Abstract：
OBJECTIVE: To present baseline characteristics and to present the perioperative corneal thickness during corneal crosslinking (CXL) treatment for progressive keratoconus and to describe how the addition of sterile water (SW) efficaciously can maintain the corneal thickness. The treatment efficacy will be evaluated when the 1-year follow-up is complete.
METHODS: A randomised clinical study using epithelium-off CXL with continuous UVA irradiation (9 mW/cm2) and two kinds of riboflavin solutions: (i) isoosmolar dextran-based riboflavin (n = 27) and (ii) hypoosmolar dextran-free riboflavin (n = 27).
METHODS: progressive keratoconus with an increase in maximum keratometry value (Kmax) of 1.0 dioptre (12 months) or 0.5 dioptres (6 months). Corneae thinner than 400 μm were also included.
METHODS: Perioperative corneal thickness and the effect of adding SW.
RESULTS: Seventy-four per cent of the patients in the isoosmolar group and 15% in the hypoosmolar group required the addition of SW, which effectively maintained a corneal thickness of 400 μm in all cases during CXL. The addition of SW was primarily needed during the irradiation procedure and not the preoperative soaking period.
CONCLUSIONS: Especially during the CXL irradiation phase, isoosmolar riboflavin causes a significant dehydrating effect leading to corneal thinning during CXL. The customised addition of SW is efficacious in maintaining the corneal thickness during CXL and could increase the safety of the procedure.
METHODS: A randomised clinical study using epithelium-off CXL with continuous UVA irradiation (9 mW/cm2) and two kinds of riboflavin solutions: (i) isoosmolar dextran-based riboflavin (n = 27) and (ii) hypoosmolar dextran-free riboflavin (n = 27).
METHODS: progressive keratoconus with an increase in maximum keratometry value (Kmax) of 1.0 dioptre (12 months) or 0.5 dioptres (6 months). Corneae thinner than 400 μm were also included.
METHODS: Perioperative corneal thickness and the effect of adding SW.
RESULTS: Seventy-four per cent of the patients in the isoosmolar group and 15% in the hypoosmolar group required the addition of SW, which effectively maintained a corneal thickness of 400 μm in all cases during CXL. The addition of SW was primarily needed during the irradiation procedure and not the preoperative soaking period.
CONCLUSIONS: Especially during the CXL irradiation phase, isoosmolar riboflavin causes a significant dehydrating effect leading to corneal thinning during CXL. The customised addition of SW is efficacious in maintaining the corneal thickness during CXL and could increase the safety of the procedure.
摘要：
目的：介绍角膜交联（CXL）治疗进行性圆锥角膜期间的基线特征和围手术期角膜厚度，并描述添加无菌水（SW）如何有效维持角膜厚度。治疗效果将在1年随访完成时进行评估。
方法：一项随机临床研究，使用上皮外CXL，连续UVA照射（9mW/cm2）和两种核黄素溶液：（i）基于葡聚糖的等渗核黄素（n=27）和（ii）无葡聚糖的低渗核黄素（n=27）。
方法：进行性圆锥角膜，最大角膜曲率测量值（Kmax）增加1.0屈光度（12个月）或0.5屈光度（6个月）。还包括比400μm薄的角膜。
方法：围手术期角膜厚度和添加SW的影响。
结果：等渗组74％的患者和低渗组15％的患者需要增加SW，在CXL期间，在所有情况下有效地保持了400μm的角膜厚度。在辐照过程中主要需要添加SW，而不是术前浸泡期。
结论：特别是在CXL照射阶段，等渗核黄素会引起明显的脱水作用，导致CXL期间角膜变薄。定制的SW添加在CXL期间有效地维持角膜厚度,并且可以增加手术的安全性。
方法：一项随机临床研究，使用上皮外CXL，连续UVA照射（9mW/cm2）和两种核黄素溶液：（i）基于葡聚糖的等渗核黄素（n=27）和（ii）无葡聚糖的低渗核黄素（n=27）。
方法：进行性圆锥角膜，最大角膜曲率测量值（Kmax）增加1.0屈光度（12个月）或0.5屈光度（6个月）。还包括比400μm薄的角膜。
方法：围手术期角膜厚度和添加SW的影响。
结果：等渗组74％的患者和低渗组15％的患者需要增加SW，在CXL期间，在所有情况下有效地保持了400μm的角膜厚度。在辐照过程中主要需要添加SW，而不是术前浸泡期。
结论：特别是在CXL照射阶段，等渗核黄素会引起明显的脱水作用，导致CXL期间角膜变薄。定制的SW添加在CXL期间有效地维持角膜厚度,并且可以增加手术的安全性。
