Efficacy of corneal collagen cross-linking for treatment of keratoconus: a meta-analysis of randomized controlled trials.
Efficacy of corneal collagen cross-linking for treatment of keratoconus: a meta-analysis of randomized controlled trials.
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DOI：
10.1371/journal.pone.0127079
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Lin X
中科院分区：
文献类型：
--
作者：
Li J;Ji P;Lin X
目的评价角膜胶原交联剂(CXL)治疗圆锥角膜的疗效。我们对随机对照试验进行了文献检索，评估了CXL在减缓圆锥角膜进展方面的效果。主要观察指标包括地形图参数、视力和屈光度的变化。疗效评估通过加权平均差(WMD)和95%可信区间(CI)评估感兴趣结果的绝对变化。CXL组平均角膜曲率计值、最大角膜曲率计值和最小角膜曲率计值均显著低于对照组(P<；0.00001；WMD=-2.05；95%CI：-3.10~-1.00；P<；0.00001；WMD=-1.94；95%CI：-2.63~-1.26；P<；0.00001)。CXL组最佳矫正视力显著提高(WMD=-0.10；95%CI：-0.15~-0.05；P<；0.00001)，裸眼视力差异无统计学意义。在敏感性分析中，接受CXL手术的患者与对照组患者相比，明显减少了显性柱体误差(wmd=-0.388；95%CI：-0.757至-0。019；P=0.04)。角膜中央厚度和眼压变化无统计学意义。CXL可能是稳定圆锥角膜的有效方法。有必要进行进一步的长期随访研究，以评估CXL的持久性。
To evaluate the efficacy of corneal collagen cross-linking (CXL) for the treatment of keratoconus. We performed a literature search for randomized controlled trials that assessed the effect of CXL in slowing progression of keratoconus. The primary outcome measures included changes of topographic parameters, visual acuity, and refraction. Efficacy estimates were evaluated by weighted mean difference (WMD) and 95% confidence interval (CI) for absolute changes of the interested outcomes. Significant decrease in mean keratometry value, maximum keratometry value and minimum keratometry value were demonstrated in the CXL group compared with the control group (WMD = -1.65; 95% CI: -2.51 to -0.80; P < 0.00001; WMD = -2.05; 95% CI: -3.10 to -1.00; P < 0.00001; WMD = -1.94; 95% CI: -2.63 to -1.26; P < 0.00001; respectively). Best spectacle-corrected visual acuity improved significantly in CXL group (WMD = -0.10; 95% CI: -0.15 to -0.05; P < 0.00001), whereas uncorrected visual acuity did not differ statistically. Manifest cylinder error decreased significantly in patients undergoing CXL procedure compared with control patients in sensitivity analysis (WMD = -0.388; 95% CI: -0.757 to -0. 019; P = 0.04). The changes in central corneal thickness and intraocular pressure were not statistically significant. CXL may be an effective option in stabilizing keratoconus. Further long-term follow-up studies will be necessary to assess the persistence of CXL.
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