Prospective Study of Corneal Collagen Cross-linking Efficacy and Tolerance in the Treatment of Keratoconus and Corneal Ectasia: 3-Year Results
Prospective Study of Corneal Collagen Cross-linking Efficacy and Tolerance in the Treatment of Keratoconus and Corneal Ectasia: 3-Year Results
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DOI：
10.1097/ico.0b013e31825e8414
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发表时间：
2013-05-01
期刊：
影响因子：
2.8
通讯作者：
Burillon, Carole
中科院分区：
文献类型：
--
作者：
Poli, Muriel;Cornut, Pierre-Loic;Burillon, Carole
目的：评价角膜胶原交联术联合角膜上皮清理术在稳定治疗原发性或继发性角膜扩张症中的疗效和耐受性。方法：对进行性原发或继发性角膜扩张症患者进行前瞻性、对照、单中心研究。对照组为双眼受累患者的同眼，随访6个月后进行治疗。检查指标包括生物显微镜检查、视力[最佳矫正视力(BSCVA)和裸眼视力(UCVA)]、中央3 mm角膜曲率、眼压、中心厚度、内皮密度和黄斑轮廓。结果：39例55只眼获得治疗，平均随访时间20.8+/-6.8个月(12~36个月)。对照组16只眼。术后3~12个月裸眼视力和BSCVA均有明显改善，6个月时达到最低值，为0.12~0.07(P<；0.05)。经过36个月的随访，这些数值和角膜曲率测量值没有明显变化。相比之下，对照组的分析显示，6个月时角膜屈光度显著恶化+1.2度(P<；0.05)，治疗后没有进一步的显著变化。对准分子激光原位角膜磨镶术后角膜扩张症患者亚组的分析证实了这些结果。在研究结束时，眼压、角膜厚度和内皮细胞密度没有明显改变，也没有观察到黄斑轮廓改变。结论：本研究表明，角膜胶原交联可以稳定进行性角膜扩张，包括原发和继发性角膜扩张，没有诱导医源性作用。
Purpose: To assess the efficacy and tolerance of corneal collagen cross-linking with corneal epithelium debridement in the stabilizing treatment of primary or secondary corneal ectasia.Methods: Prospective, comparative, single-center study of patients presenting with progressive primary or secondary corneal ectasia. The control group, comprising the fellow eye of patients with bilateral involvement, was followed up for 6 months and then treated. The parameters examined were the biomicroscopic examination, visual acuity [best spectacle-corrected visual acuity (BSCVA) and uncorrected visual acuity (UCVA)], keratometry of the central 3 mm, intraocular pressure, central pachymetry, endothelial density, and macular profile.Results: Fifty-five eyes of 39 patients were treated; the mean follow-up period was 20.8 +/- 6.8 months (range, 12-36 months). The control group comprised 16 eyes. UCVA and BSCVA were significantly improved between 3 and 12 months, reaching their minimum at 6 months, varying from 0.12 UCVA to 0.07 BSCVA (P < 0.05). These values and the keratometry values did not vary significantly after 36 months of follow-up. In contrast, analysis of the control group revealed significant keratometric deterioration of + 1.2 diopters at 6 months (P < 0.05), with no further significant variation after treatment. Analysis of the subgroups of patients with post-laser in situ keratomileusis ectasia confirmed these results. At the end of the study, intraocular pressure, pachymetry, and endothelial density were not significantly modified, and no macular profile modification was observed.Conclusion: This study shows that corneal collagen cross-linking can stabilize progressive corneal ectasia, both primary and secondary, with no induced iatrogenic effects.