Jia Hong-Zhen, Peng Xiu-Jun
Department of Ophthalmology, Chinese PLA Navy General Hospital, Beijing 100048, China.
Int J Ophthalmol. 2018 Apr 18;11(4):687-694. doi: 10.18240/ijo.2018.04.25. eCollection 2018.
Corneal cross-linking (CXL) is a noninvasive therapeutic procedure for keratoconus that is aimed at improving corneal biomechanical properties by induction of covalent cross-links between stromal proteins. It is accomplished by ultraviolet A (UVA) radiation of the cornea, which is first saturated with photosensitizing riboflavin. It has been shown that standard epithelium-off CXL (S-CXL) is efficacious, and it has been recommended as the standard of care procedure for keratoconus. However, epithelial removal leads to pain, transient vision loss, and a higher risk of corneal infection. To avoid these disadvantages, transepithelial CXL was developed. Recently, iontophoresis has been adopted to increase riboflavin penetration through the epithelium. Several clinical observations have demonstrated the safety and efficacy of iontophoresis-assisted epithelium-on CXL (I-CXL) for keratoconus. This review aimed to provide a comprehensive summary of the published studies regarding I-CXL and a comparison between I-CXL and S-CXL. All articles used in this review were mainly retrieved from the PubMed database. Original articles and reviews were selected if they were related to the I-CXL technique or related to the comparison between I-CXL and S-CXL.
角膜交联术（CXL）是一种针对圆锥角膜的非侵入性治疗方法，旨在通过诱导基质蛋白之间的共价交联来改善角膜生物力学特性。它是通过对首先用光敏性核黄素饱和的角膜进行紫外线A（UVA）照射来完成的。已表明标准的去上皮角膜交联术（S-CXL）是有效的，并且已被推荐作为圆锥角膜的标准治疗程序。然而，去除上皮会导致疼痛、短暂视力丧失以及更高的角膜感染风险。为避免这些缺点，开发了经上皮角膜交联术。最近，已采用离子电渗疗法来增加核黄素透过上皮的渗透率。多项临床观察已证明离子电渗疗法辅助的上皮在位角膜交联术（I-CXL）治疗圆锥角膜的安全性和有效性。本综述旨在全面总结已发表的关于I-CXL的研究以及I-CXL与S-CXL之间的比较。本综述中使用的所有文章主要从PubMed数据库检索。如果原始文章和综述与I-CXL技术相关或与I-CXL和S-CXL之间的比较相关，则予以选择。
