Vinciguerra Riccardo, Tzamalis Argyrios, Romano Vito, Arbabi Esmaeil M, Batterbury Mark, Kaye Stephen B
J Refract Surg. 2019 Mar 1;35(3):202-206. doi: 10.3928/1081597X-20190124-01.
To test for an association between stiffening following corneal cross-linking (CXL) and demarcation line depth.
Sixty-six eyes of 66 patients treated with CXL for progressive keratoconus were included. Dynamic corneal response parameters (DCRs) were measured with the Corvis ST (Oculus Optikgeräte GmbH; Wetzlar, Germany) on the day of CXL and after 1 month. Demarcation line was measured 4 weeks after CXL. A multivariate general linear model was used to test for an association between the change in DCRs and the ratio between demarcation line depth and the postoperative pachymetry.
The authors found no significant associations between the change in inverse concave integrated radius (1/R) and the demarcation line ratio (P = .46), age (P = .33), sex (P = .11), preoperative maximum keratometry (P = .10), and laterality (P = .82). Similarly, there was no significant correlation between the change in 1/R and the demarcation line ratio (R = .002 and P = .75). However, there was a significant association between the preoperative values of 1/R and the respective change in 1/R (P < .0001). The change in 1/R was inversely proportional to the patient's preoperative 1/R; stiffer corneas (lower values of 1/R) were less affected than less stiff corneas (R = .23, P < .0001).
CXL is associated with changes in DCRs, suggesting a change in corneal biomechanics following CXL. These changes do not appear to be associated with the demarcation line depth. [J Refract Surg. 2019;35(3):202-206.].
检测角膜交联术(CXL)后角膜硬度增加与分界线深度之间的相关性。
纳入66例因进行性圆锥角膜接受CXL治疗的患者的66只眼。在CXL当天及1个月后,使用Corvis ST(德国韦茨拉尔的Oculus Optikgeräte GmbH公司)测量动态角膜反应参数(DCRs)。在CXL后4周测量分界线。采用多变量一般线性模型检测DCRs变化与分界线深度与术后角膜厚度比值之间的相关性。
作者发现,逆凹综合半径(1/R)变化与分界线比值(P = 0.46)、年龄(P = 0.33)、性别(P = 0.11)、术前最大角膜曲率(P = 0.10)及患侧(P = 0.82)之间无显著相关性。同样,1/R变化与分界线比值之间无显著相关性(R = 0.002,P = 0.75)。然而,术前1/R值与1/R的相应变化之间存在显著相关性(P < 0.0001)。1/R变化与患者术前1/R成反比;较硬的角膜(1/R值较低)比较软的角膜受影响更小(R = 0.23,P < 0.0001)。
CXL与DCRs变化相关,提示CXL后角膜生物力学发生改变。这些变化似乎与分界线深度无关。[《屈光手术杂志》。2019年;35(3):202 - 206。]