Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
MVZ Prof. Neuhann, Munich, Germany.
Cornea. 2024 Nov 1;43(11):1397-1402. doi: 10.1097/ICO.0000000000003478. Epub 2024 Jan 30.
We evaluated the timing at and extent to which midterm to long-term keratometric changes can occur in year 1 to 7 after corneal collagen cross-linking (CXL) in patients with keratoconus.
We conducted a subgroup analysis of a retrospective cohort study of all consecutive patients who underwent CXL at our cornea center between 2007 and 2011. The inclusion criteria comprised CXL according to the Dresden protocol and a full set of keratometry parameters collected by Scheimpflug tomography preoperatively and at year 1, 3, 5, and 7 after CXL. In addition, best-corrected visual acuity was evaluated.
Sixty-three eyes of 47 patients were enrolled. Mean age was 25.46 years ±7.39 years (80.9% male patients). All relevant keratometric parameters showed significant improvement at year 1 after CXL (except for posterior astigmatism). According to mixed-effects model analysis, they all showed further significant change at different points in time between year 1, 3, 5, and 7 (except for K1). In addition, best-corrected visual acuity improved statistically significant between year 1, 3, 5, and 7. Suspected disease progression was noted in 22.2% of patients, mostly between year 1 and 3 after CXL.
After initial improvement 1 year after CXL, keratometric and functional parameters were stable until year 5 after CXL in most cases; further improvement can take place even after up to 7 years post-CXL. By contrast, in case of disease progression, changes seem to occur already between year 1 and 3 after CXL.
评估在角膜交联术(CXL)后 1 至 7 年内,圆锥角膜患者的中期至长期角膜曲率变化发生的时间和程度。
我们对 2007 年至 2011 年期间在我们角膜中心接受 CXL 的所有连续患者的回顾性队列研究进行了亚组分析。纳入标准包括根据德累斯顿方案进行 CXL 和术前及术后 1 年、3 年、5 年和 7 年收集的全套角膜曲率参数。此外,还评估了最佳矫正视力。
47 例患者的 63 只眼被纳入研究。平均年龄为 25.46 岁±7.39 岁(80.9%为男性患者)。所有相关的角膜曲率参数在 CXL 后 1 年均显示出显著改善(后表面散光除外)。根据混合效应模型分析,它们在 1 年、3 年、5 年和 7 年之间的不同时间点均显示出进一步的显著变化(K1 除外)。此外,最佳矫正视力在 1 年、3 年、5 年和 7 年之间均有统计学显著改善。在 22.2%的患者中发现疑似疾病进展,主要发生在 CXL 后 1 年至 3 年之间。
在 CXL 后 1 年初始改善后,大多数情况下,角膜曲率和功能参数在 5 年之前保持稳定;即使在 CXL 后 7 年,仍可能进一步改善。相比之下,如果发生疾病进展,变化似乎已经在 CXL 后 1 年至 3 年之间发生。