交联术后中央、旁中央和周边区角膜锥状细胞变扁平：一项多中心研究。

Flattening of Central, Paracentral, and Peripheral Cones After Non-accelerated and Accelerated Epithelium-off CXL in Keratoconus: A Multicenter Study.

出版信息

J Refract Surg. 2022 May;38(5):310-316. doi: 10.3928/1081597X-20220404-02. Epub 2022 May 1.

DOI:10.3928/1081597X-20220404-02

Abstract

PURPOSE

To assess the flattening of central, paracentral, and peripheral cones following non-accelerated (non-A-CXL) and accelerated (A-CXL) epithelium-off corneal cross-linking with 10 times higher intensity.

METHODS

In this multicenter study of 200 eyes (100 in each group), following 10 minutes of soak time with riboflavin 0.1%, continuous CXL was performed for 30 minutes (intensity: 3 mW/cm, fluence: 5.4 J/cm) in the non-A-CXL group and 3 minutes (intensity: 30 mW/cm, fluence: 5.4 J/cm) in the A-CXL group. Anterior and posterior cone flattening were compared at 12 months. Multiple regression analysis was performed to establish correlation of age, sex, cone location, and preoperative maximum keratometry (Kmax) values with postoperative flattening at 12 months.

RESULTS

In the non-A-CXL and A-CXL groups, central cones were the steepest, followed by paracentral and peripheral cones. Both groups showed significant flattening in central (1.54 ± 1.94 and 1.09 ± 1.79 diopters [D]) and paracentral (0.62 ± 1.59 and 0.55 ± 0.98 D) cones only. In the non-A-CXL group, there was a positive correlation between postoperative flattening and preoperative Kmax values, whereas paracentral and peripheral cone locations were negatively related. In the A-CXL group, only paracentral location was negatively correlated to postoperative flattening and showed posterior cone steepening at 12 months.

CONCLUSIONS

Although central cones were the steepest in both groups, there was no difference in postoperative flattening between the groups for all cone locations. In the non-A-CXL group, postoperative flattening was proportional to preoperative Kmax values in central cones and was less with paracentral and peripheral locations. With A-CXL, postoperative flattening was less only with paracentral location. In the A-CXL group, significant posterior cone steepening was noticed only in paracentral cones. .

摘要

目的

评估非加速（非 A-CXL）和加速（A-CXL）上皮下角膜交联后中央、旁中央和周边锥体的变平情况，强度提高 10 倍。

方法

在这项多中心研究中，200 只眼睛（每组 100 只），用核黄素 0.1%浸泡 10 分钟后，非 A-CXL 组连续交联 30 分钟（强度：3 mW/cm，辐照量：5.4 J/cm），A-CXL 组交联 3 分钟（强度：30 mW/cm，辐照量：5.4 J/cm）。比较 12 个月时的前、后锥体变平情况。采用多元回归分析，确定年龄、性别、锥体位置和术前最大角膜曲率（Kmax）值与术后 12 个月时的变平程度的相关性。

结果

在非 A-CXL 和 A-CXL 组中，中央锥体最陡峭，其次是旁中央和周边锥体。两组中央（1.54±1.94 和 1.09±1.79 屈光度[D]）和旁中央（0.62±1.59 和 0.55±0.98 D）锥体均出现显著变平。在非 A-CXL 组中，术后变平与术前 Kmax 值呈正相关，而旁中央和周边锥体位置呈负相关。在 A-CXL 组中，只有旁中央位置与术后变平呈负相关，并在 12 个月时出现后锥体变陡峭。