比较评估不同核黄素制剂和浸泡持续时间对进行性圆锥角膜在9mW/cm2加速角膜交联(ACXL)后的前段光学相干断层扫描(AS-OCT)结果的影响。
■在这项前瞻性研究中,连续的进行性圆锥角膜患者被随机分为4组.组1:基于羟丙基甲基纤维素(HPMC)的核黄素10分钟;组2:基于HPMC的核黄素20分钟;组3:基于葡聚糖的核黄素(0.1%)30分钟。在所有三组中,核黄素浸泡后,以9mW/cm2的紫外线A照射10分钟。第4组使用德累斯顿方案接受常规CXL(CCXL)。术后1个月评估交联角膜的AS-OCT特征,并与术后12个月的临床结果相关。
■该研究招募了每组26名患者的26只眼。在第1组和第2组中,AS-OCT发现相似(p>.05),分界线深度(DLD)深,如CCXL后获得的。与其他组相比,第3组的DLD明显更浅(p<0.01)。在视觉上没有组间差异,屈光,角化术,术后12个月的层析成像结果。随访12个月时,任何患者的眼睛均未出现明显的内皮细胞丢失或任何其他临床上显著的不良事件。
■尽管在交联的角膜中发现了结构变化,在使用基于HPMC的溶液10或20分钟的ACXL(9mW/cm2)之后观察到的DLD类似于在CCXL之后观察到的那些。然而,使用基于葡聚糖的溶液30分钟的ACXL(9mW/cm2)产生最浅的DLD。尽管这些重塑差异,视觉,术后1年随访时,所有组的屈光和断层摄影结局具有可比性.需要对更多患者和更长时间随访的研究来确定交联角膜的AS-OCT特征与ACXL疗效之间的任何关系。
UNASSIGNED: To comparatively evaluate the influence of different
riboflavin formulations and soaking durations on the anterior segment optical coherence tomography (AS-OCT) findings following accelerated corneal crosslinking (ACXL) at 9 mW/cm2 for in progressive keratoconus.
UNASSIGNED: In this prospective study, consecutive patients with progressive keratoconus were randomized into 4 groups. Group 1: hydroxypropyl methylcellulose (HPMC)-based
riboflavin for 10 min; Group 2: HPMC-based
riboflavin for 20 min; Group 3: dextran-based
riboflavin (0.1%) for 30 min.
Riboflavin soaking was followed by ultraviolet-A irradiation at 9 mW/cm2 for 10 min in all three groups. Group 4 underwent conventional CXL (CCXL) using Dresden protocol. The AS-OCT features of the crosslinked cornea were evaluated at postoperative month 1 and correlated to the clinical outcomes at postoperative month 12.
UNASSIGNED: The study enrolled 26 eyes of 26 patients in each group. In groups 1 and 2, the AS-OCT findings were similar (p > .05) and the demarcation lines depth (DLD) were deep as obtained following CCXL. The DLD was significantly shallower in group 3 compared to the other groups (p < .01). There were no between-group differences in regards to the visual, refractive, keratometric, and tomographic outcomes at postoperative month 12. No significant endothelial cell loss or any other clinically significant adverse event was encountered in any patient\'s eye at 12 months follow-up.
UNASSIGNED: Although structural variations were noted in the crosslinked cornea, DLDs observed following ACXL (9 mW/cm2) using HPMC-based solution for 10 or 20 min were similar to those observed following CCXL. Whereas, ACXL (9 mW/cm2) using dextran-based solution for 30 min resulted in the shallowest DLD. Despite these remodeling differences, the visual, refractive and tomographic outcomes of all groups were comparable at postoperative 1-year follow-up. Studies with a greater number of patients and longer follow-ups are required to establish any relation between AS-OCT characteristics of crosslinked cornea and ACXL efficacy.