■角膜扩张导致进行性不规则角膜曲率和视力下降。
■评估角膜胶原交联(CXL)治疗屈光激光手术(RSL)引起的角膜扩张的安全性和有效性。
■根据PRISMA指南进行了系统评价和荟萃分析。我们搜索了PubMed,EMBASE,科克伦,和WebofScience数据库用于研究RLS后扩张症患者的CXL。感兴趣的结果包括视力,屈光结果,地形参数(Kmax,指数表面方差(ISV),垂直不对称指数(IVA),圆锥角膜指数(KI),中央圆锥角膜指数(CKI),高度不对称指数(IHA),高度偏心指数(IHD)和Rmin(最小矢状曲率)),中央角膜厚度,内皮细胞计数,和可能的不良事件。使用R软件(4.2.3版,R统计计算基金会,维也纳,奥地利)。
■包括421例患者(512只眼)的15项研究。平均年龄为32.03±4.4岁。合并结果显示CXL后稳定的未矫正视力,矫正视力显着改善(SMD=0.09;95%CI:-0.07至0.26)。球形当量显著降低(SMD=-0.09;95%CI:-0.35,-0.02)。地形参数Kmax显著下降(SMD=0.15;95%CI:0.01~0.28);其他参数,ISV,IVA,KI,CKI,IHA,IHD,和Rmin,没有明显变化。中央角膜厚度显著下降(SMD=0.24;95%CI:0.07~0.41),内皮细胞计数保持稳定。并发症很少见。
■CXL是治疗RLS后角膜扩张的安全有效技术。
UNASSIGNED: Corneal ectasia leads to progressive irregular corneal curvature and reduced visual acuity.
UNASSIGNED: To assess the safety and effectiveness of corneal collagen cross-linking (CXL) for managing corneal ectasia resulting from refractive laser surgery (RSL).
UNASSIGNED: A systematic
review and meta-analysis were realized according to PRISMA guidelines. We searched PubMed, EMBASE, Cochrane, and Web of Science databases for studies on CXL in patients with ectasia after RLS. The outcomes of interest included visual acuity, refractive outcomes, topographic parameters (Kmax, index surface variance (ISV), index of Vertical Asymmetry (IVA), keratoconus index (KI), central keratoconus index (CKI), index of height asymmetry (IHA), index of height decentration (IHD) and Rmin (minimum sagittal curvature)), central corneal thickness, endothelial cell count, and possible adverse events. Statistical analysis was performed using the R software (version 4.2.3, R Foundation for Statistical Computing, Vienna, Austria).
UNASSIGNED: 15 studies encompassing 421 patients (512 eyes) were included. The mean age was 32.03 ± 4.4 years. The pooled results showed a stable uncorrected visual acuity post-CXL, with a significant improvement in corrected distance visual acuity (SMD = 0.09; 95% CI: -0.07 to 0.26). The spherical equivalent decreased significantly (SMD = -0.09; 95% CI: -0.35, -0.02). The topographic parameter Kmax decreased significantly (SMD = 0.15; 95% CI:0.01 to 0.28); however, the other parameters, ISV, IVA, KI, CKI, IHA, IHD, and Rmin, did not change significantly. Central corneal thickness decreased significantly (SMD = 0.24; 95% CI:0.07 to 0.41), and the endothelial cell count remained stable The complications were rare.
UNASSIGNED: CXL is a safe and effective technique for managing corneal ectasia after RLS.