Küçümen Raciha Beril, Şahan Berna, Yıldırım Canan Aslı, Çiftçi Ferda
Yeditepe University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey.
Dokuz Eylül University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey.
Turk J Ophthalmol. 2018 Aug;48(4):160-165. doi: 10.4274/tjo.56750. Epub 2018 Sep 4.
To evaluate corneal biomechanics before and after collagen crosslinking (CXL) in patients with progressive keratoconus.
In this prospective study, CXL was performed under topical anesthesia after removal of the epithelium (epi-off technique) by applying ultraviolet A (UVA) light at a wavelength of 365 nm and power of 3 mW/cm2 or 5.4 joule/cm2. Isoosmolar 0.1% riboflavin solution was administered before and during UVA irradiation. In addition to ophthalmologic examination, ocular response analyzer measurements were performed pre- and postoperatively. Corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated intraocular pressure (IOPcc), Goldmann-correlated intraocular pressure (IOPg), and central corneal thickness (CCT) were recorded.
The study included 35 eyes of 30 patients with progressive keratoconus. The mean age was 28.2±6.5 years and postoperative follow-up time was 20.2±14.7 months (range: 6-74 months). The mean CH was 8.60±1.23 mmHg preoperatively, 8.96±2.05 mmHg in the early postoperative period (1-6 months), (p=0.28) and 8.96±1.28 mmHg in the late postoperative period (10-29 months) (p=0.48). Mean CRF was 7.13±1.50 mmHg preoperatively, 8.48±2.16 mmHg in the early postoperative period (p=0.009), and 7.71±1.29 mmHg in the late postoperative period (p=0.40). Mean IOPcc was 12.78±2.34 mmHg preoperatively, 15.38±4.21 mmHg in the early postoperative period (p=0.12) and 13.68±3.61 mmHg in the late postoperative period (p=0.48). Mean IOPg was 9.56±2.73 mmHg preoperatively, 13.01±4.45 mmHg in the early postoperative period (p=0.046), and 10.86±3.47 mmHg in the late postoperative period (p=0.44). Mean CCT was 484.43±41.26 µm preoperatively, 474.16±64.74 µm in the early postoperative period (p=0.70), and 470.38±33.64 µm in late postoperative period (p=0.71).
CXL is a treatment modality believed to affect corneal biomechanics in keratoconus, but the results of larger patient series with longer follow-up periods may enable a better evaluation.
评估圆锥角膜患者胶原交联（CXL）前后的角膜生物力学。
在这项前瞻性研究中，采用表面麻醉，通过应用波长为365nm、功率为3mW/cm²或5.4焦耳/cm²的紫外线A（UVA）光去除上皮后（去上皮技术）进行CXL。在UVA照射前和照射期间给予等渗0.1%核黄素溶液。除眼科检查外，术前和术后均进行眼反应分析仪测量。记录角膜滞后（CH）、角膜阻力因子（CRF）、角膜补偿眼压（IOPcc）、Goldmann相关眼压（IOPg）和中央角膜厚度（CCT）。
该研究纳入了30例圆锥角膜患者的35只眼。平均年龄为28.2±6.5岁，术后随访时间为20.2±14.7个月（范围：6 - 74个月）。术前平均CH为8.60±1.23mmHg，术后早期（1 - 6个月）为8.96±2.05mmHg，（p = 0.28），术后晚期（10 - 29个月）为8.96±1.28mmHg（p = 0.48）。术前平均CRF为7.13±1.50mmHg，术后早期为8.48±2.16mmHg（p = 0.009），术后晚期为7.71±1.29mmHg（p = 0.40）。术前平均IOPcc为12.78±2.34mmHg，术后早期为15.38±4.21mmHg（p = 0.12），术后晚期为13.68±3.61mmHg（p = 0.48）。术前平均IOPg为9.56±2.73mmHg，术后早期为13.01±4.45mmHg（p = 0.046），术后晚期为10.86±3.47mmHg（p = 0.44）。术前平均CCT为484.43±41.26µm，术后早期为474.16±64.74µm（p = 0.70），术后晚期为470.38±33.64µm（p = 0.71）。
CXL是一种被认为会影响圆锥角膜角膜生物力学的治疗方式，但更大样本量且随访时间更长的患者系列研究结果可能会带来更好的评估。
