AlQahtani Bader S, Alshahrani Saeed, Khayyat Waleed W, Abdalla-Elsayed Maram E A, Altalhi Abdullah A, Saifaldein Amjad A, Taha Mohammed A
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Clin Ophthalmol. 2021 Jan 7;15:49-55. doi: 10.2147/OPTH.S284981. eCollection 2021.
This study aimed to assess the overall and specific topographic changes among patients who underwent corneal collagen cross-linking (CXL) due to progressive keratoconus.
This retrospective case series study was conducted at a single-arm hospital in King Abdulaziz Medical City, Riyadh. All progressive keratoconus patients who underwent CXL between January 2017 and December 2018 were included consecutively. The epi-off crosslinking technique (Dresden protocol) was applied in all patients. The topographic values were measured preoperatively and 12 months postoperatively. Patients with a history of a previous corneal procedure, corneal trauma, or any corneal scarring were excluded.
Among our population (29 eyes of 24 patients), 58.6% of eyes were for male patients, and the mean age of the population was 27.76 ± 4.21 years. Based on the topography results, the mean values of corneal thickness at central 3 mm decreased from 473.45 ± 38 µm to 465.72 ± 41.78 µm following CXL (Z = -1.93, 95% confidence interval [CI] = 0.048-0.057, p= 0.053). Clinically significant astigmatism measurements were present in 28 (96.6%) eyes before CXL compared to 26 (89.7%) eyes after CXL. The mean values of astigmatism among the patients were 3.37 ± 2.25 diopters before and 3.67 ± 2.61 diopters after CXL (Z = -1696, 95% confidence interval [CI] = 0.085-0.096, p = 0.09). After CXL, the mean values of the front elevation at the apex changed from 33.90 ± 20.13 µm to 36.10 ± 21.09 µm (Z = -2.792, 95% [CI] = 0.003-0.006, p = 0.005). The mean values of the back elevation at the apex changed from 68.4 ± 35.66 µm to 69.90 ± 35.89 µm (Z = -0.934, 95% CI = 0.343-0.366, p = 0.35).
The topographic corneal parameters improved significantly in the patients with corneal ectasia after CXL. These results revealed the safety and efficacy of CXL in stabilizing keratoconus progression among Saudi patients at 1 year of follow-up.
本研究旨在评估因进行性圆锥角膜而接受角膜胶原交联（CXL）的患者的整体和特定地形变化。
本回顾性病例系列研究在利雅得阿卜杜勒阿齐兹国王医疗城的一家单臂医院进行。连续纳入2017年1月至2018年12月期间接受CXL的所有进行性圆锥角膜患者。所有患者均采用上皮移除交联技术（德累斯顿方案）。术前和术后12个月测量地形值。排除有既往角膜手术、角膜外伤或任何角膜瘢痕病史的患者。
在我们的研究人群（24例患者的29只眼）中，58.6%的眼为男性患者，人群平均年龄为27.76±4.21岁。根据地形结果，CXL后中央3mm处角膜厚度的平均值从473.45±38μm降至465.72±41.78μm（Z=-1.93，95%置信区间[CI]=0.048-0.057，p=0.053）。CXL前28只眼（96.6%）存在临床显著散光测量值，而CXL后为26只眼（89.7%）。患者散光平均值术前为3.37±2.25屈光度，术后为3.67±2.61屈光度（Z=-1696，95%置信区间[CI]=0.085-0.096，p=0.09）。CXL后，顶点处前表面高度的平均值从33.90±20.13μm变为36.10±21.09μm（Z=-2.792，95%[CI]=0.003-0.006，p=0.005）。顶点处后表面高度的平均值从68.4±35.66μm变为69.90±35.89μm（Z=-0.934，95%CI=0.343-0.366，p=0.35）。
CXL后角膜扩张患者的地形角膜参数有显著改善。这些结果揭示了CXL在沙特患者随访1年时稳定圆锥角膜进展方面的安全性和有效性。
