[1]王萌萌,王晶晶,刘延东,等.去上皮和经上皮快速角膜交联术紫外光脉冲输出模式治疗进展期圆锥角膜患者的临床效果[J].眼科新进展,2020,40(11):1037-1040.[doi:10.13389/j.cnki.rao.2020.0232]
 WANG Mengmeng,WANG Jingjing,LIU Yandong,et al.Epithelium-off or epithelium-on accelerated corneal cross-linking using pulsed ultraviolet light for keratoconus[J].Recent Advances in Ophthalmology,2020,40(11):1037-1040.[doi:10.13389/j.cnki.rao.2020.0232]
点击复制

去上皮和经上皮快速角膜交联术紫外光脉冲输出模式治疗进展期圆锥角膜患者的临床效果/HTML
分享到:

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年11期
页码:
1037-1040
栏目:
应用研究
出版日期:
2020-11-05

文章信息/Info

Title:
Epithelium-off or epithelium-on accelerated corneal cross-linking using pulsed ultraviolet light for keratoconus
作者:
王萌萌王晶晶刘延东李明然尹会苏张印博董兴国
054001 河北省邢台市,河北省眼科医院激光近视治疗科,河北省眼科学重点实验室
Author(s):
WANG MengmengWANG JingjingLIU YandongLI MingranYIN HuisuZHANG YinboDONG Xingguo
Hebei Provincial Key Laboratory of Ophthalmology,Refractive Treating Department,Hebei Provincial Eye Hospital,Xingtai 054001,Hebei Province,China
关键词:
圆锥角膜角膜交联术角膜缘紫外光核黄素
Keywords:
keratoconus corneal cross-linking limbus ultraviolet riboflavin
分类号:
R772.2
DOI:
10.13389/j.cnki.rao.2020.0232
文献标志码:
A
摘要:
目的 探讨去上皮快速角膜交联术紫外光脉冲输出模式(pl-快速CXL)和经上皮pl-快速CXL治疗进展期圆锥角膜患者的临床效果。方法 选取2018年1月至2019年6月在河北省眼科医院行pl-快速CXL治疗的进展期圆锥角膜患者16例31眼;根据术式将患眼分为两组,去上皮pl-快速CXL组7例13眼和经上皮pl-快速CXL组9例18眼。术前及术后3个月和6个月进行随访。记录患眼最佳矫正远视力、散光度、角膜前表面最大曲率、角膜前表面最小曲率、角膜最薄点厚度、角膜内皮细胞计数、交联线深度,对各指标进行统计学分析。结果 去上皮pl-快速CXL组和经上皮pl-快速CXL组患者术后3个月和术后6个月最佳矫正远视力、散光度、角膜前表面最大曲率、角膜前表面最小曲率、角膜内皮细胞计数与术前相比,差异均无统计学意义(均为P>0.05);术后3个月和术后6个月时两组角膜最薄点厚度均较术前变薄,差异均有统计学意义(均为P<0.05)。两组患者交联线深度术后3个月与术后6个月相比,差异均无统计学意义(均为P>0.05)。术后3个月和术后6个月时,去上皮pl-快速CXL组患者角膜交联线深度均较经上皮pl-快速CXL组更深,差异均有统计学意义(均为P<0.05)。对于相同时间点的其他参数而言,两组间差异均无统计学意义(均为P>0.05)。结论 无论是去上皮pl-快速CXL还是经上皮pl-快速CXL都安全可行,在术后6个月内均能够稳定圆锥角膜病情。
Abstract:
Objective To evaluate the clinical efficacy of epithelium-off accelerated corneal cross-linking (Epi-off ACXL) and epithelium-on accelerated corneal cross-linking (Epi-on ACXL) using pulsed ultraviolet light (pl) for keratoconus.Methods The data of 16 patients (31 eyes) performed with Epi-off pl-ACXL and Epi-on pl-ACXL in Hebei Eye Hospital from January 2018 to June 2019 was included and separated into two groups, the Epi-off pl-ACXL group (7 patients 13 eyes) and the Epi-on pl-ACXL group (9 patients 18 eyes). Follow-ups were performed before and 3 months and 6 months after surgery. The two groups were compared in best corrected distance visual acuity (BCDVA), astigmatism, maximum and minimum keratometry, corneal thinnest point thickness, corneal endothelial cells, and depth of demarcation line pre- and postoperatively.Results No statistically difference was found between two groups in the parameters of BCDVA, astigmatism, maximum and minimum keratometry, and corneal endothelial cells between 3 months and 6 months after surgery and before surgery (all P> 0.05). The corneal thinnest point thickness decreased significantly at 3 months and 6 months after surgery when compared with before surgery in the two groups (P< 0.05). There was no significant differences between the two groups of patients in depth of demarcation line 3 months and 6 months after surgery (both P>0.05). At 3 months and 6 months after surgery, the depth of demarcation line of the patients in the Epi-off pl-ACXL group was deeper than that in the Epi-on pl-ACXL group group, and the difference was statistically significant (all P<0.05). For other parameters at the same time point, there was no statistically significant differences between the two groups (all P>0.05).Conclusion Both Epi-off pl-ACXL and Epi-on pl-ACXL are safe and feasible treatment for keratoconus both of which can stabilise symptoms.

参考文献/References:

[1] 王萌萌,董坤峰,张军红,刁科,李瑞芳,蔡祎.运用双通道视觉质量分析系统评估角膜交联手术后的客观视觉质量[J].国际眼科杂志,2016,16(6):1196-1198.
WANG M M,DONG K F,ZHANG J H,DIAO K,LI R F,CAI Y.Evaluation of objective visual quality after corneal cross-linking using double-pass analysis system[J].Int Eye Sci,2016,16(6):1196-1198.
[2] WOLLENSAK G,SPOERL E,SEILER T.Stress-strain measurements of human and porcine corneas after riboflavin-ultraviolet-A-induced cross-linking[J].J Cataract Refract Surg,2003,29(9):1780-1785.
[3] 孙明甡,张丰菊.紫外线A-核黄素角巩膜胶原交联术的研究进展[J].中华眼科杂志,2018,54(12):948-953.
SUN M S,ZHANG F J.Research advances in corneal and scleral collagen cross-linking with ultraviolet A and riboflavin[J].Chin J Ophthalmol,2018,54(12):948-953.
[4] HAMMER A,RICHOZ O,MOSQUERA S A,TABIBIAN D,HOOGEWOUD F,HAFEZI F.Corneal biomechanical properties at different corneal cross-linking (CXL) irradiances[J].Invest Ophthalmol Vis Sci,2014,55(5):2881-2884.
[5] WERNLI J,SCHUMACHER S,SPOERL E,MROCHEN M.The efficacy of corneal cross-linking shows a sudden decrease with very high intensity UV light and short treatment time[J].Invest Ophthalmol Vis Sci,2013,54(2):1176-1180.
[6] KLING S,RICHOZ O,HAMMER A,TABIBIAN D,JACOB S,AGARWAL A,et al.Increased biomechanical efficacy of corneal cross-linking in thin corneas due to higher oxygen availability[J].J Refract Surg,2015,31(12):840-846.
[7] 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.
[8] TURKCU U O,YUKSEL N,NOVRUZLU S,YALINBAS D,BILGIHAN A,BILGIHAN K.Protein oxidation levels after different corneal collagen cross-linking methods[J].Cornea,2016,35(3):388-391.
[9] YUKSEL N,OZEL-TURKCU U,YALINBAS D,NOVRUZLU S,BILGIHAN A,BILGIHAN K.Comparison of aqueous humor nitric oxide levels after different corneal collagen cross-linking methods[J].Curr Eye Res,2016,41(12):1539-1542.
[10] ZHU Y,REINACH P S,ZHU H,LI L,YANG F,QU J,et al.Continuous-light versus pulsed-light accelerated corneal crosslinking with ultraviolet-A and riboflavin[J].J Cataract Refract Surg,2018,44(3):382-389.
[11] PEYMAN A,NOURALISHAHI A,HAFEZI F,KLING S,PEYMAN M.Stromal demarcation line in pulsed versus continuous light accelerated corneal cross-linking for keratoconus[J].J Refract Surg,2016,32(3):206-208.
[12] MORAMARCO A,IOVIENO A,SARTORI A,FONTANA L.Corneal stromal demarcation line after accelerated crosslinking using continuous and pulsed light[J].J Cataract Refract Surg,2015,41(11):2546-2551.
[13] SUN L,LI M,ZHANG X,TIAN M,HAN T,ZHAO J,et al.Transepithelial accelerated corneal collagen cross-linking with higher oxygen availability for keratoconus: 1-year results[J].Int Ophthalmol,2018,38(6):2509-2517.
[14] SHAJARI M,KOLB C M,AGHA B,STEINWENDER G,MULLER M,HERRMANN E,et al.Comparison of standard and accelerated corneal cross-linking for the treatment of keratoconus: a meta-analysis[J].Acta Ophthalmol,2019,97(1):e22-e35.
[15] KYMIONIS G D,TSOULNARAS K I,LIAKOPOULOS D A,SKATHAROUDI C A,GRENTZELOS M A,TSAKALIS N G.Corneal stromal demarcation line depth following standard and a modified high intensity corneal cross-linking protocol[J].J Refract Surg,2016,32(4):218-222.
[16] DIAKONIS V F,LIKHT N Y,YESILIRMAK N,DELGADO D,KARATAPANIS A E,YESILIRMAK Y,et al.Corneal elasticity after oxygen enriched high intensity corneal cross linking assessed using atomic force microscopy[J].Exp Eye Res,2016,153:51-55.

相似文献/References:

[1]王向华 赵宏 丁相奇.两种深板层角膜移植术治疗圆锥角膜的比较研究[J].眼科新进展,2012,32(4):000.
[2]吴东芳 张小兰 邱乐梅 王顺清 孙成淑 邓应平.圆锥角膜的诊断与治疗[J].眼科新进展,2012,32(12):000.
[3]罗畅 邓应平.性别及年龄对圆锥角膜发病与进展的影响[J].眼科新进展,2013,33(2):000.
[4]韩莎莎 王婷 孟丽丽 史伟云.深板层及穿透性角膜移植术治疗圆锥角膜术后屈光状态的比较[J].眼科新进展,2013,33(9):000.
[5]韦伟 杨晓钊 张长宁 朱秀萍.Comfort-Kone硬性角膜接触镜矫治圆锥角膜的临床观察[J].眼科新进展,2012,32(1):000.
[6]王海燕 赵少贞 郝永娜 魏瑞华.圆锥角膜患者人口统计学及临床特点分析[J].眼科新进展,2012,32(3):000.
[7]陆燕 杨丽萍 葛轶睿 薛春燕 陈祥菲 王春红 黄振平.飞秒激光辅助的深板层角膜移植术治疗圆锥角膜及角膜扩张症[J].眼科新进展,2013,33(10):000.
[8]张沐,康丽华,管怀进.MicroRNA相关单核苷酸多态性与眼部疾病关系的研究进[J].眼科新进展,2014,34(11):1083.[doi:10.13389/j.cnki.rao.2014.0301]
 ZHANG Mu,KANG Li-Hua,GUAN Huai-Jin.Recent advances in relationship between microRNA-related SNPs and ocular diseases[J].Recent Advances in Ophthalmology,2014,34(11):1083.[doi:10.13389/j.cnki.rao.2014.0301]
[9]陆燕,朱小敏,曹谦,等.飞秒激光辅助的两种深板层角膜移植治疗圆锥角膜疗效比较[J].眼科新进展,2015,35(1):035.[doi:10.13389/j.cnki.rao.2015.0010]
 LU Yan,ZHU Xiao-Min,CAO Qian,et al.Comparison of two surgical techniques of femtosecond laser-assisted deep anterior lamellar keratoplasty for keratoconus[J].Recent Advances in Ophthalmology,2015,35(11):035.[doi:10.13389/j.cnki.rao.2015.0010]
[10]徐漫,孙荔,刘永珍,等. Belin角膜扩张分析鉴别早期圆锥角膜的敏感性与特异性[J].眼科新进展,2015,35(5):456.[doi:10.13389/j.cnki.rao.2015.0124]
 XU Man,SUN Li,LIU Yong-Zhen,et al. Sensitivity and specificity of Belin/Ambrosio Enhanced Ectasia Display in discriminating subclinical keratoconus[J].Recent Advances in Ophthalmology,2015,35(11):456.[doi:10.13389/j.cnki.rao.2015.0124]

备注/Memo

备注/Memo:
国家自然科学基金资助(编号:81700873);河北省重点研发计划项目(编号:18277754D);河北省医学科学研究课题计划项目(编号:20200842);河北省中医药管理局科研计划项目(编号:2020553);邢台市科技支撑计划项目(编号:2016ZC262)
更新日期/Last Update: 2020-11-05