Taheri Nazli, Lotfi Sadigh Afshin, Abed Nikmanesh Salar, Tarkavani Amir, Ghodraty Peyman, Arasteh Amin, Attar Gharamaleki Tahereh
Department of Ophthalmology, Nikookari Eye Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Ophthalmol. 2025 Mar 18;25(1):141. doi: 10.1186/s12886-025-03968-2.
This study aims to evaluate the effects of epithelial-off corneal cross-linking (CXL) on the ocular surface and corneal topographic and optical parameters in progressive keratoconus (KCN) cases.
Prospective single-arm interventional study.
Thirty eyes of 25 progressive KCN cases needing corneal CXL entered the study. All the included eyes underwent an epi-off corneal CXl procedure following the Dresden protocol. The ocular surface parameters, including tear break-up time (TBUT), Schirmer I test, and Ocular surface disease index (OSDI), were evaluated at baseline, one and 6 months after the procedure. The corneal imaging with Pentacam (Oculus Inc.) was conducted at these visits, measuring topographic parameters (e.g., K, K, K, and corneal thickness), indices (e.g., ISV, IVA, KI IHA), and aberrations.
The median age of the patients was 24.0 (IQR:21.0-26.5) with a baseline BCVA of 0.045 LogMAR (IQR:0.000-0.301). The BCVA had no significant change in the last follow-up (p:1.000). The baseline median values for TBUT, Schirmer test, and OSDI were 11.0s, 13.0mm, and 28.12, demonstrating a significant ocular surface malfunction. These ocular surface parameters showed no significant change 6 months after CXL (p: 0.662, 0.534, and 0.372, respectively). The K and K values decreased significantly at the last follow-up compared to the baseline (44.4 vs. 45.6 (p:0.019) and 48.0 vs. 48.1 (p:0.008), respectively). The only topographic indices that improved 6 months after CXL was the index of surface variance (ISV) (70.50 vs. 61.70, p:0.036). The corneal front surface higher-order aberrations, including spherical aberration, coma, and trefoil, showed no significant change 6 months after CXL.
Progressive KCN cases cope with some ocular surface problems, such as dry eye, but the corneal CXL is safe for these cases without causing any deterioration in the ocular surface problems. The corneal CXL might not improve the topographic indices and corneal aberrations 6 months after the procedure.
本研究旨在评估去上皮角膜交联术（CXL）对进展性圆锥角膜（KCN）患者眼表、角膜地形图及光学参数的影响。
前瞻性单臂干预性研究。
25例需要角膜CXL的进展性KCN患者的30只眼纳入研究。所有纳入的眼睛均按照德累斯顿方案进行去上皮角膜交联手术。在基线、术后1个月和6个月时评估眼表参数，包括泪膜破裂时间（TBUT）、泪液分泌试验I（Schirmer I test）和眼表疾病指数（OSDI）。在这些访视时使用Pentacam（Oculus公司）进行角膜成像，测量地形图参数（如K1、K2、K3和角膜厚度）、指数（如表面非对称性指数（ISV）、垂直非对称性指数（IVA）和圆锥角膜指数（KI））以及像差。
患者的中位年龄为24.0岁（四分位间距：21.0 - 26.5岁），基线最佳矫正视力（BCVA）为0.045 LogMAR（四分位间距：0.000 - 0.301）。末次随访时BCVA无显著变化（p = 1.000）。TBUT、泪液分泌试验和OSDI的基线中位值分别为11.0秒、13.0毫米和28.12，表明存在明显的眼表功能障碍。这些眼表参数在CXL术后6个月无显著变化（p分别为0.662、0.534和0.372）。与基线相比，末次随访时K1和K2值显著降低（分别为44.4对45.6（p = 0.019）和48.0对48.1（p = 0.008））。CXL术后6个月唯一改善的地形图指数是表面方差指数（ISV）（70.50对61.70，p = 0.036）。角膜前表面高阶像差，包括球差、彗差和三叶草像差，在CXL术后6个月无显著变化。
进展性KCN患者存在一些眼表问题，如干眼，但角膜CXL对这些患者是安全的，不会导致眼表问题恶化。角膜CXL术后6个月可能不会改善地形图指数和角膜像差。
