中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2015年
3期
152-155
,共4页
陈世豪%李旖旎%张佳%丁萍%王勤美
陳世豪%李旖旎%張佳%丁萍%王勤美
진세호%리의니%장가%정평%왕근미
角膜胶原交联术%快速交联%高能量%圆锥角膜%跨上皮方法%治疗结果
角膜膠原交聯術%快速交聯%高能量%圓錐角膜%跨上皮方法%治療結果
각막효원교련술%쾌속교련%고능량%원추각막%과상피방법%치료결과
Corneal collagen cross-linking%Accelerated cross-linking%High energy%Keratoconus%Transepithial methods%Therapy outcome
目的 采用最新超高紫外线强度超高紫外线能量经上皮快速角膜胶原交联(A-CXL)方法治疗原发性圆锥角膜,评价该方法的安全性和有效性.方法 自身前后对照研究.原发性圆锥角膜患者共13例(13眼).采用超高紫外线强度超高紫外线能量经上皮A-CXL法,紫外线辐射强度为45 mW/cm2,照射时间为2 min 40 s,总能量为7.2 J/cm2.术前和术后7d、1个月、3个月、6个月、12个月随访检查包括眼科常规检查、UCVA、BCVA、屈光不正、角膜曲率、角膜前后表面高度(AE、PE)、角膜表面上下不对称性指数(IVA)、角膜最薄点厚度(CT)、补偿眼内压(IOPcc)、角膜内皮细胞密度(ECD)等.采用重复测量方差分析法分析各参数的变化情况.结果 术后UCVA (F=6.111,P＜0.01)和BCVA(F=9.734,P＜0.01)显著提高,球镜度减少(F=5.871,P＜0.05),陡峭子午线曲率(F=19.651,P＜0.05)和最大角膜曲率(F=3.253,P＜0.05)显著下降,AE (F=23.958,P＜0.01)和PE (F=20.832,P＜0.01)显著下降,IVA减少(F=4.068,P＜0.05).CT(F=4.180,P＞0.05)、ECD(F=1.812,P＞0.05)和IOPcc (F=0.332,P＞0.05)改变无统计学意义.结论 超高紫外线强度超高紫外线能量经上皮A-CXL治疗原发性圆锥角膜是安全有效的.
目的 採用最新超高紫外線彊度超高紫外線能量經上皮快速角膜膠原交聯(A-CXL)方法治療原髮性圓錐角膜,評價該方法的安全性和有效性.方法 自身前後對照研究.原髮性圓錐角膜患者共13例(13眼).採用超高紫外線彊度超高紫外線能量經上皮A-CXL法,紫外線輻射彊度為45 mW/cm2,照射時間為2 min 40 s,總能量為7.2 J/cm2.術前和術後7d、1箇月、3箇月、6箇月、12箇月隨訪檢查包括眼科常規檢查、UCVA、BCVA、屈光不正、角膜麯率、角膜前後錶麵高度(AE、PE)、角膜錶麵上下不對稱性指數(IVA)、角膜最薄點厚度(CT)、補償眼內壓(IOPcc)、角膜內皮細胞密度(ECD)等.採用重複測量方差分析法分析各參數的變化情況.結果 術後UCVA (F=6.111,P＜0.01)和BCVA(F=9.734,P＜0.01)顯著提高,毬鏡度減少(F=5.871,P＜0.05),陡峭子午線麯率(F=19.651,P＜0.05)和最大角膜麯率(F=3.253,P＜0.05)顯著下降,AE (F=23.958,P＜0.01)和PE (F=20.832,P＜0.01)顯著下降,IVA減少(F=4.068,P＜0.05).CT(F=4.180,P＞0.05)、ECD(F=1.812,P＞0.05)和IOPcc (F=0.332,P＞0.05)改變無統計學意義.結論 超高紫外線彊度超高紫外線能量經上皮A-CXL治療原髮性圓錐角膜是安全有效的.
목적 채용최신초고자외선강도초고자외선능량경상피쾌속각막효원교련(A-CXL)방법치료원발성원추각막,평개해방법적안전성화유효성.방법 자신전후대조연구.원발성원추각막환자공13례(13안).채용초고자외선강도초고자외선능량경상피A-CXL법,자외선복사강도위45 mW/cm2,조사시간위2 min 40 s,총능량위7.2 J/cm2.술전화술후7d、1개월、3개월、6개월、12개월수방검사포괄안과상규검사、UCVA、BCVA、굴광불정、각막곡솔、각막전후표면고도(AE、PE)、각막표면상하불대칭성지수(IVA)、각막최박점후도(CT)、보상안내압(IOPcc)、각막내피세포밀도(ECD)등.채용중복측량방차분석법분석각삼수적변화정황.결과 술후UCVA (F=6.111,P＜0.01)화BCVA(F=9.734,P＜0.01)현저제고,구경도감소(F=5.871,P＜0.05),두초자오선곡솔(F=19.651,P＜0.05)화최대각막곡솔(F=3.253,P＜0.05)현저하강,AE (F=23.958,P＜0.01)화PE (F=20.832,P＜0.01)현저하강,IVA감소(F=4.068,P＜0.05).CT(F=4.180,P＞0.05)、ECD(F=1.812,P＞0.05)화IOPcc (F=0.332,P＞0.05)개변무통계학의의.결론 초고자외선강도초고자외선능량경상피A-CXL치료원발성원추각막시안전유효적.
Objective Evaluate the safety and effectiveness of transepithelial,very high fluence accelerated corneal collagen cross-linking (A-CXL) in primary keratoconus.Methods Selfcontrol study.Thirteen primary keratoconus eyes of 13 patients were treated with transepthelial,very high fluence A-CXL with a UVA intensity of 45 mW/cm2,an irradiation time of 2 min 40 s,and a total energy of 7.2 J/cm2.Routine ophthalmologic examination,UCVA,BCVA,refractive error,corneal keratometry,anterior and posterior elevation (AE and PE),index of vertical asymmetry (IVA),minimum corneal thickness (CT),compensated intraocular pressure (IOPcc),endothelial cell density (ECD) were evaluated pre-operatively and 7-day,1-month,3-month,6-month,12-month post-operatively.Results The UCVA (F=6.111,P＜0.01) and BCVA (F=9.734,P＜0.01) showed a statistically significant improvement by 12-month post-operatively.The decrease in spherical lens (F=5.871,P＜0.05),steeper K-value (F=19.651,P＜0.05),Kmax (F=3.253,P＜0.05),AE (F=23.958,P＜0.01),PE (F=20.832,P＜0.01) and IVA (F=4.068,P＜0.05) were statistically significant.CT (F=4.180,P＞0.05),ECD (F=1.812,P＞0.05) and IOPcc (F=0.332,P＞0.05) were without significant change.Conclusion Transepithelial,very high fluence A-CXL is safe and effective in treating primary keratoconus.
