低渗核黄素在圆锥角膜患者角膜交联术中的应用（英文）  

Application of hypotonic riboflavin in corneal crosslinking in patients with keratoconus

作　　者：Ana Sofia Lopes Diana Silva Susana Henriques Peter Pego Cristina Vendrell Isabel Prieto Ana Sofia Lopes;Diana Silva;Susana Henriques;Peter Pêgo;Cristina Vendrell;Isabel Prieto(Department of Ophthalmology,Hospital Professor Doutor Fernando Fonseca EPE(Amadora-Sintra),Lisbon 2720276,Portugal)

机构地区：[1]Hospital Professor Doutor Fernando Fonseca EPE,Amadora-Sintra眼科

出　　处：《国际眼科杂志》2020年第2期211-216,共6页International Eye Science

摘　　要：目的:比较圆锥角膜患者角膜交联(CXL)、等渗(IR)和低渗核黄素(HR)的结果。方法:回顾性研究,包括29例29眼圆锥角膜患者行角膜交联术,IR组15眼,HR组14眼。参数分析包括(随访1a):最佳矫正视力(BCVA),球体和柱体,中央和较薄处角膜厚度,平均和最大角膜曲率(分别为Km和Kmax),并发症及进展。结果:观察到两组的BCVA提高:治疗前IR组为0.26±0.57,HR组为0.47±0.72。术后1a,IR组为0.13±0.79,HR组为0.29±1.52,IR组BCVA更高(P=0.018)。术后1mo,两组中央角膜厚度(μm)均减少,但在接下来的数月中增加:术前IR组为497±28μm,HR组为432±14μm;术后1a,IR组为480±31μm,HR组为424±15μm。较薄处角膜厚度也是如此,术前IR组为487±29μm,HR组为410±20μm;术后1a,IR组为468±33μm,HR组为413±13μm。两组中Km和Kmax均降低。每组6眼呈现短暂的混浊,无持续性混浊。结论:在中央角膜厚度<400μm的患者中,HR的使用似乎是一个有效的替代执行传统CXL的技术。·AIM:To compare the results of corneal cross-linking(CXL) with isotonic(IR) and hypotonic riboflavin(HR)in patients with keratoconus.·METHODS:Retrospective study of 29 eyes/keratoconus patients submitted to CXL,15 eyes with application of IR(IR group) and 14 eyes with application of HR(HR group).The parameters analysed included(1-year follow-up):best corrected visual acuity(BCVA),sphere and cylinder,central and finer pachymetry,mean and maximum keratometry(Km and Kmax respectively),complications and progression.·RESULTS:An increase on the BCVA scale(LogMAR,logarithm of the minimal angle of resolution) was observed in the two groups:0.26±0.57(IR) and 0.47±0.72(HR) before treatment,and 0.13±0.79(IR) and0.29±1.52(HR) at the 1y.Only at 1y,the difference was statistically significant(P=0.018,group IR with higher BCVA).The central pachymetry(u m) decreased at 1 mo in both groups,and increased in the following months:497±28 μm(IR) and 432±14 μm(HR) before treatment,and 480±31 μm(IR) and 424±15 μm(HR) to the 1y.The thinner pachymetry(μm) presented the same evolution:487±29 μm(IR) and 410±20 pm(HR) before treatment,and 468±33 μm(IR) and 413±13μm(HR) at 1y.Km and Kmax decreased in both groups(P> 0.05).6 eyes from each group presented transitory haze.No eye progressed to the 1y.·CONCLUSION:The use of hypotonic riboflavin seems to be a valid alternative for performing the traditional corneal cross-linking technique in eyes with a central corneal thickness of <400 μm.

关 键 词：圆锥角膜 交联术 核黄素 薄角膜 

分 类 号：R779.6[医药卫生—眼科]