Pircher Niklas, Lammer Jan, Holzer Stephan, Gschließer Andreas, Donner Ruth, Pieh Stefan, Schmidinger Gerald
Department of Ophthalmology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Graefes Arch Clin Exp Ophthalmol. 2018 Apr;256(4):759-764. doi: 10.1007/s00417-018-3922-z. Epub 2018 Feb 23.
A stromal demarcation line (DL) after corneal cross-linking (CXL) has lately been suggested as a surrogate parameter for the success of CXL. The aim of this study was to investigate the correlation between depth of the central DL 1 month and the change in K values 12 months after CXL.
Treatment-naive subjects with keratoconus were treated using an accelerated CXL protocol [A-CXL(9*10)]. Depth of the DL/relative depth of the DL (DL%) was measured using Visante OCT imaging 1 month postoperatively (OP). K/K (preOP) and change in K/K (preOP - 12 months postOP) were assessed using corneal tomography (Pentacam HR, Oculus GmBH).
Forty eyes were treated following the A-CXL(9*10). The mean DL depth was 200 ± 99 μm (range 71 to 479)/mean DL% = 42.70 ± 20.00% (range 17-90). There was no statistically significant correlation between stromal depth of the DL and change in K or K, respectively (Spearman rho DL/∆K - 0.14 and DL/∆K - 0.14). Between DL% and the changes in maximum K values or K, no statistically significant correlation was found as well (Spearman rho DL%/∆K - 0.10 and DL%/∆K - 0.19). Mean change in K after 12 months was - 0.68 ± 2.26 diopters (D) (median - 0.35 D) and - 0.82 ± 1.6 D (median - 0.65 D) for K (p = 0.07; p = 0.02).
No statistically significant correlation was found between the stromal central depth of the DL and any outcome parameter for CXL after 12 months. Therefore, the interpretation of the DL as a predictive parameter for the effect of the procedure may not apply.
角膜交联术（CXL）后出现的基质分界线（DL）最近被认为是CXL成功的替代参数。本研究的目的是调查CXL术后1个月中央DL深度与术后12个月K值变化之间的相关性。
对初治圆锥角膜患者采用加速CXL方案[A-CXL(9*10)]进行治疗。术后1个月（OP）使用Visante OCT成像测量DL深度/DL相对深度（DL%）。使用角膜地形图仪（Pentacam HR，德国奥culus公司）评估术前K值/K（preOP）以及K值/K的变化（preOP - 术后12个月）。
40只眼接受了A-CXL(9*10)治疗。平均DL深度为200±99μm（范围71至479μm）/平均DL% = 42.70±20.00%（范围17 - 90%）。DL的基质深度与K值或K值变化之间分别无统计学显著相关性（斯皮尔曼相关系数DL/∆K - 0.14以及DL/∆K - 0.14）。在DL%与最大K值或K值变化之间也未发现统计学显著相关性（斯皮尔曼相关系数DL%/∆K - 0.10以及DL%/∆K - 0.19）。术后12个月K值的平均变化对于K值而言为-0.68±2.26屈光度（D）（中位数-0.35 D），对于K值为-0.82±1.6 D（中位数-0.65 D）（p = 0.07；p = 0.02）。
术后12个月，未发现DL的基质中央深度与CXL的任何结果参数之间存在统计学显著相关性。因此，将DL解释为该手术效果的预测参数可能并不适用。
