Corneal collagen crosslinking in patients treated with dextran versus isotonic hydroxypropyl methylcellulose (HPMC) riboflavin solution: a retrospective analysis  

作　　者：Patrick B.Rapuano Priya M.Mathews George J.Florakis Stephen L.Trokel Leejee H.Suh 

机构地区：[1]Department of Ophthalmology,Edward S.Harkness Eye Institute,Columbia College of Physicians and Surgeons,635 West 165th Street,New York,NY 10032,USA

出　　处：《Eye and Vision》2018年第1期211-216,共6页眼视光学杂志（英文）

基　　金：study was provided by the Columbia University Department of Ophthalmology。

摘　　要：Background:Corneal collagen crosslinking(CXL)is a widely used treatment for halting the progression of keratoconus.Although initial studies of CXL were performed with a riboflavin solution containing dextran,recent protocols for CXL have indicated the use of a riboflavin solution containing isotonic hydroxypropyl methylcellulose(HPMC).This study was performed to investigate differences in visual outcomes and Scheimpflug(Pentacam)analysis in patients who have undergone epithelium-off CXL with riboflavin solution containing either 20%dextran versus 1.1%HPMC.Methods:All patients in this non-randomized,non-masked,retrospective cohort analysis were treated at Edward S.Harkness Eye Institute,Columbia University Medical Center,New York,NY,USA.Thirty-seven eyes of 33 patients were crosslinked with a dextran solution and 19 eyes of 19 patients crosslinked with an isotonic HPMC solution,both using an epithelium-off 30-min,3 mW/cm2 protocol.All patients had a diagnosis of keratoconus or postrefractive surgery ectasia.Best spectacle corrected visual acuity(BSCVA)and Pentacam parameters were compared at all follow up visits(1,6,12,and 24 months).Differences between groups treated with HPMC and dextran were compared using student’s t-test.Differences between treated eye and fellow eye were calculated and compared between HPMC and dextran groups using paired t-test.Results:Patients treated with a dextran solution had significantly greater improvement in BSCVA at 1,6,and 24 months(p<0.05)compared to the isotonic HPMC-treated group.Kmax increased in both groups at 1 month;however,HPMC-treated patients had a greater increase compared to dextran-treated patients(p=0.01).Kmax decreased in both groups at 6 and 12 months,although this finding was only significant in the HPMC-treated group at 12 months.Conclusions:Our data suggest that crosslinking with the dextran solution may result in significantly better visual outcomes(demonstrated by visual acuity)compared to the isotonic HPMC riboflavin solution.Dextran solutions may have othe

关 键 词：Corneal crosslinking Isotonic HPMC DEXTRAN 

分 类 号：R94[医药卫生—药剂学]