经上皮角膜交联术治疗最大角膜曲率值大于 58 屈光度的圆锥角膜眼。

Transepithelial accelerated corneal crosslinking for keratoconus eyes with maximum keratometry values larger than 58 diopters.

机构信息

From the Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China (Sun, Zhao, Zhang, Shen, Tian, Zhou); NHC Key Laboratory of Myopia, Fudan University, Shanghai, China (Sun, Zhao, Zhang, Shen, Tian, Zhou); Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China (Sun, Zhao, Zhang, Shen, Tian, Zhou).

出版信息

J Cataract Refract Surg. 2022 Feb 1;48(2):208-214. doi: 10.1097/j.jcrs.0000000000000733.

DOI:10.1097/j.jcrs.0000000000000733

PMID:34288636

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8845528/

Abstract

PURPOSE

To evaluate the safety and efficacy of transepithelial accelerated corneal crosslinking (CXL) for advanced keratoconus eyes with maximum keratometry (Kmax) values >58 diopters (D).

SETTING

Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China.

DESIGN

Prospective parallel control study.

METHODS

41 keratoconus eyes from 41 patients (mean age, 21.93 ± 5.48 years) who underwent transepithelial accelerated CXL were included prospectively. The enrolled eyes were divided into 2 groups according to their Kmax values (Group A, Kmax ≥58.0 D; Group B, Kmax <58.0 D). The examinations including assessment of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), corneal topography, and corneal endothelial cell density count were conducted preoperatively, at 1 day, 1 month, 3 months, 6 months, and 1 year postoperatively.

RESULTS

All 41 eyes finished 1 year follow-up. No statistical difference was noted between the mean UDVA and CDVA in both groups throughout the follow-up duration. At 1-year postoperative follow-up, the CDVA increased by ≥2 lines in 45% (9/20) and 28.6% (6/21) eyes in Groups A and B, respectively. The mean preoperative Kmax in Groups A and B were 62.51 ± 3.34 D and 49.98 ± 4.32 D, respectively, and that at postoperative 1-year follow-up were 61.94 ± 4.11 D and 50.24 ± 4.72 D, respectively. The Kmax values of 30% (6/20) eyes in Group A and 4.8% (1/21) eyes in Group B decreased by more than 1 D. Deduction of flat K, steep K, mean K, and Kmax showed no significant difference between the 2 groups at 1-year postoperative follow-up. Moreover, 20% (4/20) and 23.8% (5/21) of eyes in Groups A and B, respectively, showed progress at postoperative 1-year follow-up.

CONCLUSIONS

Transepithelial accelerated CXL can safely treat advanced keratoconus eyes with Kmax values ≥58.0 D with some extent of efficacy and has similar progressive rate as Kmax values <58.0 D.

摘要

目的

评估经上皮加速角膜交联（CXL）治疗最大角膜曲率（Kmax）值>58 屈光度（D）的晚期圆锥角膜眼的安全性和疗效。

设置

复旦大学附属眼耳鼻喉科医院眼科，中国上海。

设计

前瞻性平行对照研究。

方法

前瞻性纳入 41 例（41 只眼）接受经上皮加速 CXL 的圆锥角膜患者，患者平均年龄 21.93±5.48 岁。根据 Kmax 值将纳入的眼分为 2 组（A 组，Kmax≥58.0 D；B 组，Kmax<58.0 D）。术前、术后 1 天、1 个月、3 个月、6 个月和 1 年分别进行未矫正距离视力（UDVA）、矫正距离视力（CDVA）、角膜地形图和角膜内皮细胞密度检查。

结果

41 只眼均完成 1 年随访。2 组患者在整个随访期间的平均 UDVA 和 CDVA 均无统计学差异。术后 1 年随访时，A 组和 B 组分别有 45%（9/20）和 28.6%（6/21）的眼 CDVA 提高≥2 行。A 组和 B 组术前平均 Kmax 分别为 62.51±3.34 D 和 49.98±4.32 D，术后 1 年随访时分别为 61.94±4.11 D 和 50.24±4.72 D。A 组 30%（6/20）的眼 Kmax 值下降超过 1 D，B 组 4.8%（1/21）的眼 Kmax 值下降超过 1 D。术后 1 年随访时，2 组间扁平 K、陡峭 K、平均 K 和 Kmax 的降低无统计学差异。此外，A 组和 B 组分别有 20%（4/20）和 23.8%（5/21）的眼在术后 1 年随访时出现进展。