Corneal Cross-linking to Halt the Progression of Keratoconus and Corneal Ectasia: Seven-Year Follow-up
Corneal Cross-linking to Halt the Progression of Keratoconus and Corneal Ectasia: Seven-Year Follow-up
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DOI：
10.1016/j.ajo.2015.08.023
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发表时间：
2015-12-01
影响因子：
4.2
通讯作者：
O'Brart, Naomi A.
中科院分区：
文献类型：
--
作者：
O'Brart, David P. S.;Patel, Parul;O'Brart, Naomi A.
目的：评价核黄素/紫外线A角膜交联术(CXL)的远期疗效和安全性。设计：前瞻性队列研究。方法：对6-8年前在一所大学医院(Guy‘s和St Thomas’s National Health Service Foundation Trust)接受去上皮化CXL手术的36例(36只眼)患者进行检查。结果：术后7年平均等效球镜屈光度(SEQ)较术前增加+0.78 D(P<；.005)，平均模拟地形性角膜曲率(SimK)和平均最大角膜曲率(Kmax)分别减少-0.74 D(P<；.0001)和-0.91 D(P<；.0001)。裸眼远视力(UCDA)(P<；.0005)和矫正远视力(CDVA)(P<；.0001)均有改善，均方根(RMS)(P<；.0005)、昏迷(P<；.0005)和继发性散光(P<；.005)减少。与1年相比，7年的CDVA改善(P<；平均SimK(P<；.0005)和平均Kmax(P<；.005)分别减少-0.45 D和-0.56 D，RMS(P<；.0005)和Coma(P<；.0005)减少。7年与5年相比，CDVA改善(P<；0.05)，三叶减少(P<；0.05)。接受治疗的眼睛没有进展。29只初治眼平均SimK增加+0.54D(P<；0.02)，平均Kmax增加+0.87D(P<0.05)。
PURPOSE: To determine long-term efficacy and safety of riboflavin/ultraviolet A corneal cross-linking (CXL).DESIGN: Prospective cohort study.METHODS: Thirty-six patients (36 eyes) who underwent epithelium-off CXL at a University Hospital (Guy's and St Thomas' National Health Service Foundation Trust) 6-8 years previously were examined. The main outcome measures were refractive error, visual acuity, corneal topographic keratometry, ultrasonic pachymetry, and topography-derived corneal wavefront.RESULTS: At 7 years compared to preoperative values, mean spherical equivalent refractive error (SEQ) increased by +0.78 diopter (D) (P < .005) and mean simulated topographic keratometry (SimK) and mean maximum keratometry (Kmax) reduced by -0.74 D (P < .0001) and -0.91 D (P < .0001), respectively. Uncorrected distance acuity (UCDA) (P < .0005) and corrected distance acuity (CDVA) (P < .0001) had improved and root mean square (RMS) (P < .0005), coma (P < .0005), and secondary astigmatism (P < .005) lessened. At 7 years compared to 1 year, CDVA improved (P < . 05); mean SimK (P < .0005) and mean KMax (P < .005) reduced by -0.45 D and -0.56 D, respectively; and RMS (P < .0005) and coma (P < .0005) decreased. At 7 years compared to 5 years, CDVA improved (P < .05) and trefoil reduced (P < .05). No treated eyes progressed. In 29 initially untreated fellow eyes mean SimK increased by +0.54 D (P < .02), mean Kmax by +0.87 D (P