进行性圆锥角膜中“去上皮”加速与“去上皮”标准角膜胶原交联-UVA的比较结果——7年随访
Comparative Results Between "Epi-Off" Accelerated and "Epi-Off" Standard Corneal Collagen Crosslinking-UVA in Progressive Keratoconus - 7 Years of Follow-Up.
作者信息
Nicula Cristina Ariadna, Rednik Anca Maria, Nicula Ariadna Patricia, Bulboaca Adriana Elena, Nicula Dorin, Horvath Karin Ursula
机构信息
Department of Ophthalmology, Medicine and Pharmacy University "Iuliu Hațieganu", Cluj-Napoca, Romania.
Oculens Clinic, Cluj-Napoca, Romania.
出版信息
Ther Clin Risk Manag. 2021 Sep 7;17:975-988. doi: 10.2147/TCRM.S321410. eCollection 2021.
PURPOSE
The purpose of the present study was to assess the long-term efficiency and safety of the "epi-off" accelerated CXL (9 mW/cm for 10 minutes) in comparison to the standard "epi-off" CXL (3 mW/cm for 30 minutes) in terms of topographical and keratometric parameters, refractive data and visual outcomes at 7 years of follow-up, in progressive keratoconus.
MATERIAL AND METHOD
A retrospective and comparative study was performed. A total of 183 eyes from 183 patients with documented progressive keratoconus were included in the study. The patients were divided in two groups: 93 eyes from 93 patients underwent "epi-off" standard cross-linking technique (3 mW/cm for 30 minutes) (S-CXL group) and 90 eyes from 90 patients underwent accelerated "epi-off" corneal CXL technique (9 mW/cm for 10 minutes) (A-CXL group).
RESULTS
Improvements in uncorrected distance visual acuity (UDVA) were statistically significant compared to baseline values in both groups at each time-point visit (=0.0421 at 1 year, =0.0411 at 7 years for A-CXL and =0.0375 at 1 year, =0.0389 at 7 years for S-CXL). At 7 years there was a statistically significant increase in CDVA (=0.039 in the A-CXL group and =0.0343 in the S-CXL group at 7 years). Statistically significant reduction was noticed in Ksteep (=0.0411 in A-CXL group and =0.0224 in S-CXL group), Kflat (=0.0198 in A-CXL group and =0.008 in S-CXL group), K mean (=0.0106 in A-CXL group and =0.0193 in S-CXL group) and Kmax (=0.0413 in A-CXL group and =0.054 in S-CXL group) at 7 years, compared to baseline values, in both groups, but without any statistically difference between the two procedures, at all time-point visits (>0.05).
CONCLUSION
The long-term outcomes of "epi-off" accelerated corneal collagen crosslinking-UVA (9 mW/cm for 10 minutes) are similar to standard "epi-off" corneal collagen crosslinking procedure in the treatment of progressive keratoconus.
目的
本研究旨在比较“去上皮”加速角膜交联（9毫瓦/平方厘米，持续10分钟）与标准“去上皮”角膜交联（3毫瓦/平方厘米，持续30分钟）在治疗进展性圆锥角膜方面，随访7年时的地形学和角膜曲率参数、屈光数据及视觉效果的长期有效性和安全性。
材料与方法
进行了一项回顾性对比研究。研究纳入了183例有记录的进展性圆锥角膜患者的183只眼。患者被分为两组：93例患者的93只眼接受“去上皮”标准交联技术（3毫瓦/平方厘米，持续30分钟）（S-CXL组），90例患者的90只眼接受加速“去上皮”角膜交联技术（9毫瓦/平方厘米，持续10分钟）（A-CXL组）。
结果
两组在每次随访时间点的未矫正远视力（UDVA）较基线值均有统计学显著改善（A-CXL组1年时P = 0.0421，7年时P = 0.0411；S-CXL组1年时P = 0.0375，7年时P = 0.0389）。7年时，最佳矫正远视力（CDVA）有统计学显著提高（A-CXL组7年时P = 0.039；S-CXL组7年时P = 0.0343）。两组在7年时，与基线值相比，角膜最陡曲率（Ksteep）（A-CXL组P = 0.0411，S-CXL组P = 0.0224）、角膜最平曲率（Kflat）（A-CXL组P = 0.0198，S-CXL组P = 0.008）、平均角膜曲率（K mean）（A-CXL组P = 0.0106，S-CXL组P = 0.0193）和最大角膜曲率（Kmax）（A-CXL组P = 0.0413，S-CXL组P = 0.054）均有统计学显著降低，但在所有随访时间点，两种手术方式之间均无统计学差异（P>0.05）。
结论
“去上皮”加速角膜胶原交联-UVA（9毫瓦/平方厘米，持续10分钟）治疗进展性圆锥角膜的长期效果与标准“去上皮”角膜胶原交联手术相似。
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