Kopaenko A I, Ivanova N V
Medical Academy named after S.I. Georgievsky of Vernadsky CFU, 5/7 Lenin Avenue, Simferopol, Republic of Crimea, Russian Federation, 295051.
Vestn Oftalmol. 2018;134(2):42-47. doi: 10.17116/oftalma2018134242-47.
To assess the effectiveness of transepithelial collagen crosslinking (CXL) in patients with keratoconus.
The study involved 44 patients (44 eyes) with stage I-II progressive keratoconus. Patients were divided into two groups. The 1 group included 22 patients that had underwent transepithelial CXL. The 2 group included 22 patients that had underwent traditional CXL.
All patients of the group 2 all patients had corneal syndrome, which lasted 2-4 days. In the 1 group, 98% of the patients did not have corneal syndrome and their visual acuity (VA) was same as preoperative on the next day after the surgery. In the 2 group, the mean level of postoperative pain was 1.7 times higher than in group 1 (p<0.05). Six months after the treatment, uncorrected VA (UCVA) in the 1 group has increased by 52%, the best corrected VA (BCVA) - by 17%, in the 2 group UCVA increased by 53%, BCVA - by 20% (p<0.05). The demarcation line in the 2 group was 2.2 times deeper than in the 1 group (p<0.05). Six months after the treatment in the 1 group mean K1, K2 and K decreased by 1.5%, 2.3% and 1.7% respectively (p>0.05); in the 2 group - by 3.6%, 3.9% and 4.1% (p<0.05) compared with the data before the surgery. One year after the treatment, mean K in the 1 group decreased by 2.1%, in the 2 group - by 3.9%. Differences with preoperative values were statistically significant only in the 2 group.
Transepitelial CXL is a safe procedure well tolerated by patients and leading to a rapid restoration of visual function. Transepithelial CXL proved to have reduced effectiveness in inducing improvement in keratometric values, its effect on visual acuity was likely to be similar to that of epithelium-off CXL.
评估经上皮胶原交联术（CXL）治疗圆锥角膜患者的有效性。
该研究纳入了44例（44眼）I-II期进行性圆锥角膜患者。患者被分为两组。第1组包括22例接受经上皮CXL的患者。第2组包括22例接受传统CXL的患者。
第2组所有患者均出现角膜综合征，持续2 - 4天。在第1组中，98%的患者未出现角膜综合征，且术后第二天视力（VA）与术前相同。在第2组中，术后疼痛平均水平比第1组高1.7倍（p<0.05）。治疗6个月后，第1组未矫正视力（UCVA）提高了52%，最佳矫正视力（BCVA）提高了17%；第2组UCVA提高了53%，BCVA提高了20%（p<0.05）。第2组的分界线比第1组深2.2倍（p<0.05）。治疗6个月后，第1组平均K1、K2和K值分别下降了1.5%、2.3%和1.7%（p>0.05）；与手术前数据相比，第2组分别下降了3.6%、3.9%和4.1%（p<0.05）。治疗1年后，第1组平均K值下降了2.1%，第2组下降了3.9%。仅在第2组中，与术前值的差异具有统计学意义。
经上皮CXL是一种安全的手术，患者耐受性良好，能使视功能迅速恢复。经上皮CXL在诱导角膜曲率值改善方面效果降低，其对视敏度的影响可能与去上皮CXL相似。
