Lang Stefan J, Maier Philip, Reinhard Thomas
Klin Monbl Augenheilkd. 2021 Jun;238(6):733-747. doi: 10.1055/a-1472-0411. Epub 2021 Apr 19.
Keratoconus leads to a progressive protrusion and thinning of the cornea. In order to stop this, corneal crosslinking can be performed if the progression of the disease is proven. Crosslinking according to the "Dresden protocol" includes abrasion of the corneal epithelium, application of riboflavin eye drops and irradiation with UV-A light of an intensity of 3 mW/cm² for 30 minutes. The efficacy has been shown in several prospective randomized studies. One of the more recent developments is accelerated crosslinking, which allows a shorter irradiation time. On the other hand, the possibility of transepithelial crosslinking was presented, which does not require an abrasion of the cornea. This should reduce the occurrence of postoperative pain. The range of indications has also been expanded. Corneal crosslinking is used for post-LASIK keratectasia as well. It is also being considered for use in infectious keratitis. Topographically controlled crosslinking can likewise be used to try to positively influence the refractive power of the cornea. The risks of crosslinking include the occurrence of pain, haze or scarring, endothelial cell damage and, rarely, the occurrence of keratitis.
圆锥角膜会导致角膜逐渐突出和变薄。为了阻止这种情况，如果疾病进展得到证实，可以进行角膜交联。按照“德累斯顿方案”进行的交联包括角膜上皮擦除、应用核黄素滴眼液以及用强度为3毫瓦/平方厘米的紫外线A光照射30分钟。其疗效已在多项前瞻性随机研究中得到证实。最近的进展之一是加速交联，它可以缩短照射时间。另一方面，提出了经上皮交联的可能性，这种方法不需要角膜擦除。这应该会减少术后疼痛的发生。适应证范围也有所扩大。角膜交联也用于准分子激光原位角膜磨镶术（LASIK）后的角膜扩张。它也被考虑用于感染性角膜炎。地形学控制的交联同样可用于试图积极影响角膜的屈光力。交联的风险包括疼痛、 haze或瘢痕形成、内皮细胞损伤，以及罕见的角膜炎发生。
