PDF(Pubmed)
Abstract：
UNASSIGNED: We describe a patient after customized crosslinking (CXL) for progressive keratoconus who developed corneal edema with spontaneous resolution.
UNASSIGNED: A 24-year-old male with progressive keratoconus of the left eye underwent a customized CXL procedure with a total energy of 10 J/cm2 for 16.4 minutes. Preoperative corrected distance visual acuity (CDVA) was 20/30 with a maximum keratometry (K)-value of 58.6 diopter (D) and the thinnest point measured 414 μm. The preoperative endothelial cell density (ECD) was 2414 cells/mm2. During treatment, corneal thickness was 325 μm after epithelial debridement and 375 μm after the application of 0.1 % riboflavin containing HPMC. After the treatment, antibiotic and steroid drops were prescribed for 5 days and 3 weeks, respectively. At the 1-month post-CXL visit the patient had no complaints, visual acuity and clinical examination showed no irregularities. At the 4-months post-CXL visit the patient complained of blurry vision. The CDVA was 20/100 and slit-lamp examination showed microcystic corneal edema. The corneal thickness at the thinnest point measured 440 μm. One month later the edema had resolved spontaneously and CDVA had restored to 20/25. Corneal thickness at the thinnest point measured 415 μm, the ECD was 1514 cells/mm2 and confocal microscopy showed normal structural changes in the anterior stroma after CXL, with the demarcation line located at a depth of 414 μm, just above the corneal endothelium.
UNASSIGNED: We report a case of corneal edema following customized CXL with endothelial cell loss that resolved spontaneously. We recommend either adhering to a minimal stromal thickness of 400 μm before administering UV-A irradiation, using a contact lens or adjusting the irradiation to prevent this complication.
UNASSIGNED: A 24-year-old male with progressive keratoconus of the left eye underwent a customized CXL procedure with a total energy of 10 J/cm2 for 16.4 minutes. Preoperative corrected distance visual acuity (CDVA) was 20/30 with a maximum keratometry (K)-value of 58.6 diopter (D) and the thinnest point measured 414 μm. The preoperative endothelial cell density (ECD) was 2414 cells/mm2. During treatment, corneal thickness was 325 μm after epithelial debridement and 375 μm after the application of 0.1 % riboflavin containing HPMC. After the treatment, antibiotic and steroid drops were prescribed for 5 days and 3 weeks, respectively. At the 1-month post-CXL visit the patient had no complaints, visual acuity and clinical examination showed no irregularities. At the 4-months post-CXL visit the patient complained of blurry vision. The CDVA was 20/100 and slit-lamp examination showed microcystic corneal edema. The corneal thickness at the thinnest point measured 440 μm. One month later the edema had resolved spontaneously and CDVA had restored to 20/25. Corneal thickness at the thinnest point measured 415 μm, the ECD was 1514 cells/mm2 and confocal microscopy showed normal structural changes in the anterior stroma after CXL, with the demarcation line located at a depth of 414 μm, just above the corneal endothelium.
UNASSIGNED: We report a case of corneal edema following customized CXL with endothelial cell loss that resolved spontaneously. We recommend either adhering to a minimal stromal thickness of 400 μm before administering UV-A irradiation, using a contact lens or adjusting the irradiation to prevent this complication.
摘要：
■我们描述了一名患者在定制交联（CXL）进行性圆锥角膜后出现自发消退的角膜水肿。
■一名24岁的男性左眼进行性圆锥角膜接受了定制的CXL手术，总能量为10J/cm2，持续16.4分钟。术前校正的远距视力（CDVA）为20/30，最大角膜曲率（K）值为58.6屈光度（D），最薄点测量为414μm。术前内皮细胞密度(ECD)为2414细胞/mm2。治疗期间,上皮清创术后角膜厚度为325μm，应用含0.1％核黄素的HPMC后角膜厚度为375μm。治疗后,抗生素和类固醇滴剂开了5天和3周，分别。在CXL访视后1个月，患者没有投诉，视力和临床检查未显示不规则。在CXL访视后4个月，患者抱怨视力模糊。CDVA为20/100，裂隙灯检查显示微囊性角膜水肿。测量的最薄点的角膜厚度为440μm。一个月后，水肿自发消退，CDVA恢复到20/25。测得最薄点的角膜厚度415μm,ECD为1514个细胞/mm2，共聚焦显微镜显示CXL后前基质的正常结构变化，分界线位于414μm的深度，就在角膜内皮上方。
■我们报告了一例定制CXL后角膜水肿，内皮细胞丧失自发消退。我们建议在施用UV-A照射之前坚持400μm的最小基质厚度，使用隐形眼镜或调整照射，以防止这种复杂性。
■一名24岁的男性左眼进行性圆锥角膜接受了定制的CXL手术，总能量为10J/cm2，持续16.4分钟。术前校正的远距视力（CDVA）为20/30，最大角膜曲率（K）值为58.6屈光度（D），最薄点测量为414μm。术前内皮细胞密度(ECD)为2414细胞/mm2。治疗期间,上皮清创术后角膜厚度为325μm，应用含0.1％核黄素的HPMC后角膜厚度为375μm。治疗后,抗生素和类固醇滴剂开了5天和3周，分别。在CXL访视后1个月，患者没有投诉，视力和临床检查未显示不规则。在CXL访视后4个月，患者抱怨视力模糊。CDVA为20/100，裂隙灯检查显示微囊性角膜水肿。测量的最薄点的角膜厚度为440μm。一个月后，水肿自发消退，CDVA恢复到20/25。测得最薄点的角膜厚度415μm,ECD为1514个细胞/mm2，共聚焦显微镜显示CXL后前基质的正常结构变化，分界线位于414μm的深度，就在角膜内皮上方。
■我们报告了一例定制CXL后角膜水肿，内皮细胞丧失自发消退。我们建议在施用UV-A照射之前坚持400μm的最小基质厚度，使用隐形眼镜或调整照射，以防止这种复杂性。
