Department of Ophthalmology, Yildirim Beyazit University, Ankara, Turkey.
Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
Cornea. 2019 Aug;38(8):980-985. doi: 10.1097/ICO.0000000000002003.
To evaluate visual, refractive, topographic, and aberrometric outcomes of transepithelial phototherapeutic keratectomy (PTK) + corneal collagen crosslinking in the treatment of pellucid marginal degeneration.
This retrospective study includes 20 eyes of 15 patients with pellucid marginal degeneration treated with transepithelial PTK + accelerated corneal collagen crosslinking. Visual acuity, refraction, topographic keratometry, pachymetry, and aberrations were recorded pretreatment and 6, 12, 24, and 36 months after treatment.
Stabilization in visual acuity was observed throughout the 36 months of follow-up (P > 0.05). The cylindrical value was significantly lower (P < 0.05) during the follow-up compared with the baseline (4.97 ± 2.00, 3.86 ± 2.01, 3.92 ± 2.27, 2.87 ± 1.70, and 3.28 ± 3.12 D at the baseline and postoperative 6th, 12th, 24th, and 36th month, respectively). Spherical equivalent was significantly lower at the 24th (P = 0.02) and 36th month (P = 0.01) follow-up intervals. A significant decrease (P < 0.05) in average keratometry readings was observed in all follow-up points (47.12 ± 4.66, 46.65 ± 4.38, 46.57 ± 4.57, 46.46 ± 4.81, and 46.27 ± 4.46 D, respectively). The maximum keratometry value remained stable (P > 0.05) in all visits (64.30 ± 10.70, 63.49 ± 10.05, 62.97 ± 9.50, 63.33 ± 10.06, and 62.27 ± 10.36 D, respectively). The Baiocchi Calossi Versaci index was significantly lower (P < 0.05) at all follow-up points compared with the baseline (3.21 ± 1.93, 2.99 ± 1.96, 2.96 ± 1.93, 2.82 ± 1.95, and 2.86 ± 1.99 μm, respectively). Central and minimum corneal thicknesses were significantly lower (P ≤ 0.01) compared with the baseline throughout the follow-up. Higher order aberration, trefoil, coma, and spherical aberration values remained stable during the follow-up compared with the baseline (P > 0.05).
The combination of transepithelial PTK with accelerated corneal collagen crosslinking seems to be an effective treatment in patients with pellucid marginal degeneration in the long-term.
评估经上皮准分子激光光动力角膜切削术（PTK）联合角膜胶原交联术治疗透明边缘性角膜变性的视力、屈光、地形和像差结果。
本回顾性研究纳入了 15 名透明边缘性角膜变性患者的 20 只眼，这些患者接受了经上皮 PTK+加速角膜胶原交联术治疗。在治疗前以及治疗后 6、12、24 和 36 个月时，记录了视力、屈光度、角膜地形学、角膜厚度和像差。
在整个 36 个月的随访中，视力稳定（P>0.05）。与基线相比，随访期间的圆柱镜值显著降低（P<0.05）（4.97±2.00、3.86±2.01、3.92±2.27、2.87±1.70 和 3.28±3.12 D，分别为基线和术后 6、12、24 和 36 个月时）。在 24 个月（P=0.02）和 36 个月（P=0.01）的随访间隔，等效球镜显著降低。在所有随访点，平均角膜曲率读数均显著降低（P<0.05）（47.12±4.66、46.65±4.38、46.57±4.57、46.46±4.81 和 46.27±4.46 D，分别为基线和术后 6、12、24 和 36 个月时）。最大角膜曲率值在所有访视中均保持稳定（P>0.05）（64.30±10.70、63.49±10.05、62.97±9.50、63.33±10.06 和 62.27±10.36 D，分别为基线和术后 6、12、24 和 36 个月时）。与基线相比，Baiocchi Calossi Versaci 指数在所有随访点均显著降低（P<0.05）（3.21±1.93、2.99±1.96、2.96±1.93、2.82±1.95 和 2.86±1.99 μm，分别为基线和术后 6、12、24 和 36 个月时）。中央和最小角膜厚度在整个随访期间均显著低于基线（P≤0.01）。与基线相比，高阶像差、三叶形、彗差和球差值在整个随访期间保持稳定（P>0.05）。
经上皮准分子激光光动力角膜切削术联合加速角膜胶原交联术似乎是治疗透明边缘性角膜变性的一种有效方法，可长期应用。
