Krolo Iva, Kasumović Aida, Matoc Ines, Sabol Ivan, Radman Ivana, Ratković Mirko
University Department of Ophthalmology, University Hospital Center Sestre milosrdnice, Vinogradska cesta 29, 10 000 Zagreb, Croatia.
University Department of Ophthalmology, University Hospital Center Sestre milosrdnice, Vinogradska cesta 29, 10 000 Zagreb, Croatia.
J Optom. 2023 Jan-Mar;16(1):74-80. doi: 10.1016/j.optom.2021.09.002. Epub 2021 Oct 15.
The aim of this study was to analyse the postoperative corneal cross-linking results of corneal parameters and the ABCD grading system, depending on the cone location.
Thirty eyes of 25 patients with keratoconus (KC), who received the corneal cross-linking (CXL) treatment, were included in this study. The exclusion criteria were: patients under 18 years of age, corneal pachymetry less than 400 μm, corneal scarring, history of ocular trauma, history of ocular surgery, and corneal pathology other than KC. Patients were examined at the baseline visit, and followed-up at three, six, and twelve months after the CXL. All patients underwent visual acuity and Scheimpflug tomography at all visits. Progression parameters, keratometries, and ABCD grading were compared between the visits. Patients were classified into two groups: central and paracentral cones group (within the central 5 mm corneal zone) and peripheral cones group (outside the central 5 mm corneal zone), based on X-Y coordinates of maximal keratometry (Kmax).
Parameter A remained relatively stable throughout the follow-up period in both groups. Parameter B and parameter C showed a significant increase in both groups postoperatively. Parameter D showed stability at the 6-month post-CXL visit in the peripheral KC group, while the central and paracentral KC group showed improvement at the 12-month post-CXL visit.
There was no significant difference in the postoperative response between different cone locations in the ABCD grading system, when classifying according to the Kmax, except an earlier recovery of the parameter D in peripherally located cones.
本研究旨在根据圆锥角膜的位置,分析角膜交联术后角膜参数及ABCD分级系统的结果。
本研究纳入了25例接受角膜交联(CXL)治疗的圆锥角膜(KC)患者的30只眼。排除标准为:年龄小于18岁、角膜厚度小于400μm、角膜瘢痕、眼外伤史、眼部手术史以及除KC以外的角膜病变。患者在基线检查时进行检查,并在CXL术后3个月、6个月和12个月进行随访。所有患者在每次就诊时均进行视力检查和眼前节光学相干断层扫描。比较各次就诊之间的进展参数、角膜曲率测量值和ABCD分级。根据最大角膜曲率(Kmax)的X-Y坐标,将患者分为两组:中央和旁中央圆锥角膜组(在中央5mm角膜区域内)和周边圆锥角膜组(在中央5mm角膜区域外)。
两组在整个随访期间参数A均保持相对稳定。参数B和参数C在两组术后均显著增加。参数D在周边KC组CXL术后6个月时保持稳定,而中央和旁中央KC组在CXL术后12个月时有所改善。
在根据Kmax进行分类时,ABCD分级系统中不同圆锥角膜位置的术后反应无显著差异,只是周边圆锥角膜的参数D恢复较早。