Kasai Kozue, Kato Naoko, Konomi Kenji, Shinzawa Megumi, Shimazaki Jun
Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Chiba Department of Ophthalmology, Jikei University School of Medicine, Tokyo Department of Ophthalmology, Saitama Medical University Hospital, Saitama Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Medicine (Baltimore). 2017 Oct;96(40):e8160. doi: 10.1097/MD.0000000000008160.
A retrospective observational study was conducted to validate the effect of corneal cross-linking (CXL) on eyes with progressing keratoconus, depending on severity.In total, 45 eyes of 33 patients (age: 23.9 ± 6.8 years, range: 14-42 years) with progressive keratoconus who underwent CXL were enrolled. Examinations were performed at pre-, 1, 3, 6, and 12 months after surgery. In addition to a slit lamp microscopy, measurement of visual acuity, the steepest keratometric value (Kmax), the thinnest corneal thickness (TCT), and the corneal endothelial cell density (ECD) were assessed. Change in Kmax (ΔKmax) was calculated by subtracting the preoperative Kmax from the 12-month postoperative Kmax.CDVA, TCT, and ECD did not change significantly throughout the follow-up period. Kmax was 56.4 ± 7.2 D preoperatively and 54.3 ± 5.6 D at 12 months after CXL (P = .174). The average value of ΔKmax was -2.23 ± 4.31 D at 12 months after CXL. ΔKmax was negatively correlated with preoperative Kmax (ρ = -0.5517, P = .0001), and positively correlated with preoperative TCT (ρ = 0.4791, P = .0012). However, no correlation was observed between Kmax and patient age or the decrease ratio of ECD.The more flattening was obtained after CXL in cases with the more advanced keratoconus. No complication, including corneal endothelial damage, was observed even in advanced cases.
开展了一项回顾性观察研究，以验证角膜交联术（CXL）对不同严重程度的圆锥角膜进展期患眼的疗效。共有33例（年龄：23.9±6.8岁，范围：14 - 42岁）进展期圆锥角膜患者的45只患眼接受了CXL治疗。在术前、术后1个月、3个月、6个月和12个月进行检查。除裂隙灯显微镜检查外，还评估了视力、最陡角膜曲率值（Kmax）、最薄角膜厚度（TCT）和角膜内皮细胞密度（ECD）。通过用术后12个月的Kmax减去术前Kmax来计算Kmax的变化量（ΔKmax）。在整个随访期间，最佳矫正视力（CDVA）、TCT和ECD均无显著变化。术前Kmax为56.4±7.2D，CXL术后12个月为54.3±5.6D（P = 0.174）。CXL术后12个月时，ΔKmax的平均值为-2.23±4.31D。ΔKmax与术前Kmax呈负相关（ρ = -0.5517，P = 0.0001），与术前TCT呈正相关（ρ = 0.4791，P = 0.0012）。然而，未观察到Kmax与患者年龄或ECD降低率之间存在相关性。圆锥角膜病情越严重，CXL术后角膜越扁平。即使在病情严重的病例中，也未观察到包括角膜内皮损伤在内的并发症。
