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圆锥角膜紫外线角膜交联术后角膜对称性的评估

Evaluation of corneal symmetry after UV corneal crosslinking for keratoconus.

作者信息

Mofty Hanan, Alzahrani Khaled, Carley Fiona, Harper Sophie, Brahma Arun, Au Leon, Morley Debbie, Hillarby M Chantal

机构信息

Optometry Department, College of Applied Medical Science, King Saud University, Riyadh, Kingdom of Saudi Arabia.

Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester.

出版信息

Clin Ophthalmol. 2017 Nov 20;11:2043-2049. doi: 10.2147/OPTH.S143511. eCollection 2017.

Abstract

PURPOSE

The purpose of this study was to assess UV corneal crosslinking (CXL) treatment outcomes for keratoconus by evaluating the corneal regularity in patients through follow-up using the Oculus Pentacam.

PATIENTS AND METHODS

A total of 18 eyes from CXL patients with keratoconus were studied before and after CXL treatment, and six eyes from six patients who were not treated with CXL served as controls. Treated patients had Pentacam images taken before CXL treatment and regularly 3 months post treatment up to the 12th month. Controls were imaged during their first appointment and after 12 months. Symmetry and asphericity were evaluated and correlated with both best-corrected visual acuity (BCVA) and maximum -readings.

RESULTS

In the CXL-treated group, there was a significant improvement in the index of symmetrical variation (ISV) and keratoconus index (KI) at 3 months and in the index of height asymmetry (IHA) and minimum radius of curvature () at 9 months post treatment. On the contrary, the untreated group's indices showed some significant worsening in ISV, KI, central keratoconus index (CKI), and . A novel finding in our study was a slight positive shift of anterior asphericity in the 6 mm, 7 mm, and 8 mm 3 months after treatment, which had a correlation with BCVA (=0.390, =0.053) and a strong correlation with maximum -reading (=0.690, =0.005). However, the untreated group had no significant changes after 1 year.

CONCLUSION

The corneal asymmetrical shape is associated with the spherical aberration alteration influenced by temporal evolution of surface ablation and increased corneal haze. However, insignificant changes in symmetry attest the stabilization effect on cornea postoperatively as compared with controls.

摘要

目的

本研究的目的是通过使用Oculus Pentacam对圆锥角膜患者进行随访来评估紫外线角膜交联(CXL)治疗圆锥角膜的效果,评估角膜规则性。

患者与方法

共对18例接受CXL治疗的圆锥角膜患者的患眼在CXL治疗前后进行研究,6例未接受CXL治疗患者的6只眼作为对照。接受治疗的患者在CXL治疗前以及治疗后3个月定期进行Pentacam图像采集,直至第12个月。对照组在首次就诊时和12个月后进行成像。评估对称性和非球面性,并将其与最佳矫正视力(BCVA)和最大读数相关联。

结果

在CXL治疗组中,治疗后3个月对称变化指数(ISV)和圆锥角膜指数(KI)有显著改善,治疗后9个月高度不对称指数(IHA)和最小曲率半径有显著改善。相反,未治疗组的ISV、KI、中央圆锥角膜指数(CKI)和最小曲率半径有显著恶化。我们研究中的一个新发现是治疗后3个月6mm、7mm和8mm处前表面非球面性有轻微正向偏移,这与BCVA(r = 0.390,P = 0.053)相关,与最大读数(r = 0.690,P = 0.005)有强相关性。然而,未治疗组1年后无显著变化。

结论

角膜不对称形状与表面消融的时间演变和角膜混浊增加所影响的球差改变有关。然而,与对照组相比,对称性的微小变化证明了术后角膜的稳定作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49fc/5700762/6f5a6b52d36e/opth-11-2043Fig1.jpg

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