■比较接受加速角膜交联(A-CXL)和无丝裂霉素C(MMC)的选择性波前引导的经上皮光折射角膜切除术(WG-tranPRK)与接受A-CXL的患者的雾度和屈光结果。
■这项前瞻性研究分析了2018年10月至2022年10月患有进行性圆锥角膜的95只眼睛(86例患者)。第一组行CXL联合角膜或眼部WG-transPRK(CXL+PRK,n=52),瞄准高阶像差(HOAs)。第二个仅接受CXL(n=43),两者都遵循SCHWINDAmaris激光平台(SCHWINDeye-tech-solutions)上没有MMC的相同加速CXL协议。基线和术后评估(1、3、6和12个月)包括未矫正(UDVA)和矫正(CDVA)远距视力,明显的折射,断层摄影术,角膜HOAs,和光学相干断层扫描(OCT)扫描。专利的机器学习算法以灰度单位客观地检测和量化OCT扫描上的基质雾度。
■在两组中,角膜前雾霾反射率和上皮下雾霾在术后3个月达到峰值,然后在6个月和12个月时逐渐下降。在任何时间点,组之间的雾度没有差异。到12个月,CDVA在CXL+PRK组增加2.5行(P<.001),在CXL组增加0.7行(P=.10),最大角膜曲率从51.70±5.10降至47.90±7.90屈光度(D)(CXLPRK组)(P<.001),从51.20±5.10降至50.30±4.60D(CXL组)(P=.004)。两组角膜HOA均下降,但CXLPRK组下降更多。
■与单独的A-CXL相比,在没有MMC的情况下将CXL与WG-tranPRK组合不会导致雾度增加。这种组合方法在视觉上实现了更大的改进,地形,和像差参数。[JRefractSurg.2024;40(9):e583-e594。].
UNASSIGNED: To compare haze and refractive outcomes in patients undergoing combined accelerated corneal cross-linking (A-CXL) and selective wavefront-guided transepithelial photorefractive keratectomy (WG-transPRK) without mitomycin C (MMC) versus those undergoing A-CXL.
UNASSIGNED: This prospective study analyzed 95 eyes (86 patients) with progressive keratoconus from October 2018 to October 2022. The first group underwent CXL combined with corneal or ocular WG-transPRK (CXL+PRK, n = 52), targeting higher order aberrations (HOAs). The second underwent CXL only (n = 43), both following the same accelerated CXL protocol without MMC on the SCHWIND Amaris laser platform (SCHWIND eye-tech-solutions). Baseline and postoperative evaluations (1, 3, 6, and 12 months) included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest refraction, tomography, corneal HOAs, and optical coherence tomography (OCT) scans. A patented machine learning algorithm objectively detected and quantified stromal haze on OCT scans in grayscale units.
UNASSIGNED: In both groups, anterior corneal haze reflectivity and subepithelial haze peaked at 3 months postoperatively, then progressively decreased at 6 and 12 months. Haze did not differ between groups at any time point. By 12 months, CDVA increased by 2.5 lines in the CXL+PRK group (P < .001) and by 0.7 lines in the CXL group (P = .10), and maximum keratometry decreased from 51.70 ± 5.10 to 47.90 ± 7.90 diopters (D) (CXL+PRK group) (P < .001) and from 51.20 ± 5.10 to 50.30 ± 4.60 D (CXL group) (P = .004). Corneal HOAs decreased in both groups but more in the CXL+PRK group.
UNASSIGNED: Combining CXL with WG-transPRK without MMC does not result in increased haze when compared to A-CXL alone. This combined approach achieves greater improvements in visual, topographic, and aberrometric parameters. [J Refract Surg. 2024;40(9):e583-e594.].