Transepithelial versus epithelium-off crosslinking in adults with progressive keratoconus
Transepithelial versus epithelium-off crosslinking in adults with progressive keratoconus
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DOI：
10.1016/j.jcrs.2014.10.041
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发表时间：
2015-07-01
影响因子：
2.8
通讯作者：
Ozcan, Deniz Ozarslan
中科院分区：
文献类型：
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作者：
Cerman, Eren;Toker, Ebru;Ozcan, Deniz Ozarslan
目得：比较上皮脱落角膜胶原交联（CXL）与经上皮CXL治疗进行性圆锥角膜患者的疗效。单位：土耳其伊斯坦布尔马尔马拉大学医学院眼科。设计：回顾性队列研究。方法：将经上皮CXL与经上皮CXL治疗的眼睛进行比较。所有患者随访18个月，评价裸眼（UDVA）和矫正（CDVA）远视力、角膜地形图、像差和角膜厚度结果：患者平均年龄为22.8岁± 4.7岁（SD）经上皮组（30只眼）为23.7 ± 3.9岁（范围18 - 30岁），去上皮组（30只眼）为23.7 ± 3.9岁。两组的平均UDVA和CDVA均显著改善（P < .001）。两组之间的CDVA增益无显著差异。在上皮细胞去除组，球镜误差（P = .002）、等效球镜（P = .004）、最大角膜曲率（K）、平坦K（P = .036）和陡峭K（P < .001）均有显著改善。上皮脱落组的平坦K、陡峭K和最大K的降低幅度更大（平坦K P = 0.004;陡峭K和最大K P <0.001）。在经上皮组中，柱镜误差（P = 0.009）和表面方差指数和表面不对称指数（均P <0.001）出现显著改善。结论：尽管经上皮CXL在诱导地形指数改善方面的有效性似乎降低，但其对视力的影响可能与上皮脱落CXL相似。
PURPOSE: To compare the efficacy of epithelium-off corneal collagen crosslinking (CXL) with transepithelial CXL in patients with progressive keratoconus.SETTING: Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey.DESIGN: Retrospective cohort study.METHODS: Eyes that had transepithelial CXL were compared with eyes treated with epithelium-off CXL. All patients with a follow-up of 18 months were evaluated for uncorrected (UDVA) and corrected (CDVA) distance visual acuities, corneal topography, aberrometry, and pachymetry (Pentacam).RESULTS: The mean patient age was 22.8 years +/- 4.7 (SD) (range 18 to 31 years) in the transepithelial group (30 eyes) and 23.7 +/- 3.9 years (range 18 to 30 years) in the epithelium-off group (30 eyes). The mean UDVA and CDVA significantly improved in both groups (P < .001). There was no significant difference in the CDVA gain between the 2 groups. In the epithelium-off group, significant improvements occurred in spherical error (P = .002), spherical equivalent (P = .004), maximum keratometry (K), flat K (P = .036), and steep K (P < .001). The reductions in flat K, steep K, and maximum K were greater in the epithelium-off group (P = .004 for flat K; P < .001 for steep K and maximum K). In the transepithelial group, significant improvements occurred in the cylindrical error (P = .009) and in the index of surface variance and index of surface asymmetry (both P < .001).CONCLUSION: Although transepithelial CXL seemed to have reduced effectiveness in inducing improvement in topographic indices, its effect on visual acuity is likely to be similar to that of epithelium-off CXL.