Sharif Walid, Ali Zaid Rushdi, Sharif Khaled
Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman 11183, Jordan.
Sharif Eye Centers, Amman 11183, Jordan.
Int J Ophthalmol. 2019 Feb 18;12(2):333-337. doi: 10.18240/ijo.2019.02.22. eCollection 2019.
This study was designed to evaluate efficacy and stability of corneal collagen crosslinking (CXL) in halting the progression of post-laser keratomileusis (LASIK) ectasia and provide long-term follow-up results with an average of 80mo. Patients with post-LASIK ectasia were treated with CXL between December 2007 and January 2012. Main outcome measures were uncorrected distance visual acuities (UDVA) and corrected distance visual acuities (CDVA), minimum and maximum keratometry (K) values, spherical and cylindrical refraction, and corneal thickness. The study evaluated 17 eyes for 13 patients (8 men, 5 women) with mean age of 31y (range 23 to 39) and mean follow-up of 80.7±15 (range 57 to 102)mo. UDVA and CDVA improved from logMAR 0.53±0.36 (20/63) to 0.49±0.4 (20/50) (=0.43) and from 0.18±0.17 (20/28) to 0.16±0.16 (20/27) (=0.55) respectively. In 15 eyes UDVA and in 13 eyes CDVA either remained stable or improved ≥1 Snellen lines (88.2%) and (76.5%) respectively. Although statistically insignificant, spherical and cylindrical refraction decreased post-CXL from -1.26±2.87 to -0.38±2.32 diopters (D) (=0.054) and from -3.80±2.47 to -3.04±2.18 D (=0.13) respectively. Kmax significantly decreased from 44.23±3.76 to 42.85±3.08 D (=0.013) and Kmin decreased from 41.07±3.61 to 40.00±2.65 D (=0.057). Corneal thickness decreased from 470±42 to 460±41 µm, but was statistically non-significant (=0.063). Therefore, CXL is effective in halting and partially reversing the progression of post-LASIK ectasia on the long-term (mean follow-up of more than 80mo), thus highlighting the stability and maintained effect of CXL for such cases.
本研究旨在评估角膜交联术（CXL）在阻止准分子激光原位角膜磨镶术（LASIK）后角膜扩张进展方面的疗效和稳定性，并提供平均80个月的长期随访结果。2007年12月至2012年1月期间，对LASIK术后角膜扩张患者进行了CXL治疗。主要观察指标为未矫正远视力（UDVA）、矫正远视力（CDVA）、最小和最大角膜曲率（K）值、球镜和柱镜屈光度以及角膜厚度。该研究评估了13例患者（8例男性，5例女性）的17只眼，平均年龄31岁（范围23至39岁），平均随访时间为80.7±15个月（范围57至102个月）。UDVA从logMAR 0.53±0.36（20/63）提高到0.49±0.4（20/50）（P = 0.43），CDVA从0.18±0.17（20/28）提高到0.16±0.16（20/27）（P = 0.55）。15只眼的UDVA和13只眼的CDVA分别保持稳定或提高了≥1行Snellen视力表（分别为88.2%和76.5%）。虽然无统计学意义，但CXL术后球镜和柱镜屈光度分别从-1.26±2.87降低至-0.38±2.32屈光度（D）（P = 0.054）和从-3.80±2.47降低至-3.04±2.18 D（P = 0.13）。Kmax从44.23±3.76显著降低至42.85±3.08 D（P = 0.013），Kmin从41.07±3.61降低至40.00±2.65 D（P = 0.057）。角膜厚度从470±42μm降低至460±41μm，但无统计学意义（P = 0.063）。因此，CXL在长期（平均随访超过80个月）内有效地阻止并部分逆转了LASIK术后角膜扩张的进展，从而突出了CXL对此类病例的稳定性和持续效果。
