Di Yu, Wang Jingyi, Li Ying, Jiang Yang
Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
J Ophthalmol. 2021 Jan 29;2021:6679770. doi: 10.1155/2021/6679770. eCollection 2021.
To compare the clinical results of standard corneal cross-linking (SCXL) with transepithelial corneal cross-linking (TECXL) in progressive keratoconus using a meta-analysis.
PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were searched up to June 2020 to identify relevant studies. The PRISMA guidelines were followed. Primary outcomes were change in uncorrected distance visual acuity and maximum keratometry ( ) after CXL. Secondary outcomes were change in corrected distance visual acuity, mean refractive spherical equivalent (MRSE), spherical and cylindrical error, endothelial cells density (ECD), and central corneal thickness (CCT).
Sixteen studies with a total of 690 eyes (SCXL: 332 eyes; TECXL: 358 eyes) were included. At the last follow-up, SCXL provided a greater decrease in maximum keratometry ( ) than TECXL (weighted mean difference (WMD) -1.12; 95% confidence interval (CI) -1.96, -0.29). For the other outcomes, there were no statistically significant differences.
Except for a greater decrease in Kmax with SCXL group, both groups have a comparable effect on visual, pachymetric, and endothelial parameters at 24 months after surgery. Larger studies with a longer follow-up time are necessary to determine whether these techniques are comparable in the long term.
采用荟萃分析比较标准角膜交联术（SCXL）与经上皮角膜交联术（TECXL）治疗进展性圆锥角膜的临床效果。
检索截至2020年6月的PubMed、EMBASE和Cochrane对照试验中心注册库，以识别相关研究。遵循PRISMA指南。主要结局指标为角膜交联术后未矫正远视力和最大角膜曲率（ ）的变化。次要结局指标为矫正远视力、平均等效球镜度（MRSE）、球镜和柱镜误差、内皮细胞密度（ECD）及中央角膜厚度（CCT）的变化。
纳入16项研究，共690只眼（SCXL组：332只眼；TECXL组：358只眼）。在末次随访时，SCXL组最大角膜曲率（ ）的降低幅度大于TECXL组（加权平均差（WMD）-1.12；95%置信区间（CI）-1.96，-0.29）。对于其他结局指标，两组间无统计学显著差异。
除SCXL组Kmax降低幅度更大外，两组在术后24个月时对视力、角膜厚度和内皮参数的影响相当。需要开展更大规模、随访时间更长的研究来确定这些技术从长期来看是否具有可比性。
