Kato Naoko, Konomi Kenji, Shinzawa Megumi, Kasai Kozue, Ide Takeshi, Toda Ikuko, Sakai Chikako, Negishi Kazuno, Tsubota Kazuo, Shimazaki Jun
Department of Ophthalmology, Saitama Medical University, Morohongo 38, Moroyamamachi, Iruma, Saitama, 350-0495, Japan.
Department of Ophthalmology, Ichikawa General Hospital, Tokyo Dental College, Chiba, Japan.
Jpn J Ophthalmol. 2018 Sep;62(5):560-567. doi: 10.1007/s10384-018-0610-9. Epub 2018 Jul 10.
We retrospectively investigated the efficacy of corneal crosslinking (CXL) on progressive keratoconus in a Japanese population and compared the outcomes of conventional and accelerated CXL.
A retrospective cohort study METHODS: A total of 108 consecutive eyes in 95 patients (75 men; 21.9 ± 6.2 years) with progressive keratoconus were enrolled. The epithelium was ablated in all eyes. After presoaking the corneal stroma in riboflavin, UV-A was irradiated at 3.0 mW/cm (conventional CXL) for 30 min on 23 eyes and 18.0 mW/cm for 5 min (accelerated CXL) on 85 eyes. Best spectacle-corrected visual acuity (BSCVA), manifest refraction, keratometric value, corneal thickness, corneal endothelial cell density (ECD), intraocular pressure, and complications were evaluated at 1, 3, 6, and 12 months after the procedure.
BSCVA, manifest refraction, ECD, and corneal thickness did not change significantly after both procedures. The keratometric value was significantly decreased from the preoperative value at 12 months (p < 0.001). Progression to more than 1.0 D after CXL was observed in 10 eyes (9.3%). The ΔKmax was negatively associated with preoperative Kmax (p < 0.001) and positively associated with preoperative thinnest corneal thickness (p < 0.001). Both treatment modules showed no significant difference in all parameters.
CXL was as effective in treating keratoconus in Japanese patients as in individuals of other ethnicities. Overall, CXL could be performed using either the conventional or accelerated approach to halt the progression of keratoconus in Japanese populations.
我们回顾性研究了角膜交联术（CXL）对日本人群中进行性圆锥角膜的疗效，并比较了传统CXL和加速CXL的结果。
一项回顾性队列研究
共纳入95例（75例男性；年龄21.9±6.2岁）进行性圆锥角膜患者的108只连续眼。所有眼均行上皮消融。在角膜基质用核黄素预浸泡后，23只眼以3.0 mW/cm²（传统CXL）照射紫外线A 30分钟，85只眼以18.0 mW/cm²照射5分钟（加速CXL）。在术后1、3、6和12个月评估最佳眼镜矫正视力（BSCVA）、明显验光、角膜曲率值、角膜厚度、角膜内皮细胞密度（ECD）、眼压和并发症。
两种手术术后BSCVA、明显验光、ECD和角膜厚度均无显著变化。角膜曲率值在术后12个月时较术前值显著降低（p<0.001）。CXL术后10只眼（9.3%）进展超过1.0 D。最大角膜曲率变化量（ΔKmax）与术前最大角膜曲率呈负相关（p<0.001），与术前最薄角膜厚度呈正相关（p<0.001）。两个治疗模块在所有参数上均无显著差异。
CXL治疗日本患者圆锥角膜的效果与其他种族个体相同。总体而言，在日本人群中，可采用传统或加速方法进行CXL以阻止圆锥角膜进展。
