目的:评估跨上皮角膜胶原交联(CXL)治疗对进行性圆锥角膜患者CXL术后12个月随访时角膜光学性能的影响。
方法:纳入67例患者的110只眼。通过Sirius双扫描角膜断层扫描记录了4毫米直径瞳孔上的以下角膜光学像差:角膜高阶像差的前后量[HOAs],垂直昏迷,水平昏迷,垂直三叶草,斜三叶形,和球面像差,和点扩散函数(PSF)的Strehl比率。
结果:角膜总HOA的均均方根误差值有显著改善,完全昏迷,前HOA,前昏迷,CXL后垂直昏迷(全部P>0.05)。后像差参数未发现显着变化。CXL后PSF值无明显变化(P>0.05)。角膜地形图测量结果与基线测量结果相比,平均模拟角膜曲率测量1,模拟角膜曲率测量2和最大角膜曲率测量没有变化(全部P>0.05)。12个月时,未矫正(UCVA)和最佳矫正(BCVA)视力均有显著改善(P<0.001,两者).大多数角膜像差与术后BCVA显着相关,但HOA的变化与视力改善无统计学关联.
结论:经上皮CXL在手术1年后可有效稳定角膜测量指数并改善大多数角膜像差。虽然对CXL术后像差的愈合效果在总参数和前参数上,在后表面没有观察到显著的变化。此外,观察到,经上皮CXL治疗未引起PSF分布数据的显著变化.
OBJECTIVE: To evaluate the effect of transepithelial corneal collagen crosslinking (CXL) treatment on the optical performance of the cornea at 12-month follow-up after CXL in patients with progressive keratoconus.
METHODS: One hundred and ten eyes of 67 patients were included. The following corneal optical aberrations over the 4-mm-diameter pupil were recorded via Sirius dual-scanning corneal tomography: total, anterior and posterior amount of corneal higher order aberrations [HOAs], vertical coma, horizontal coma, vertical trefoil, oblique trefoil, and spherical aberration, and Strehl ratio of point spread function (PSF).
RESULTS: There were significant improvements in mean root mean square error values for corneal total HOA, total coma, anterior HOA, anterior coma, and vertical coma following CXL (P > 0.05, for all). No significant changes were found in the posterior aberometric parameters. PSF value did not change after CXL (P > 0.05). The corneal topographic measurements not revealed a change in the mean simulated keratometry-1, simulated keratometry-2, and maximum keratometry compared with the baseline measurements (P > 0.05, for all). At 12 months, there was a significant improvement in the uncorrected (UCVA) and best corrected (BCVA) visual acuity (P < 0.001, both). Most corneal aberrations correlated significantly with postoperative BCVA, but changes in HOAs were not statistically associated with improvements in visual acuity.
CONCLUSIONS: Transepithelial CXL was effective in stabilizing the keratometric indices and improving the most corneal aberrations in keratoconic eyes 1 year after the procedure. While the healing effect on aberrations after CXL was in total and anterior parameters, no significant changes were observed in the posterior surface. In addition, it was observed that transepithelial CXL treatment did not cause a significant change in PSF distribution data.