[1]贾洪真,庞旭,樊郑军,等.三种不同方案角膜交联后角膜厚度减小量的比较[J].眼科新进展,2017,37(6):555-558.[doi:10.13389/j.cnki.rao.2017.0140]
 JIA Hong-Zhen,PANG Xu,FAN Zheng-Jun,et al.Comparison of corneal thickness reduction after corneal crosslinking in three different protocols[J].Recent Advances in Ophthalmology,2017,37(6):555-558.[doi:10.13389/j.cnki.rao.2017.0140]
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三种不同方案角膜交联后角膜厚度减小量的比较/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
37卷
期数:
2017年6期
页码:
555-558
栏目:
应用研究
出版日期:
2017-06-05

文章信息/Info

Title:
Comparison of corneal thickness reduction after corneal crosslinking in three different protocols
作者:
贾洪真庞旭樊郑军隋艳来彭秀军
100048 北京市,海军总医院眼科
Author(s):
JIA Hong-ZhenPANG XuFAN Zheng-JunSUI Yan-LaiPENG Xiu-Jun
Department of Ophthalmology,Navy General Hospital,Beijing 100048,China
关键词:
角膜交联最薄角膜厚度离子导入核黄素
Keywords:
corneal crosslinkingthinnest-point corneal thicknessiontophoresisriboflavin
分类号:
R772.23
DOI:
10.13389/j.cnki.rao.2017.0140
文献标志码:
A
摘要:
目的 评估三种不同方案角膜交联(corneal crosslinking,CXL)治疗进展期圆锥角膜后最薄角膜厚度(thinnest-point corneal thickness,TCT)减小量的差异。方法 回顾性临床病例研究。选取2010年8月至2015年11月在海军总医院眼科确诊并行CXL治疗的进展期圆锥角膜连续性病例85例(110眼)。21例(25眼)行标准的去上皮CXL(standard epithelium-off corneal crosslinking,S-CXL)治疗;14例(22眼)行1 g·L-1核黄素乳酸钠林格液离子导入CXL(iontophoresis-assisted CXL,I-CXLa)治疗;50例(63眼)行1 g·L-1核黄素蒸馏水溶液离子导入CXL(iontophoresis-assisted CXL,I-CXLb)治疗。应用ALLEGRO眼前节分析仪测量术前、术后TCT,比较三种CXL方案术后TCT减小量的差异。结果 S-CXL术后3个月、6个月、12个月TCT与术前差值分别为(-14.93±27.16)μm、(-31.94±22.89)μm、(-27.71±26.01)μm;I-CXLa术后3个月、6个月、12个月TCT与术前差值分别为(-20.14±19.09)μm、(-10.10±24.28)μm、(-7.11±22.26)μm;I-CXLb术后3个月、6个月、12个月TCT与术前差值分别为(-28.08±26.14)μm、(-21.08±25.62)μm、(-15.91±19.19)μm。术后3个月时,三组TCT减小量差异没有统计学意义(P=0.188);术后6个月、12个月时,S-CXL组和I-CXLa组比较差异均有统计学意义(均为P<0.05),I-CXLb组和S-CXL组、I-CXLb组和I-CXLa组比较差异均无统计学意义(均为P>0.05)。结论 三种CXL方案治疗术后6个月和12个月,TCT减小量与交联方案相关,反映了交联强度的大小。I-CXLb术后TCT减小量小于S-CXL,但差异不显著,两者交联强度差异亦不显著。
Abstract:
Objective To evaluate the differences of the thinnest-point corneal thickness (TCT) decrease after three different corneal crosslinking (CXL) protocols for progressive keratoconus.Methods Retrospective clinical case study.From August 2010 to November 2015,consecutive 85 patients (110 eyes) with progressive keratoconus were enrolled and treated with CXL in Department of Opthalmology,Navy General Hospital.21 patients of 25 eyes underwent standard epithelium-off corneal crosslinking (S-CXL),14 patients of 22 eyes underwent 1 g·L-1 riboflavin-sodium lactate Ringer’s solution iontophoresis-assisted CXL (I-CXLa),and 50 patients of 63 eyes underwent 0.1% riboflavin-distilled water solution I-CXLb.Preoperative and postoperative TCT were measured by ALLEGRO oculyzer.The differences of TCT decrease after treatment were compared among the three CXL protocols.Results The differences of TCT from baseline after 3 months,6 months and 12 months in the S-CXL group were (-14.93±27.16)μm,(-31.94±22.89)μm,(-27.71±26.01)μm,respectively,the I-CXLa group were (-20.14±19.09)μm,(-10.10±24.28)μm,(-7.11±22.26)μm,respectively,the I-CXLb group were (-28.08±26.14)μm,(-21.08±25.62)μm,(-15.91±19.19)μm,respectively.Three months after treatment,the differences of TCT decrease in the three groups was not statistically significant (P=0.188);Six and 12 months after treatment,the differences between S-CXL and I-CXLa were statistically significant (all P<0.05),but the differences between S-CXL and I-CXLb,between I-CXLb and I-CXLa showed no significant difference (all P>0.05).Conclusion Six and 12 months after treatment,TCT decrease is related to the CXL protocol.TCT decrease degree may reflect the intensity of crossinking.TCT decrease in I-CXLb is smaller than that in S-CXL,but there is no statistical difference.

参考文献/References:

[1] WOLLENSAK G,SPOERL E,SEILER T.Riboflavin/ultraviolet-A-induced collagen crosslinking for the treatment of keratoconus[J].Am J Ophthalmol,2003,135(5):620-627.
[2] SHALCHI Z,WANG X,NANAVATY MA.Safety and efficacy of epithelium removal and transepithelial corneal collagen crosslinking for keratoconus[J].Eye (Lond),2015,29(1):15-29.
[3] CHOI S,LEE SC,LEE HJ,CHEONG Y,JUNG GB,JIN KH,et al.Structural response of human corneal and scleral tissues to collagen cross-linking treatment with riboflavin and ultraviolet A light[J].Lasers Med Sci,2013,28(5):1289-1296.
[4] SPOERL E,HUHLE M,SEILER T.Induction of cross-links in corneal tissue[J].Exp Eye Res,1998,66(1):97-103.
[5] MEEK KM,HAYES S.Corneal cross-linking-a review[J].Ophthal Physl Opt,2013,33(2):78-93.
[6] LI N,FAN Z,PENG X,PANG X,TIAN C.Clinical observation of transepithelial corneal collagen cross-linking by lontophoresis of riboflavin in treatment of keratoconus[J].Eye Sci,2014,29(3):160-164.
[7] LI N,PENG X,FAN Z,XIA Y.Iontophoretic delivery of riboflavin into the rabbit cornea:a primary study[J].Eye Sci,2014,29(1):30-35.
[8] SEILER T,HAFEZI F.Corneal cross-linking-induced stromal demarcation line[J].Cornea,2006,25(9):1057-1059.
[9] LOMBARDO M,PUCCI G,BARBERI R,LOMBARDO G.Interaction of ultraviolet light with the cornea:clinical implications for corneal crosslinking[J].J Cataract Refract Surg,2015,41(2):446-459.
[10] RICHOZ O,HAMMER A,TABIBIAN D,GATZIOUFAS Z,HAFEZI F.The Biomechanical effect of corneal collagen cross-linking (CXL) with riboflavin and UV-A is oxygen dependent[J].Transl Vis Sci Technol,2013,2(7):6.
[11] TOPRAK I,YAYLALI V,YILDIRIM C.Factors affecting outcomes of corneal collagen crosslinking treatment[J].Eye (Lond),2014,28(1):41-46.
[12] ZHANG X,TAO XC,ZHANG J,LI ZW,XU YY,WANG YM,et al.A review of collagen cross-linking in cornea and sclera[J].J Ophthalmol,2015,2015:289467.
[13] NGAL,CHAN TC,ChENG AC.Conventional versus accelerated corneal collagen cross-linking in the treatment of keratoconus[J].Clin Exp Ophthalmol,2016,44(1):8-14.
[14] ERASLAN M,TOKER E,CERMAN E,OZARSLAN D.Efficacy of epithelium-off and epithelium-on corneal collagen cross-linking in pediatric keratoconus[J].Eye Contact Lens,2016,2016:26925536.
[15] GOLDICH Y,BARKANA Y,WUSSUKU LIOR O,MARCOVICH AL,HIRSH A,AVNI I,et al.Corneal collagen cross-linking for the treatment of progressive keratoconus:3-year prospective outcome[J].Can J Ophthalmol,2014,49(1):54-59.
[16] SEFIC-KASUMOVIC S,RACIC-SAKOVIC A,KASUMOVIC A,PAVLJASEVIC S,DURIC-COLIC B,CABRIC E,et al.Assessment of the tomographic values in keratoconic eyes after collagen crosslinking procedure[J].Med Arch,2015,69(2):91-94.
[17] MENCUCCI R,PALADINI I,VIRGILI G,GIACOMELLI G,MENCHINI U.Corneal thickness measurements using time-domain anterior segment OCT,ultrasound,and Scheimpflug tomographer pachymetry before and after corneal cross-linking for keratoconus[J].J Refract Surg,2012,28(8):562-566.
[18] GREENSTEIN SA,SHAH VP,FRY KL,HERSH PS.Corneal thickness changes after corneal collagen crosslinking for keratoconus and corneal ectasia:one-year results[J].J Cataract Refract Surg,2011,37(4):691-700.
[19] NAWAZ S,GUPTA S,GOGIA V,SASIKALA NK,PANDA A.Trans-epithelial versus conventional corneal collagen crosslinking:A randomized trial in keratoconus[J].Oman J Ophthalmol,2015,8(1):9-13.
[20] CINAR Y,CINGU AK,TURKCU FM,YUKSEL H,SAHIN A,YILDIRIM A,et al.Accelerated corneal collagen cross-linking for progressive keratoconus[J].Cutan Ocul Toxicol,2014,33(2):168-171.
[21] BIKBOVA G,BIKBOV M.Standard corneal collagen crosslinking versus transepithelial iontophoresis-assisted corneal crosslinking,24 months follow-up:randomized control trial[J].Acta Ophthalmol,2016,94(7):e600-606.
[22] MAZZOTTA C,TRAVERSI C,BAIOCCHI S,CAPOROSSI O,BOVONE C,SPARANO MC,et al.Corneal healing after riboflavin ultraviolet-A collagen cross-linking determined by confocal laser scanning microscopy in vivo:early and late modifications[J].Am J Ophthalmol,2008,146(4):527-533.
[23] CROXATTO JO,TYTIUN AE,ARGENTO CJ.Sequential in vivo confocal microscopy study of corneal wound healing after cross-linking in patients with keratoconus[J].J Refract Surg,2010,26(9):638-645.
[24] DHAWAN S,RAO K,NATRAJAN S.Complications of corneal collagen cross-linking[J].J Ophthalmol,2011,2011:869015.
[25] KYMIONIS GD,DIAKONIS VF,KALYVIANAKI M,PORTALIOU D,SIGANIOS C,KOZOBOLIS VP,et al.One-year follow-up of corneal confocal microscopy after corneal cross-linking in patients with post laser in situ keratosmileusis ectasia and keratoconus[J].Am J Ophthalmol,2009,147(5):774-778.
[26] MASTROPASQUA L,LANZINI M,CURCIO C,CALIENNO R,MASTROPASQUA R,COLASANTE M,et al.Structural modifications and tissue response after standard epi-off and iontophoretic corneal crosslinking with different irradiation procedures[J].Invest Ophthalmol Vis Sci,2014,55(4):2526-2533.

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备注/Memo

备注/Memo:
北京市科学技术委员会资助(编号:Z151100004015217)
更新日期/Last Update: 2017-06-28