目的:为了比较视觉,屈光,在儿童和成人进行性圆锥角膜(KC)患者之间进行了12个月的随访后,高辐照度加速角膜交联(ACXL)方案的地形结果。
方法:回顾性,比较,队列研究。KC患者分为两组:儿科(≤18岁)和成人(>18岁)。所有这些都用epi-OFFACXL(30mW/cm2,8分钟,脉冲1:1开和关=7.2J/cm2)。视觉,屈光,术前和术后1,3,6和12个月测量地形图值.KC进展,定义为随访期间Kmax增加≥1D,被记录下来。
结果:89只眼(53例)纳入分析;45只(50.6%)眼来自儿科患者,44只(49.4%)眼来自成人。在一年的随访中,儿科患者的进展率显着较高(22.2%vs.4.5%,p=.014)。相反,女性(Beta=-3.62,p=0.018),Snellen的基线未矫正视力≥20/60(Beta=-5.96,p=.007),ACXL治疗≥15年(β=-0.31,p=.021)与非进行性疾病相关。最佳矫正视力的显著改善,Kmin,Km,记录两组的Kmax。总的来说,两组均有86.5%的眼显示Kmax稳定或改善。
结论:尽管视觉上相似,屈光,两组的地形结果,在随访1年时,年龄较小与ACXL后KC进展相关.
OBJECTIVE: To compare the visual, refractive, and topographic outcomes of a high irradiance accelerated corneal crosslinking (ACXL) protocol after a 12-month follow-up between pediatric and adult patients with progressive keratoconus (KC).
METHODS: Retrospective, comparative, cohort
study. Patients with KC were divided into two groups: pediatric (≤ 18 years) and adult (> 18 years). All of them were managed with epi-OFF ACXL (30 mW/cm2, 8 min, pulsed 1:1 on and off = 7.2 J/cm2). Visual, refractive, and topographic values were measured preoperatively and at 1, 3, 6, and 12 months postoperative. KC progression, defined as a Kmax increase of ≥ 1D during follow-up, was recorded.
RESULTS: Eighty-nine eyes (53 patients) were included for analysis; 45 (50.6%) eyes were from pediatric patients and 44 (49.4%) from adults. At one-year follow-up, pediatric patients experienced significantly higher rates of progression (22.2% vs. 4.5%, p = .014). Contrariwise, female gender (Beta = - 3.62, p = .018), a baseline uncorrected visual acuity of Snellen ≥ 20/60 (Beta = - 5.96, p = .007), and being ≥ 15 years at ACXL treatment (Beta = - 0.31, p = .021) were associated with non-progressive disease. A significant improvement in best-corrected visual acuity, Kmin, Km, and Kmax was recorded in both groups. Overall, 86.5% of eyes from both groups showed Kmax stabilization or improvement.
CONCLUSIONS: Despite the similarity in visual, refractive, and topographic outcomes in both groups, younger age was associated with KC progression after ACXL at one year of follow-up.