摘要
目的对比去上皮与跨上皮快速角膜交联术(accelerated corneal collagen crosslinking,ACXL)在圆锥角膜中的临床疗效.方法选取圆锥角膜患者45例(45只眼),按治疗方案不同分为A组和B组,A组(21例21只眼)行去上皮ACXL,B组(24例24只眼)行跨上皮ACXL.比较术前及术后3个月2组的视力[裸眼视力(uncorrected visual acuity,UCVA)和最佳矫正视力(best corrected visual acuity,BCVA)]、角膜最薄点厚度、角膜最大曲率、角膜后表面高度及角膜内皮(角膜内皮细胞密度和六边形角膜内皮细胞比率).结果术后3个月,2组的UCVA、BC-VA、角膜后表面高度、角膜内皮细胞密度、六边形角膜内皮细胞比率与术前比较差异均无统计学意义(P>0.05);术前及术后3个月,2组间UCVA、BCVA、角膜后表面高度、角膜内皮细胞密度和六边形角膜内皮细胞比率比较差异均无统计学意义(P>0.05).术前,2组间角膜最薄点厚度和角膜最大曲率比较差异均无统计学意义(P>0.05);术后3个月,2组的角膜最薄点厚度和角膜最大曲率均较术前小(P<0.001或P<0.05),且B组的角膜最薄点厚度和角膜最大曲率均较A组大(P<0.05).结论去上皮与跨上皮ACXL治疗圆锥角膜均有效,在改善角膜厚度和角膜曲率方面跨上皮ACXL略逊于去上皮ACXL.
Objective To compare the clinical effect of de-epithelialized and trans-epithelial accelerated corneal collagen crosslinking(ACXL)on keratoconus.Methods Forty-five patients with keratoconus(45 eyes)were assigned to receive either de-epithelialized ACXL(group A,21 patients,21 eyes)or trans-epithelial ACXL(group B,24 patients,24 eyes).The uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),corneal thickness at the thinnest point,maximum corneal curvature,posterior corneal surface height,corneal endothelial cell density,and hexagonal endothelial cell ratio were compared between the two groups before and 3 months after treatment.Results At 3 months after operation,there were no obvious differences in UCVA,BCVA,posterior corneal surface height,corneal endothelial cell density and hexagonal endothelial cell ratio in both groups compared with those before operation(P>0.05).Furthermore,no significant differences in these parameters were found between the two groups before and 3 months after operation(P>0.05).Before operation,corneal thickness at the thinnest point and maximum corneal curvature were not significantly different between the two groups(P>0.05).However,compared with those before operation,corneal thickness at the thinnest point and maximum corneal curvature obviously decreased at 3 months after operation,and those in the group B were greater than those in the group A(P<0.05).Conclusion Both de-epithelialized and trans-epithelial ACXL are effective for keratoconus.Nonetheless,trans-epithelial ACXL is slightly inferior to de-epithelialized ACXL in improving corneal thickness and curvature.
作者
王彩霞
高笑娇
王家良
WANG Cai-xia;GAO Xiao-jiao;WANG Jia-liang(Department of Ophthalmology,Zhengzhou Boai Eye,Ear,Nose and Throat Hospital,Zhengzhou 450000,China)
出处
《实用临床医学（江西）》
CAS
2023年第3期78-82,共5页
Practical Clinical Medicine
关键词
跨上皮快速角膜交联术
去上皮快速角膜交联术
圆锥角膜
临床疗效
trans-epithelial accelerated corneal collagen crosslinking
de-epithelialized accelerated corneal collagen crosslinking
keratoconus
clinical efficacy
