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《伴补氧的经上皮角膜交联术治疗圆锥角膜:1 年临床疗效观察》。

Transepithelial Corneal Cross-linking With Supplemental Oxygen in Keratoconus: 1-Year Clinical Results.

出版信息

J Refract Surg. 2021 Jan 1;37(1):42-48. doi: 10.3928/1081597X-20201111-01.

Abstract

PURPOSE

To evaluate the efficacy and safety of transepithelial corneal cross-linking (CXL) with supplemental oxygen.

METHODS

This was a prospective, non-comparative, pilot cohort study conducted at the National Reference Center for Keratoconus (Toulouse, France) on patients with progressive keratoconus. Transepithelial, pulsed, accelerated CXL was performed in an oxygen-rich atmosphere. Oxygen goggles were applied to the eyes to maintain a high level of oxygen during treatment. The main efficacy outcome was the mean change from baseline in maximum keratometry (Kmax) and the secondary outcomes were the mean changes in flat keratometry (K1), steep keratometry (K2), mean keratometry (Km), corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), and demarcation line depth. The safety outcomes were the incidence of adverse events, the mean change in pachymetry, and endothelial cell count.

RESULTS

Thirty-four eyes of 34 patients were included. At 12 months postoperatively, the Kmax decreased by 1.56 ± 1.71 diopters (D) (P < .0001) and CDVA improved by 0.093 ± 0.193 logMAR (P < .02). The K2 and Km decreased by 0.51 ± 1.03 D (P < .02) and 0.40 ± 0.78 D (P < .01), respectively. There was no change in K1 and UDVA. The most frequent adverse event was corneal haze (64.78%). There were neither cases of infectious keratitis or loss of more than two lines in CDVA nor changes in pachymetry or endothelial cell count.

CONCLUSIONS

Transepithelial CXL performed in an oxygen-rich atmosphere results in improved Kmax and CDVA with good safety. These promising findings suggest that this procedure could be safe and capable of halting the progression of keratoconus. [J Refract Surg. 2021;37(1):42-48.].

摘要

目的

评估补充氧的经上皮角膜交联(CXL)的疗效和安全性。

方法

这是一项在法国图卢兹国家圆锥角膜参考中心进行的前瞻性、非对照、试点队列研究,纳入了进展性圆锥角膜患者。在富含氧气的环境中进行经上皮、脉冲、加速 CXL。治疗过程中,将氧气护目镜应用于眼睛,以维持高水平的氧气。主要疗效指标是最大角膜曲率(Kmax)的基线平均变化,次要疗效指标是平角膜曲率(K1)、陡角膜曲率(K2)、平均角膜曲率(Km)、矫正距离视力(CDVA)、未矫正距离视力(UDVA)和分界线深度的平均变化。安全性指标是不良事件的发生率、角膜厚度的平均变化和内皮细胞计数。

结果

共纳入 34 例 34 只眼。术后 12 个月时,Kmax 下降 1.56 ± 1.71 屈光度(D)(P<0.0001),CDVA 提高 0.093 ± 0.193 logMAR(P<0.02)。K2 和 Km 分别下降 0.51 ± 1.03 D(P<0.02)和 0.40 ± 0.78 D(P<0.01)。K1 和 UDVA 无变化。最常见的不良事件是角膜混浊(64.78%)。无感染性角膜炎或 CDVA 损失超过两线的病例,也无角膜厚度或内皮细胞计数的变化。

结论

在富含氧气的环境中进行经上皮 CXL 可改善 Kmax 和 CDVA,安全性良好。这些有前景的发现表明,该手术可能是安全的,并且能够阻止圆锥角膜的进展。

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