目的:评估加速角膜胶原交联(CXL)在小儿圆锥角膜中的安全性和有效性。
方法:前瞻性非随机观察性研究。
方法:纳入25例圆锥角膜患儿的33只眼。机械去除角膜上皮。接下来,核黄素/羟丙基甲基纤维素溶液)应用10分钟。加速CXL(10mW/cm2,持续9分钟),已完成。视敏度,裂隙灯检查,折射,角膜曲率测量读数,测厚仪,前后立面图,平均进展指数,并记录Q值。后续访问定于一天进行,3天,7天,一个月,然后在手术后的3,6,12个月。
结果:平均UAVA有统计学意义的改善,AVA,和平均角膜散光(P<0.0001)。平均角膜厚度显着减少。术前平均Kmax读数从术前的49.12±3.7D降低至12个月时的47.9±3.7D。平均最大前高度,平均进展指数和Q值显示有统计学意义的改善.没有记录到对后抬高的显着影响。在这项研究中没有遇到严重的并发症。
结论:加速CXL在小儿圆锥角膜中显示稳定和有益的临床结果。在这个年龄段,这似乎是一个有效和安全的程序。加速CXL对角膜后表面的影响将需要进一步评估。
OBJECTIVE: To evaluate the safety and effectiveness of accelerated corneal collagen crosslinking (CXL) in pediatric keratoconus.
METHODS: Prospective non-randomized observational study.
METHODS: 33 eyes of 25 children with keratoconus were included. The corneal epithelium was mechanically removed. Next, riboflavin/hydroxypropyl methylcellulose solution) was applied for 10 min. Accelerated CXL (10 mW/cm2 for 9 min), was accomplished. Visual acuity, slit lamp examination, refraction, keratometry readings, pachymetry, anterior and posterior elevations, average progression indices, and Q values were recorded. The follow-up visits were scheduled on one day, 3 days, 7 days, one month and then on 3, 6, 12 months after the procedure.
RESULTS: It was statistically significant improvement of the mean UAVA, AVA, and the mean corneal astigmatism (P < .0001). The mean corneal thickness showed a significant reduction. The preoperative mean K max reading was reduced from 49.12 ± 3.7 D preoperatively to 47.9 ± 3.7 D at 12 months. The mean max anterior elevation, average progression index and Q value showed statistically significant improvement. No significant impact on posterior elevation was recorded. Serious complications were not encountered in this study.
CONCLUSIONS: Accelerated CXL shows a stabilization and beneficial clinical outcomes in pediatric keratoconus. It seems an effective and safe procedure in this age group. Effects of accelerated CXL on the posterior corneal surface will need further evaluation.