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小儿角膜交联:常规和加速治疗的视觉和地形预后比较 Pediatric Corneal Cross-linking: Comparison of Visual and Topographic Outcomes Between Conventional and Accelerated Treatment

Baenninger, P.B., Bachmann, L.M., Wienecke, L., Thiel, M.A., Kaufmann, C.

期刊名称:American journal of ophthalmology


交联 预后 角膜


摘要:目的:旨在比较常规(C-CXL)与加速角膜交联(A-CXL)治疗小儿圆锥角膜(KC1年后的视觉和地形结预后。设计:比较性,回顾性,连续性病例系列。方法:招募确诊的进行性KC,手术时角膜厚度≥400μm的患者。研究入组时和随访12个月时,测量未矫正的(UCVA)和最佳屈光矫正视力(BCVA)和正常最大角膜曲率测量读数(Kmax)。治疗失败率定义为在随访期间Kmax增加大于1.0屈光度的眼百分比。不良事件发生率是指基线BCVA视力≥2Snellen的眼百分比。对58名接受C-CXL39只眼)和A-CXL39只眼)患者的78只眼进行了单中心分析。结果:C-CXLA-CXL组术后12个月与术前UCVA0.01 log MAR; 95%可信区间-0.140.15P = 0.944);BCVA0.05log MAR; 95%可信区间-0.05-0.15P = .310)和Kmax-0.77屈光度; 95%可信区间-2.20-0.65P = 0.282)无统计学差异。 C-CXL39只眼中有9只眼(23.1%),A-CXL39只眼中有6只眼(15.4%)治疗失败(P = 0.389)。 C-CXL组仅有1只眼中出现不良事件。结论:在这项回顾性比较中,加速方法与常规方法治疗小儿圆锥形角膜同样有效。

PURPOSE:To compare visual and topographic outcomes 1 year after conventional (C-CXL) vs accelerated corneal cross-linking (A-CXL) in pediatric keratoconus (KC).DESIGN:Comparative, retrospective, consecutive case series.METHODS:Patients with topography-confirmed, progressive KC and a corneal thickness of 400μm at the time of surgery were enrolled. Uncorrected (UCVA) and best phoropter-corrected visual acuity (BCVA) and normal maximum keratometry reading (Kmax) were measured at study entry and at the 12-month follow-up. Treatment failure rate was defined as the percentage of eyes with an increase in Kmax of more than 1.0 diopter during follow-up. The adverse event rate was the percentage of eyes with a loss of 2 Snellen lines of BCVA from baseline. This was a single-center analysis of 78 eyes of 58 patients that underwent C-CXL (39 eyes) and A-CXL (39 eyes). No eyes were lost to follow-up after 12months.RESULTS:No significant difference between changes in 12months after as compared to the time before CXL for UCVA (0.01 log MAR; 95% confidence interval-0.14 to 0.15, P= .944), BCVA (0.05 log MAR; 95% confidence interval-0.05 to 0.15, P= .310), and Kmax (-0.77 diopters; 95% confidence interval-2.20 to 0.65, P= .282) between the C-CXL and A-CXL group were observed. Treatment failure rate was observed in 9 of 39 eyes (23.1%) in C-CXL and in 6 of 39 eyes (15.4%) in A-CXL (P= .389). Adverse events were seen only in 1 eye in the C-CXL group.CONCLUSIONS:In this retrospective comparison, the accelerated approach was equally as effective as the conventional protocol to treat pediatric keratoconus.


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