Safety and Efficacy of Corneal Minimized-Volume Ablation With Accelerated Cross-Linking in Improving Visual Function for Keratoconus.
Safety and Efficacy of Corneal Minimized-Volume Ablation With Accelerated Cross-Linking in Improving Visual Function for Keratoconus.
复制标题
DOI：
10.1097/ico.0000000000002462
复制
发表时间：
2020-08
期刊：
影响因子：
2.8
通讯作者：
Xiaonan Yang;Quan Liu;Qiting Feng;Haiqin Lin
中科院分区：
文献类型：
--
作者：
Xiaonan Yang;Quan Liu;Qiting Feng;Haiqin Lin
目的评价加速交联法角膜小体积切削术治疗圆锥角膜的安全性和有效性。方法通过一项初步研究，招募了25例连续的I-III级圆锥角膜患者的25只眼，这些患者在同一疗程中接受了具有“最小体积”消融轮廓和加速角膜交联的角膜经上皮激光屈光性角膜切削术。术前和术后评估了矫正和未矫正的远视力、明显屈光度、角膜曲率和高阶像差、内皮细胞以及眼部调制传递函数，至少随访6个月。P值< 0.05是统计学显著性的阈值。结果术后8.2 ± 3.6个月，平均矫正和未矫正远视力（LogMAR）分别为0.07 ± 0.15和0.45 ± 0.39，较基线值0.24 ± 0.24（P8 m-before = 0.005）和1.12 ± 0.33（P8 m-before < 0.001）有显著改善。等效球镜为-2.80 ± 2.72屈光度（D），较基线-6.61 ± 3.06 D显著降低（P8 m-之前< 0.001），而尝试矫正的等效球镜为-2.30 ± 1.22 D。同时，高阶像差明显减少，沿着眼调制传递函数改善。术后角膜表面形态参数显著降低（表面变化指数：P8 m-before = 0.003;垂直不对称指数：P8 m-before = 0.005;圆锥角膜指数：P8 m-before = 0.004;圆锥角膜中心指数：P8 m-before = 0.003;高度偏心指数：P8 m-before < 0.001）。然而，在术前和术后期间未发现后角膜曲率或内皮细胞密度的显著变化。结论：加速交联的角膜最小体积消融术是矫正轻度屈光不正的有效和安全的选择，可显著改善圆锥角膜患者的视功能。
PURPOSE To evaluate the safety and efficacy of corneal minimized-volume ablation with accelerated cross-linking in improving visual function in keratoconus eyes. METHODS Through a pilot study, 25 eyes of 25 consecutive patients with keratoconus grade I-III were recruited that underwent corneal transepithelial photorefractive keratectomy with "minimized volume" ablation profile and accelerated corneal cross-linking in the same session. Corrected and uncorrected distance visual acuities, manifest refraction, corneal curvature and higher-order aberrations, endothelial cells, and the ocular modulation transfer function were assessed preoperatively and postoperatively, with a minimum follow-up of 6 months. A P value < 0.05 was the threshold of statistical significance. RESULTS At 8.2 ± 3.6 months postoperatively, the mean corrected and uncorrected distance visual acuities (LogMAR) were 0.07 ± 0.15 and 0.45 ± 0.39, significantly improving from the baseline of 0.24 ± 0.24 (P8m-before = 0.005) and 1.12 ± 0.33 (P8m-before < 0.001), respectively. Spherical equivalent was -2.80 ± 2.72 diopters (D), significantly decreasing from the baseline of -6.61 ± 3.06 D (P8m-before < 0.001), whereas the attempted corrected spherical equivalent was-2.30 ± 1.22 D. Meanwhile, a significant reduction was found in higher-order aberration, along with the postoperative improvement in ocular modulation transfer function. Corneal surface morphological parameters were found with significant decreases postoperatively (index of surface variance: P8m-before = 0.003; index of vertical asymmetry: P8m-before = 0.005; keratoconus index: P8m-before = 0.004; center keratoconus index: P8m-before = 0.003; and index of height decentration: P8m-before < 0.001). Nevertheless, no significant change was found in posterior corneal curvature or endothelial cell density between pre- and post-operative periods. CONCLUSIONS Corneal minimized-volume ablation with accelerated cross-linking was an effective and safe option for correction of mild refractive error, leading to significant improvement of visual function in patients with keratoconus.