J Refract Surg. 2021 Feb 1;37(2):78-82. doi: 10.3928/1081597X-20201123-02.
To describe a new surgical technique where corneal cross-linking (CXL) (to treat corneal ectasias) and photo-activated chromophore for keratitis-CXL (PACK-CXL) are performed while the patient is seated in an upright position at the slit lamp.
Topical anesthesia is applied in the waiting room, 10 minutes before the procedure. Once in the office or procedure room, eyelids and periorbital areas are disinfected with chloramphenicol and the patient is seated at the slit lamp. Epithelial debridement is performed with a cotton swab soaked in freshly prepared 40% ethanol, using 70 seconds of tapping, followed by gentle pressure to remove the epithelium. The patient is placed in the supine position for riboflavin application for 10 minutes. Stromal thickness is assessed using ultrasound pachymetry after 5 and 10 minutes. Finally, the patient is returned to the slit lamp to receive ultraviolet irradiation.
CXL at the slit lamp is an easy-to-perform technique that substantially reduces the infrastructure needed to perform CXL and PACK-CXL procedures.
A significant advantage of allowing CXL treatment at the slit lamp is that CXL technology can now be used in clinics that do not have easy access to an operating room infrastructure. Slit-lamp CXL can also reduce procedure costs by eliminating the technical fees related to the use of an operating room, making this treatment not only more accessible for patients, but also affordable. [J Refract Surg. 2021;37(2):78-82.].
描述一种新的手术技术，即在裂隙灯前让患者保持坐姿时即可进行角膜交联（CXL）（用于治疗角膜扩张）和光激活染色质用于角膜炎-CXL（PACK-CXL）。
在术前 10 分钟于等候室进行表面麻醉。一旦进入办公室或治疗室，用氯霉素对眼睑和眶周区域进行消毒，然后让患者坐在裂隙灯前。用蘸有新鲜制备的 40%乙醇的棉签进行上皮清创，用 70 秒的轻敲，然后轻轻施压去除上皮。患者仰卧位接受 10 分钟的核黄素滴注。在 5 分钟和 10 分钟后使用超声角膜测厚仪评估基质厚度。最后，让患者返回裂隙灯接受紫外线照射。
裂隙灯处的 CXL 是一种易于实施的技术，可大大减少进行 CXL 和 PACK-CXL 程序所需的基础设施。
允许在裂隙灯处进行 CXL 治疗的一个显著优势是，现在 CXL 技术可用于那些不易获得手术室基础设施的诊所。裂隙灯 CXL 还可以通过消除与使用手术室相关的技术费用来降低手术费用，使这种治疗不仅对患者更容易获得，而且负担得起。[J Refract Surg. 2021;37(2):78-82.]。
