Corneal haze and visual outcome after collagen crosslinking for keratoconus: A comparison between total epithelium off and partial epithelial removal methods.
Corneal haze and visual outcome after collagen crosslinking for keratoconus: A comparison between total epithelium off and partial epithelial removal methods.
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DOI：
10.4103/2277-9175.145677
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发表时间：
2014
影响因子：
1
通讯作者：
Peyman A
中科院分区：
文献类型：
--
作者：
Razmjoo H;Rahimi B;Kharraji M;Koosha N;Peyman A
圆锥角膜是一种不对称的、双侧的、进行性的非炎症性角膜扩张症，约占总人口的1/2000。这可能会对生活质量造成严重的负面影响。角膜胶原交联术(CXL)是最近引入的一种方法，特别是用于减缓圆锥角膜的进展，以及其他角膜变薄过程。在获得知情同意后，22名患者的44只圆锥角膜纳入了这项随机前瞻性研究。第一组完全切除角膜上皮，第二组保留中央3 mm厚的角膜上皮，部分切除。两组患者均于术前、术后6个月进行全面眼科检查。本文在www.ClinicalTrial.gov上注册，注册号为NCT01809977。术后角膜模糊度、屈光度和视力两组间差异无统计学意义(P>；0.05)。两组手术前后比较，全切眼术后K-max(P值：0.009)和Q值(P值)均有明显改善，而部分摘除组矫正视力改善较好(P值：0.006)。两种方法的角膜光学密度均显著增加，且差异无统计学意义(P<；0.0001)。在我们的研究中，保持中央角膜上皮的完整不利于减少角膜的模糊度，但这种方法对矫正视力有更好的改善。全上皮剥离技术能更好地改善K-max和Q-值。
Keratoconus is an asymmetric, bilateral, progressive noninflammatory ectasia of the cornea that affects approximately 1 in 2000 of the general population. This may cause a significant negative impact on quality of life. Corneal collagen crosslinking (CXL) is one of the recently introduced methods that have been used to decrease the progression of keratoconus, in particular, as well as other corneal-thinning processes. A total of 44 keratoconic eyes of 22 patients were enrolled in this randomized prospective study, after obtaining informed consent. In the first group, the corneal epithelium were totally removed and in the second group, the central 3 mm of epithelium was kept intact and partial removal was performed. After collagen crosslinking in both groups, comprehensive ophthalmologic examination was performed on all patients before and 6 months after the surgery. This article is registered at www.clinicaltrial.gov with registration number NCT01809977. The difference between the two groups was not statistically significant regarding postoperative corneal haziness, refraction, and visual acuity (P > 0.05). However, comparison of pre- and postoperative parameters within each group revealed that total removal of the cornea has resulted in significant improvement of K-max (P value: 0.01) and Q-value (P value: 0.009); while eyes in partial removal group had better improvement of corrected vision (P value: 0.006). Both methods had significant and similar increase in optical corneal density (P < 0.0001). In our study, keeping the central corneal epithelium intact was not beneficial for decreasing corneal haziness, however, this method caused better improvement in corrected vision. Total epithelium off technique resulted in better improvement of K-max and Q-value.