Honorary Clinical Lecturer at Tishreen University, Scientific Director of Tratous Specialist Eye Center(Tartous, Syria), Lattakia, Syrian Arab Republic.
Department of Ophthalmology, 37585Tishreen University, Latakia, Syria.
Eur J Ophthalmol. 2022 Jan;32(1):50-58. doi: 10.1177/11206721211052878. Epub 2021 Oct 30.
To evaluate the long-term outcomes of corneal cross-linking (CXL) in patients with progressive keratoconus.
In this retrospective non-comparative study, forty-five eyes of 31 patients with progressive keratoconus were treated with 30 min "epi-off" corneal cross-linking. The visual, refractive, topographic and tomographic outcomes were evaluated preoperatively and at least 10 years after cross-linking.
Ten years post-corneal cross-linking, the mean anterior maximum keratometry decreased (-2.10 ± 3.25 D, P = 0.0001). Conversely, the posterior maximum keratometry increased (6.38 ± 9.79 D, P = 0.065). Both uncorrected and corrected distance visual acuity improved (LogMAR -0.08 ± 0.30) and (LogMAR -0.05 ± 0.21), respectively (P > 0.05, both). A statistically significant hyperopic shift was observed postoperatively (0.70 ± 1.31 D, P = 0.0009). The anterior topographic cylinder values revealed no change (-0.17 ± 1.31 D, P = 0.3), whereas the mean posterior cylinder values decreased (absolute value increased) significantly compared to baseline from -1.31 ± 0.97 D to -1.82 ± 1.78 D, (P < 0.05). The minimum corneal thickness values decreased significantly (-35.11 ± 48.63 µm, P = 0.0001). Four eyes (8.8%) showed more than 1 D increase in the anterior maximum keratometry.
This protocol and duration of Epi-off corneal cross-linking was found to be effective in halting keratoconus progression over the follow up period (10 years). Anterior corneal flattening and a hyperopic shift were observed. A statistically significant increase in the posterior corneal cylinder was observed. Although, not reaching statistical significance, the logMAR uncorrected and corrected visual acuity were improved.
评估角膜交联术（CXL）治疗进展性圆锥角膜的长期疗效。
本回顾性非对照研究纳入 31 例（45 只眼）进展性圆锥角膜患者，接受 30 分钟“ epi-off”角膜交联术。术前及交联术后至少 10 年，评估患者的视力、屈光、地形图和断层扫描结果。
交联术后 10 年，平均前角膜最大曲率下降（-2.10±3.25 D，P=0.0001），而后角膜最大曲率增加（6.38±9.79 D，P=0.065）。未矫正和矫正距离视力分别提高（LogMAR 0.08±0.30 和 0.05±0.21，均 P>0.05）。术后观察到明显的远视漂移（0.70±1.31 D，P=0.0009）。前角膜地形图柱值无变化（-0.17±1.31 D，P=0.3），而后角膜平均柱值明显降低（绝对值增加），从基线的-1.31±0.97 D 降至-1.82±1.78 D（P<0.05）。角膜最薄点值明显降低（-35.11±48.63 μm，P=0.0001）。4 只眼（8.8%）前角膜最大曲率增加超过 1 D。
本研究方案和 Epi-off 角膜交联术的持续时间被发现可有效阻止圆锥角膜在随访期间（10 年）的进展。观察到前角膜变平和远视漂移，后角膜柱增加有统计学意义。虽然未达到统计学意义，但 logMAR 未矫正和矫正视力有所提高。
