角膜胶原交联术治疗不同曲率圆锥角膜的临床效果  

Clinical efficacy of corneal collagen cross-linking for the treatment of keratoconus with different keratometry

作　　者：沈策英 赵宏[1] 李彩红[1] Shen Ceying;Zhao Hong;Li Caihong(Department of Ophthalmology,Zhengzhou Second People’s Hospital,Zhengzhou Eye Institute,Zhengzhou 450006,China)

机构地区：[1]郑州市第二人民医院眼科郑州市眼科研究所,450006

出　　处：《中华眼外伤职业眼病杂志》2020年第6期429-433,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省科技攻关项目(182102310459)。

摘　　要：目的观察去上皮角膜胶原交联术(corneal collagen cross-linking,CXL)治疗不同曲率圆锥角膜的临床效果。方法回顾性分析郑州市第二人民医院2017年1月至2019年1月共78例(78眼)圆锥角膜的临床资料。每例任选1眼纳入研究。将所有患者分为两组:A组患者角膜前表面最大角膜曲率值(Kmax)≥55,共39例(39眼);B组患者Kmax<55,共39例(39眼)。所有患者均采用核黄素/UVA诱导的快速去上皮CXL治疗。术后随访12个月。结果术后两组患者的裸眼视力(UCVA)差异有统计学意义(F=7.762,P=0.007)。两组患者的术后最佳矫正视力(BCVA)差异有统计学意义(F=15.199,P=0.000)。两组患者不同时间点的BCVA差异有统计学意义(F=3.544,P=0.018)。术后B组患者的角膜内皮细胞密度更高,屈光状态(等效球镜度)较低。结论去上皮CXL治疗Kmax<55的圆锥角膜患者效果较好。Objective To observe the clinical efficacy of epithelium-removed corneal collagen cross-linking(CXL)in the treatment of keratoconus with different keratometry.Methods The clinical data of 78 eyes of 78 cases of keratoconus with different keratometry from Jan.2017 to Jan.2019 in Zhengzhou Second People’s Hospital was analyzed retrospectively.One eye selected for each patient was included in the study.All patients were divided into two groups.Group A included 39 eyes of 39 cases with maximal keratometry of the anterior corneal surface(Kmax)≥55.Group B included 39 eyes of 39 cases with Kmax<55.All patients were treated with riboflavin/UVA-induced rapid epithelium-removed CXL.The follawed up time was 12 months.Results The difference in UCVA after surgery was statistically significant between the two groups(F=7.762,P=0.007),and UCVA was higher in group B than that in group A.The difference in best corrected visual acuity(BCVA)after surgery between the two groups was statistically significant(F=15.190,P=0.000),and BCVA of group B was higher than that of group A.There was statistically significant difference in BCVA between the two groups at different time points(F=3.544,P=0.018).The improvement rate of BCVA in group B was higher than that in group A.Patients in group B had higher endothelial cell density and lower spherical equivalent.Conclusion Epithelium-removed CXL for the treatment of keratoconus with Kmax<55 have better efficacy.

关 键 词：圆锥角膜 交联术 胶原 角膜 曲率 角膜 效果 治疗 

分 类 号：R779.6[医药卫生—眼科]