角膜交联术治疗进展性圆锥角膜患者的成功回归。

Successful Regression in Patients with Progressive Keratoconus by Corneal Crosslinking.

机构信息

Department für Augenheilkunde, Universitäts-Augenklinik, Eberhard-Karls-Universität Tübingen, Deutschland.

Abteilung für Allgemeinmedizin, Ruhr-Universität Bochum, Deutschland.

出版信息

Klin Monbl Augenheilkd. 2021 Nov;238(11):1229-1235. doi: 10.1055/a-1264-7928. Epub 2021 Feb 19.

DOI:10.1055/a-1264-7928

PMID:33607693

Abstract

BACKGROUND

Since 2019, corneal collagen crosslinking (CXL) is included in the catalog of procedures covered by statutory health insurance in Germany. CXL is an established ophthalmological procedure for the last 20 years. The aim of this investigation was the measurement of progression before and after CXL.

MATERIAL UND METHODS

65 consecutive eyes with progressive keratoconus from 53 patients were included in the retrospective study, which were observed at the University Eye Hospital Tübingen at least two years before and at least two years after CXL. The time of observation took place from October 2009 until March 2018. Parameters of interest had been the best corrected visual acuity (BCVA) and the keratometric values from the elevation maps measured by a Scheimpflug camera.

RESULTS

65 eyes of 53 patients had been documented. The study population included 46 (86.8%) male and 7 (13.2%) female subjects. The mean age was 24 ± 8 years. The averaged observation time between the primary consultation and CXL showed 25 ± 15 months. Preoperatively the mean BCVA pointed out in a significant increase (0.13 ± 0.17 [first visit] vs. 0.23 ± 0.22 [preOP], p < 0.0001) while the mean Kmax resulted in a statistically significant increase (46.34 ± 3.33 dpt [first visit] vs. 48.78 ± 4.17 dpt [preOP], p < 0.0001). The mean thinnest point of the cornea showed a significant decrease (490.48 ± 34.23 µm [first visit] vs. 468.62 ± 29.84 µm [preop], p < 0.0001). Postoperatively the mean BCVA resulted in a significant improvement at the 12th postoperative month in comparison to the preoperative measurement (0.23 ± 0.22 [preOP] vs. 0.16 ± 0.14 [12 months], p = 0.04 respectively 0.17 ± 0.17 [24 months], p = 0.0006). The mean Kmax demonstrated in the 12th postoperative month a significant reduction (48.78 ± 4.17 dpt [preOP] vs. 47.91 ± 3.41 dpt [12 months], p = 0.0009 respectively 48 ± 4.56 dpt [24 months], p = 0.0051). The mean thinnest point of the cornea indicated a decrease at the 12th postoperative month (468.62 ± 29.84 µm [preOP] vs. 459.82 ± 35.88 µm [12 months], p = 0.0078 respectively 453.47 ± 43.39 µm [24 months], p = 0.0227).

CONCLUSION

CXL is a successful procedure for the therapy of progressive keratoconus.

摘要

背景

自 2019 年以来，角膜胶原交联（CXL）已被纳入德国法定健康保险涵盖的程序目录。CXL 是一种已确立的眼科手术，已有 20 年的历史。本研究的目的是测量交联前后的进展情况。

材料和方法

回顾性研究共纳入 53 例患者的 65 只连续进行性圆锥角膜眼，在图宾根大学眼科医院至少观察 2 年，CXL 前后至少 2 年。观察时间为 2009 年 10 月至 2018 年 3 月。感兴趣的参数包括最佳矫正视力（BCVA）和通过 Scheimpflug 相机测量的角膜高度图的角膜屈光度。

结果

共记录了 65 只眼睛 53 例患者。研究人群包括 46 名（86.8%）男性和 7 名（13.2%）女性受试者。平均年龄为 24±8 岁。在初次就诊和 CXL 之间的平均观察时间为 25±15 个月。术前平均 BCVA 明显增加（0.13±0.17[初次就诊]与 0.23±0.22[术前]，p<0.0001），而平均 Kmax 则呈统计学意义增加（46.34±3.33 dpt[初次就诊]与 48.78±4.17 dpt[术前]，p<0.0001）。角膜最薄点明显减少（490.48±34.23 µm[初次就诊]与 468.62±29.84 µm[术前]，p<0.0001）。术后第 12 个月，平均 BCVA 与术前测量相比有显著改善（0.23±0.22[术前]与 0.16±0.14[12 个月]，p=0.04；0.17±0.17[24 个月]，p=0.0006）。第 12 个月时平均 Kmax 显著降低（48.78±4.17 dpt[术前]与 47.91±3.41 dpt[12 个月]，p=0.0009；48±4.56 dpt[24 个月]，p=0.0051）。角膜最薄点在术后第 12 个月也有所下降（468.62±29.84 µm[术前]与 459.82±35.88 µm[12 个月]，p=0.0078；453.47±43.39 µm[24 个月]，p=0.0227）。