Department of Ophthalmology, Zagreb University Hospital Center, 10000 Zagreb, Croatia.
School of Medicine, University of Zagreb, Šalata 2, 10000 Zagreb, Croatia.
Medicina (Kaunas). 2023 May 28;59(6):1043. doi: 10.3390/medicina59061043.
: To determine the 6-month effect of conventional (CXL30) and accelerated cross-linking with a UVA intensity of 9 mW/cm (CXL10) on corneal stability and to investigate whether there was a difference in ABCD grading system parameters regarding the two different procedures. : Twenty-eight eyes of 28 patients with a documented keratoconus (KN) progression were included. Patients were selected to undergo either epi off CXL30 or CXL10. At the baseline and the follow-up visits after one (V1), three (V2), and six months (V3), the patients underwent complete ophthalmic examination and corneal tomography. : In the CXL30 group, all the parameters from the ABCD grading system significantly changed from baseline to V3; parameter A decreased ( = 0.048), B and C increased ( = 0.010, < 0.001), and D decreased ( < 0.001). In the CXL10 group, there were no changes in parameters A ( = 0.247) and B ( = 0.933), though parameter C increased ( = 0.001) and D decreased ( < 0.001). After an initial decline after one month, visual acuity (VA) recovered on V2 and V3 ( < 0.001), and median maximal keratometry (Kmax) decreased in both groups ( = 0.001, = 0.035). In the CXL30 group, there were significant changes in other parameters; average pachymetric progression index ( < 0.001), Ambrósio relational thickness maximum (ARTmax) ( = 0.008), front and back mean keratometry ( < 0.001), pachymetry apex (PA) ( < 0.001), and front elevation ( = 0.042). However, in the CXL10 group, there were significant changes only in ARTmax ( = 0.019) and PA ( < 0.001). : Both epi-off CXL protocols showed similar short-term efficacy in improving VA and Kmax, halting the progression of KN, and both similarly changed tomographic parameters. However, the conventional protocol modified the cornea more significantly.
: 目的：评估传统交联（CXL30）和 9 mW/cm2 紫外线强度加速交联（CXL10）对角膜稳定性的 6 个月效果，并研究两种不同程序的 ABCD 分级系统参数是否存在差异。: 纳入 28 例进展性圆锥角膜（KN）患者的 28 只眼。患者入选接受离上皮 CXL30 或 CXL10。在基线和第 1、3、6 个月随访（V1、V2、V3）时，患者接受全面眼科检查和角膜断层扫描。: 在 CXL30 组，ABCD 分级系统的所有参数均从基线至 V3 显著改变；参数 A 降低（ = 0.048），参数 B 和 C 增加（ = 0.010，<0.001），参数 D 降低（<0.001）。在 CXL10 组，参数 A（ = 0.247）和 B（ = 0.933）无变化，参数 C 增加（ = 0.001），参数 D 降低（<0.001）。在术后第 1 个月视力（VA）下降后恢复，V2 和 V3 时 VA 增加（<0.001），两组最大角膜曲率（Kmax）中位数降低（ = 0.001， = 0.035）。在 CXL30 组，其他参数显著改变；平均角膜厚度进展指数（<0.001）、Ambrósio 相关厚度最大（ARTmax）（ = 0.008）、前、后平均角膜曲率（<0.001）、角膜顶点厚度（PA）（<0.001）和前突（ = 0.042）。然而，在 CXL10 组，仅 ARTmax（ = 0.019）和 PA（<0.001）显著改变。: 两种离上皮 CXL 方案在提高 VA 和 Kmax、阻止 KN 进展方面显示出相似的短期疗效，且同样改变了角膜地形图参数。然而，传统方案对角膜的改变更显著。
