统CXL治疗的KC患者(136只眼)。术后最佳矫正视力(BCVA)和最大角膜曲率(K max)被视为主要预测变量。根据预测变量的临界值将所有参与者分为亚组。比较各亚组1年后的预测术后结果。接下来,通过单变量和多变量线性回归分析预测变量。

结果

关于BCVA,单变量分析显示,BCVA越差、K max越高以及角膜相对越薄是改善的相对良好预测指标,而多变量评估仅显示与术前BCVA有很强的相关性。关于术后角膜变平,单变量分析发现圆锥位置和术前较差的BCVA是显著的预测指标,而多变量评估仅关注圆锥位置的影响。

结论

多变量分析揭示了基线BCVA与术后BCVA之间存在显著的负相关,以及圆锥偏心度与术后K max之间存在正相关。

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