Department of Ophthalmology and Visual Sciences, Faculty of Medicine, University of Balamand, Lebanon, Advanced Eye Care Hospital, Lebanon.
Middle East Afr J Ophthalmol. 2023 Nov 21;29(4):186-189. doi: 10.4103/meajo.meajo_314_21. eCollection 2022 Oct-Dec.
The purpose of this study was to evaluate the outcome of patients presenting with mild-to-moderate corneal haze after undergoing corneal collagen cross-linking (CXL) for keratoconus (KCN) and their response to a proposed standardized topical steroid-based treatment.
This study included 19 eyes of 14 patients presenting with corneal haze after undergoing CXL for KCN. Corrected distance visual acuity, corneal thickness and Kmax values by Pentacam Scheimpflug tomography, as well as subjective corneal haze changes were evaluated before and after a topical steroid- and cyclosporine-based treatment.
Visual acuity improved after the completion of the treatment by 0.043 logMAR ( = 0.017) and Kmax values decreased by 1.17D ( = 0.0024), while the corneal thinnest pachymetry remained stable. Data collected from the examiner's slit-lamp examination description revealed that seven eyes had a decrease in haze compared to 12 eyes with stable or no changes in the haze.
Our findings suggest an improvement in visual acuity and possible corneal flattening with decreasing Kmax after the completion of topical steroids with taper course treatment in patients suffering from corneal haze post-CXL. This paper also highlights the importance of postcross-linking anti-inflammatory treatment and close follow-up.
本研究旨在评估行角膜交联术(CXL)治疗圆锥角膜(KCN)后出现轻至中度角膜混浊患者的治疗效果,并评估其对拟议的标准化局部皮质类固醇治疗的反应。
本研究纳入了 14 例 19 只眼,这些患者均在接受 CXL 治疗 KCN 后出现了角膜混浊。通过 Pentacam 眼前节断层扫描仪评估治疗前后的视力矫正值、角膜厚度和 Kmax 值,以及主观角膜混浊变化。同时还评估了局部皮质类固醇和环孢素治疗后的变化。
治疗结束后,视力矫正值提高了 0.043 logMAR(=0.017),Kmax 值降低了 1.17D(=0.0024),而角膜最薄的厚度保持稳定。裂隙灯检查描述显示,7 只眼的混浊程度减轻,12 只眼的混浊程度稳定或无变化。
我们的研究结果表明,在接受局部皮质类固醇药物治疗并逐渐减量后,患者的视力矫正值提高,角膜变得更加平坦,Kmax 值可能降低。这表明在 CXL 后进行抗炎治疗和密切随访非常重要。