From the Department of Ophthalmology, Sanggye Paik Hospital, College of Medicine, Inje University (Kang, Hwang); Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea (Chung), Seoul, Republic of Korea.
J Cataract Refract Surg. 2021 May 1;47(5):641-648. doi: 10.1097/j.jcrs.0000000000000488.
To compare the clinical outcomes between pulsed and continuous accelerated crosslinking (CXL) for keratoconus.
Hospital.
Retrospective comparison study.
Korean patients who were treated for keratoconus between September 2015 and January 2018 at Seoul St. Mary's Hospital were included. Eyes were subjected to pulsed accelerated crosslinking (30 mW/cm2 for 8 minutes, 1 second on/1 second off) or continuous accelerated crosslinking (30 mW/cm2 for 4 minutes; delivering 7.2 J/cm2). Outcomes were evaluated after 1 year.
At 1 year, the 2 groups did not exhibit changes in their corrected and uncorrected distance visual acuity values. The pulsed group (25 eyes in 25 patients) exhibited significantly improved values for sphere (P = .009) and spherical equivalent (P = .033), although no statistically significant difference was observed in the continuous group (20 eyes in 20 patients). All keratometry (k)values (SimKf, SimKs, SimKmean, and Kmax) improved in both groups (all P < .05), although the pulsed group had significantly greater changes in the SimKmean value (P = .036) and the Kmax value (P = .03). Both groups had significantly decreased central and thinnest corneal thicknesses (all P < .001), although the pulsed group had a substantially lower thinnest corneal thickness (P = .017). Corneal densitometry measured using the Pentacam device increased in both groups (all P < .001), with a higher densitometry value in the pulsed group (P = .013). Furthermore, the depth of the demarcation line was deeper in the pulsed group (P = .015).
Pulsed accelerated crosslinking might provide better postcrosslinking effects than continuous accelerated crosslinking.
比较脉冲和连续加速交联（CXL）治疗圆锥角膜的临床效果。
医院。
回顾性比较研究。
纳入 2015 年 9 月至 2018 年 1 月在首尔圣玛丽医院接受治疗的圆锥角膜韩国患者。眼睛接受脉冲加速交联（30 mW/cm2，8 分钟，1 秒 ON/1 秒 OFF）或连续加速交联（30 mW/cm2，4 分钟；输送 7.2 J/cm2）。在 1 年后评估结果。
在 1 年时，两组的矫正和未矫正远视力值均无变化。脉冲组（25 眼，25 例）的球镜（P =.009）和等效球镜（P =.033）值显著改善，而连续组（20 眼，20 例）则无统计学意义。两组的所有角膜曲率计（K）值（SimKf、SimKs、SimKmean 和 Kmax）均有改善（均 P <.05），但脉冲组的 SimKmean 值（P =.036）和 Kmax 值（P =.03）变化显著。两组的中央和最薄角膜厚度均显著减少（均 P <.001），但脉冲组的最薄角膜厚度显著较低（P =.017）。Pentacam 设备测量的角膜密度均增加（均 P <.001），脉冲组的密度值较高（P =.013）。此外，脉冲组的分界线深度更深（P =.015）。
脉冲加速交联可能比连续加速交联提供更好的交联后效果。
