摘要
目的观察快速角膜胶原交联术(ACXL)治疗圆锥角膜的患者2年期有效性、安全性及稳定性。方法对2016年5月至2018年12月于该院确诊圆锥角膜行ACXL的29例(男23例,女6例)52眼2年随访资料完整的患者进行分析,所有患者均行去上皮ACXL治疗,比较患者术前及术后3、6、12、24个月的最佳矫正视力(BCVA)、球镜、柱镜、等效球镜、角膜前表面最大曲率(Kmax)、前表面平均曲率(前表面Km)、后表面平均曲率(后表面Km)、前表面对称指数(SLF)、后表面对称指数(SLB)、最薄点角膜厚度(TCT)、总像差、总高阶像差、彗差、三叶草、球差、眼前节OCT角膜交联线深度、眼压、角膜内皮细胞密度、裂隙灯观察炎性反应及Haze情况。结果患者术前BCVA、球镜、柱镜及等效球镜分别为LogMAR 0.24±0.27、(-3.96±3.36)D,(-3.28±2.56)D,(-5.60±3.67)D,术后24个月分别为LogMAR 0.17±0.21、(-3.44±2.96)D,(-2.67±1.18)D,(-4.77±3.32)D,差异均有统计学意义(均P<0.05);术前角膜前表面Kmax、后表面Km、DK、SLF、TCT分别为(53.74±7.27)D、(-7.23±1.13)D、(-3.10±2.06)D、(3.89±3.80)D、(461.85±38.34)μm,术后24个月分别为(53.08±6.62)D、(-7.00±1.01)D、(-2.88±1.98)D、(3.05±3.33)D、(451.42±42.77)μm,差异均有统计学意义(均P<0.05);而术前与术后24个月比较,前表面Km、SLB、总像差、高阶像差、彗差、三叶草、球差、眼压及角膜内皮细胞密度差异均无统计学意义(均P>0.05)。结论ACXL治疗能显著降低圆锥角膜患者的角膜前表面Kmax及后表面Km,有效阻止角膜扩张进展,具有良好的有效性、安全性及稳定性。
Objective To investigate the efficacy,safety and stability of accelerated epithelium-off corneal collagen cross-linking(ACXL)in the treatment of patients with keratoconus in two years.Methods A total of 52 eyes of 29 patients(23 male and 6 female),who were diagnosed with keratoconus and treated with ACXL in the hospital from May 2016 to December 2018 were enrolled in this study.All patients had complete follow-up data.The uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),spherical lens,cylindrical lens,equivalent spherical lens,maximum curvature of the front surface(Kmax),mean curvature of the front surface(front surface Km),mean curvature of the back surface(back surface Km),symmetry index of the front surface(SLF),the back surface(SLB),thinnest point corneal thickness(TCT),total aberration,total high-order aberration,coma,clover,spherical aberration,anterior segment OCT corneal cross-linking line depth,intraocular pressure and corneal endothelial cell density were compared before and 3,6,12 and 24 months after the operation.The inflammatory reaction and haze were observed by slit lamp.Results The UCVA,BCVA,cylindrical lens and equivalent spherical lens before the operation were LogMAR 0.24±0.27,(-3.96±3.36)D,(-3.28±2.56)D,(-5.60±3.67)D respectively.And 24 months after the operation were LogMAR 0.17±0.21,(-3.44±2.96)D,(-2.67±1.18)D,(-4.77±3.32)D respectively.The differences were statistically significant(P<0.05).The Kmax,back surface Km,DK,SLF and TCT before the operation were(53.74±7.27)D,(-7.23±1.13)D,(-3.10±2.06)D,(3.89±3.80)D,(461.85±38.34)μm respectively.And 24 months after operation were(53.08±6.63)D,(-7.00±1.01)D,(-2.88±1.98)D,(3.05±3.33)D,(451.42±42.77)μm,respectively.The differences were statistically significant(P<0.05).There was no significant difference in other indexes before and 24 months after the operation(P>0.05).Conclusion The ACXL treatment can reduce maximum curvature of the front surface and mean curvature of the back surface,and effectively prevent the progress of corneal dilatation,and has good effectiveness,safety and stability.
作者
罗启惠
熊洁
周青青
周友惠
LUO Qihui;XIONG Jie;ZHOU Qingqing;ZHOU Youhui(Department of Ophthalmology,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China)
出处
《重庆医学》
CAS
2022年第3期402-408,共7页
Chongqing medicine
基金
“军事医学科技创新计划”科研项目(SWH2016LCYB-05)
“军事医学与战创伤救治临床新技术计划”科研项目(SWH2016JSTSYB-14)。
关键词
圆锥角膜
去上皮
快速角膜胶原交联术
角膜曲率
像差
keratoconus
epithelium-off
accelerated corneal collagen cross-linking
corneal curvature
corneal aberration
