Parasurgical therapy for keratoconus by rib oflavin-ultraviolet type A rays induced cross-linking of corneal collagen - Preliminary refractive results in an Italian study
Parasurgical therapy for keratoconus by rib oflavin-ultraviolet type A rays induced cross-linking of corneal collagen - Preliminary refractive results in an Italian study
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DOI：
10.1016/j.jcrs.2006.01.091
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发表时间：
2006-05-01
影响因子：
2.8
通讯作者：
Caporossi, T
中科院分区：
文献类型：
--
作者：
Caporossi, A;Baiocchi, S;Caporossi, T
目的：评估核黄素-紫外线 A 型射线诱导角膜胶原交联在减少圆锥角膜进展和改善进展性圆锥角膜患者视力方面的有效性。地点：意大利锡耶纳锡耶纳大学眼科。方法：这是一项第二阶段前瞻性非随机开放研究。自2004年9月开始，对10名双侧圆锥角膜患者（平均年龄31.4岁）的10只眼睛进行了核黄素-A型紫外线（UVA）胶原交联联合治疗。在距角膜顶点 1 cm 处照射 30 分钟，辐射能量为 3 mW/cm(2) 或 5.4 焦耳/cm(2)。进行了完整的眼科检查（裸眼视力 [UCVA]、球面眼镜矫正视力 (SSCVA)、最佳眼镜矫正视力 [BSCVA]）。患者在 1、2、3 和 6 个月时接受角膜计算机地形图检查、线性扫描光学断层扫描、内皮细胞计数、超声测厚、眼内压 (IOP) 评估和 HIRT II 系统共聚焦显微镜检查。治疗后，对眼睛进行药物治疗并戴上软性隐形眼镜。 结果：术前和术后比较结果显示，UCVA 增加了 3.6 行 (P =.0000112)，SSCVA 增加了 1.85 行 (P =.00065)，BSCVA 增加了 1.66 行 (P =.00071)。形貌分析显示中央 3.0 毫米处的平均 K 值降低了 2.1 +/- 0.13 屈光度 (D)。眼压和内皮细胞计数的统计分析没有显示出显着差异。角膜对称性的地形像差分析结果表明，角膜对称性有增加的趋势，垂直半子午线之间的不对称性显着减少。结论：屈光结果显示，平均球面当量减少了约 2.5 D，这通过平均 K 的减少得到了地形证实。表面像差分析的结果显示，形态对称性得到改善，彗形像差显着减少。
PURPOSE: To assess the effectiveness of riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen in reducing progression of keratoconus and in improving visual acuity in patients with progressive keratoconus.SETTING: Department of Ophthalmology, Siena University, Siena, Italy.METHODS: This was a second-phase prospective nonrandomized open study. Starting in September 2004, 10 eyes of 10 patients (mean age 31.4 years) with bilateral keratoconus were treated by combined riboflavin-ultraviolet type A rays (UVA) collagen cross-linking. Radiant energy was 3 mW/cm(2) or 5.4 joule/cm(2) for a 30-minute exposure at I cm from the corneal apex. A complete ophthalmologic examination (uncorrected visual acuity [UCVA], sphere spectacles corrected visual acuity (SSCVA), best spectacle-corrected visual acuity [BSCVA]) was performed. Patients had corneal computerized topographic examination, linear scan optical tomography, endothelial cell count, ultrasound pachometry, intraocular pressure (IOP) evaluation, and HIRT II system confocal microscopy at 1, 2, 3, and 6 months. After treatment, eyes were medicated and dressed with a soft contact lens.RESULTS: Comparative preoperative and postoperative results showed increases of 3.6 lines for UCVA (P =.0000112), 1.85 lines for SSCVA (P =.00065), and 1.66 lines for BSCVA (P =.00071). Topographic analysis showed a mean K reduction of 2.1 +/- 0.13 diopters (D) in the central 3.0 mm. Statistical analysis of IOP and endothelial cell count did not show significant differences. Topo-aberrometric analysis findings of corneal symmetry showed a trend toward increasing corneal symmetry with a major reduction in asymmetry between vertical hemimeridians.CONCLUSIONS: Refractive results showed a reduction of about 2.5 D in the mean spherical equivalent, topographically confirmed by the reduction in mean K. Results of surface aberrometric analysis showed improvement in morphologic symmetry with a significant reduction in comatic aberrations.