Ozek Dilay, Kemer Ozlem Evren, Ozer Pinar Altiaylik
Department of Ophthalmology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Department of Ophthalmology, Faculty of Medicine, Ufuk University, Ankara, Turkey.
Int Ophthalmol. 2019 Jun;39(6):1329-1335. doi: 10.1007/s10792-018-0951-x. Epub 2018 Jun 14.
The aim of this study is to compare the effect of different riboflavin solutions (hypotonic and isotonic) used during accelerated corneal cross-linking (CXL) on the mean depth of the demarcation line (DDL) formed in corneal stroma.
This prospective, cross-sectional study included 38 eyes of 26 patients. All patients underwent accelerated CXL due to progressive keratoconus. When the corneal epithelium was removed, 17 eyes of 12 patients with corneal thickness < 400 µm were categorized as Group 1, and 21 eyes of 14 patients with corneal thickness > 400 µm as Group 2. Hypotonic riboflavin was applied to Group 1 patients, and isotonic riboflavin to Group 2 patients. Anterior segment optical coherence tomography was performed on all patients by two independent observers at the end of the first and third months.
Group 1 included 5 male and 7 female patients with an average age of 25.1 ± 8.0 years, whereas Group 2 included 7 male and 7 female patients with an average age of 31.8 ± 10.12 years. At the end of the first month, the mean DDL in Group 1 and Group 2 was 180.32 ± 10.26 and 287.21 ± 15.01 µm, respectively. This difference was statistically significant (p < 0.05).
Application of different riboflavin solutions was observed to have an effect on measured corneal thickness after saturation and the depth of the demarcation line. The use of hypotonic riboflavin results in swelling of the cornea and more superficial localization of the stromal demarcation line after CXL.
本研究旨在比较加速角膜交联术（CXL）期间使用的不同核黄素溶液（低渗和等渗）对角膜基质中形成的分界线（DDL）平均深度的影响。
这项前瞻性横断面研究纳入了26例患者的38只眼。所有患者因进行性圆锥角膜接受加速CXL。去除角膜上皮后，12例角膜厚度<400 µm患者的17只眼被归为第1组，14例角膜厚度>400 µm患者的21只眼被归为第2组。第1组患者应用低渗核黄素，第2组患者应用等渗核黄素。在第1个月和第3个月末，由两名独立观察者对所有患者进行眼前节光学相干断层扫描。
第1组包括5名男性和7名女性患者，平均年龄为25.1±8.0岁，而第2组包括7名男性和7名女性患者，平均年龄为31.8±10.12岁。在第1个月末，第1组和第2组的平均DDL分别为180.32±10.26和287.21±15.01 µm。这种差异具有统计学意义（p<0.05）。
观察到应用不同的核黄素溶液对饱和后测量的角膜厚度和分界线深度有影响。使用低渗核黄素会导致角膜肿胀，并且在CXL后角膜基质分界线的定位更浅。
