核黄素角膜胶原交联治疗早期轻中度圆锥角膜的研究

摘要

目的:核黄素角膜胶原交联早期治疗轻度至中度圆锥角膜的预后.方法:三级眼科诊疗中心的前瞻性研究.共38例47眼轻至中度圆锥角膜接受核黄素角膜胶原交联治疗的患者纳入本研究.术前数据包括参与眼数,视力,眼压,角膜厚度与角膜地形图.术后数据包括最佳矫正视力,眼压,角膜厚度,角膜地形图和术后并发症.结果:研究包含年龄16 ～ 30岁的患者38例47眼.平均术前视力为0.58 ±0.40 logMAR,术后随访2a显著提高(0.40±0.27l0gMAR)(P=0.005).平均术前角膜曲率为50.5±4.6 D,术后显著降低.随访2a平均角膜曲率为48.2±4.1 D(P=0.011).术后随访2a眼压(15.1 ±3.0mmHg)较术前(12.9±2.5 mmHg)显著增加(P=o.035).术前角膜厚度467.9±38.8μm,术后随访2a(465.0±39.3 μm)明显降低.所有患者均无并发症出现.结论:早期使用核黄素角膜胶原交联治疗轻至中度圆锥角膜可获得长期的良好视力,而不必等其发展为进展期.%AIM:To present the outcomes of early treatment with corneal collagen cross-linking with riboflavin in patients with mild to moderate keratoconus.METHODS:It is a prospective interventional study at tertiary eye care center.Forty-seven eyes of 38 patients with mild to moderate keratoconus who underwent collagen cross linking with riboflavin were enrolled.Preoperative data included eye involved,presenting visual acuity,intraocular pressure (IOP),pachymetry and corneal topography.Postoperative data included the best -corrected visual acuity (BCVA),IOP,pachymetry,corneal topography and postoperative complications.RESULTS:Study comprised of 47 eyes of 38 patients aged between 16-30y.The average preoperative vision was 0.58± 0.40 IogMAR which significantly improved to 0.40±0.27 IogMAR at 2y follow up (P=0.005).The average preoperative keratometry readings were 50.5±4.6 D which significantly decreased during the subsequent follow up and the average keratometry readings at 2y was 48.2±4.1 D (P=0.011).The average IOP significantly increased postoperatively and at 2y follow up was 15.1 ±3.0mmHg compared to preoperative IOP (12.9±2.5 mmHg) (P=0.035).The average preoperativepachymetry was 467.9± 38.8 μm,which decreased significantly and was 465.0± 39.3 μ m at 2y follow up.No complications were noted in any of our cases.CONCLUSION:Early treatment with collagen crosslinking with riboflavin provide good long term visual outcomes in patients with mild to moderate keratoconus without awaiting for progression of the keratoconus.