Abdel-Radi Mahmoud, Anwar Mohamed, Aly Momen Ahmad Mohammad, Eata Wael El Shazly, Goda Islam
Department of Ophthalmology, Assiut University, Assiut, Egypt; and.
Department of Ophthalmology, South Valley University, Qena, Egypt.
Cornea. 2024 Nov 15. doi: 10.1097/ICO.0000000000003756.
To investigate the effectiveness and safety of accelerated epithelium-on crosslinking to stabilize tomographically suspicious fellow eyes of young patients with unilateral clinically evident keratoconus (KC) compared with observation alone.
This retrospective observational study included 43 fellow eyes of 43 young patients with unilateral clinically evident KC who completed a 24-month follow-up. Twenty-four eyes underwent accelerated epithelium-on crosslinking [epi-on corneal crosslinking (CXL) group] and 19 eyes were observed (observation group). A third healthy control group was added for comparison. The primary outcome measures were tomographic parameters and topometric indices assessed by pentacam. Secondary outcome measures included corneal ectatic progression defined as 1-diopter or more increase in maximum or steep keratometry (Kmax or K2), visual & refractive outcomes, and complications.
Baseline demographic and tomographic characteristics were similar between the epi-on CXL and observation groups (P > 0.05). Almost all mean tomographic parameters and topometric indices showed insignificant differences between baseline and after 24 months in the epi-on CXL and control groups (P > 0.05), whereas a significant progression was documented in the observation group (P < 0.05). At the end of the follow-up, progression was documented in 1 eye (4.2%) and in 8 eyes (42.1%) in the epi-on CXL and observation groups, respectively. Visual and refractive outcomes were more favorable in the epi-on CXL group. No significant complications were reported after accelerated epi-on CXL.
Accelerated epithelium-on CXL was safe and achieved better tomographic stability and less corneal ectatic progression in tomographically suspicious fellow eyes of young patients with unilateral clinically evident keratoconus compared with observation alone.
研究与单纯观察相比，加速上皮下交联术用于稳定年轻单侧临床诊断为圆锥角膜（KC）患者的断层扫描可疑对侧眼的有效性和安全性。
这项回顾性观察研究纳入了43例年轻单侧临床诊断为KC患者的43只对侧眼，这些患者均完成了24个月的随访。24只眼接受了加速上皮下交联术（上皮下角膜交联术[epi-on CXL]组），19只眼进行观察（观察组）。增加了一个健康对照组进行比较。主要观察指标是通过Pentacam评估的断层扫描参数和角膜地形图指数。次要观察指标包括角膜扩张进展，定义为最大或最陡角膜曲率（Kmax或K2）增加1屈光度或更多、视力和屈光结果以及并发症。
上皮下CXL组和观察组之间的基线人口统计学和断层扫描特征相似（P>0.05）。上皮下CXL组和对照组中，几乎所有平均断层扫描参数和角膜地形图指数在基线和24个月后差异均无统计学意义（P>0.05），而观察组有显著进展（P<0.05）。随访结束时，上皮下CXL组和观察组分别有1只眼（4.2%）和8只眼（42.1%）出现进展。上皮下CXL组的视力和屈光结果更好。加速上皮下CXL术后未报告明显并发症。
与单纯观察相比，加速上皮下CXL术对于年轻单侧临床诊断为圆锥角膜患者的断层扫描可疑对侧眼是安全的，并且能实现更好的断层扫描稳定性和更少的角膜扩张进展。
