核黄素/UVA诱导的角膜交联术治疗晚期圆锥角膜的安全性和有效性

doi:10.6040/j.issn.1673-3770.0.2014.338

山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (2): 86-88.doi: 10.6040/j.issn.1673-3770.0.2014.338

核黄素/UVA诱导的角膜交联术治疗晚期圆锥角膜的安全性和有效性

张春晓, 李志伟, 徐文文, 李凤娇, 陶祥臣, 牟国营

山东大学附属省立医院眼科, 山东济南 250021

收稿日期:2014-10-14 出版日期:2015-04-16 发布日期:2015-04-16
作者简介:张春晓。E-mail:littlechunxiao@sina.com

Efficacy and safety evaluation of UVA/riboflavin crosslinking for late and thin cornea keratoconus

ZHANG Chun-xiao, LI Zhi-wei, XU Wen-wen, LI Feng-jiao, TAO Xiang-chen, MU Guo-ying

Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China

Received:2014-10-14 Online:2015-04-16 Published:2015-04-16
Contact: 牟国营。E-mail:mgyeyes@163.com E-mail:mgyeyes@163.com

摘要/Abstract

摘要： 目的评价角膜厚度低于400 μm的圆锥角膜患者行核黄素诱导的长波紫外线角膜交联术的安全性和有效性。方法选择角膜厚度低于400 μm的圆锥角膜患者14例18眼, 表面麻醉下去除上皮, 点低渗核黄素溶液使角膜基质水肿厚度达到400 μm以上, 行角膜交联术, 术后戴软性角膜接触镜。术前、术后记录观察最佳矫正视力、角膜顶点K值、角膜厚度、角膜内皮、晶体等变化。结果术后所有患者角膜上皮于1周内愈合, 14眼于5 d内愈合;角膜Haze于2~6周内消退;最佳矫正视力: 术前为4.76±0.61, 术后3个月为4.83±0.46, 6个月为4.84±0.51;角膜顶点K值:术前为(56.29±7.33)D, 3个月为(52.42±5.76)D, 6个月为(48.12±6.6)D;角膜厚度:治疗前为(318±33)μm, 水肿后为(447±18)μm, 3个月为(381±72)μm, 6个月为(354±35)μm;角膜内皮密度:术前为(3 069±202)/mm²,术后3个月为(2 910±213)/mm², 6个月为(2 935±215)/mm²;未见晶体、视网膜并发症。结论采用低渗核黄素法行角膜交联术治疗晚期薄角膜圆锥安全、有效。

关键词: 圆锥角膜, 核黄素/UVA角膜交联术, 角膜厚度, 角膜内皮计数

Abstract: Objective To evaluate the efficacy and safety of UVA/riboflavin corneal crosslinking in late keratoconus cases with cornea thinner than 400 μm. Methods A total of 18 eyes of 14 keratoconus patients with corneal thickness less than 400 μm were recruited in this study. Corneal epithelium of central 8mm was removed mechanically under topical anesthesia, then hypo-osmotic riboflavin was applied until corneal thickness reached over 400 μm. Then standard UVA/riboflavin corneal crosslinking was applied. BCVA, apex K value, corneal thickness, endothelium and lens changes were examined and recorded. Results Corneal epithelium of all patients was recovered within 1 week, and it of 14 eyes within 5 days. Corneal haze was found in all patients and vanished in 2 to 6 weeks. BCVA was 4.76±0.61 before treatment and 4.83±0.46 and 4.84±0.51 on 3 and 6 months after the operation. Apex K value was 56.29±7.33D, 52.42±5.76D and 48.12±6.6D before the treatment, and 3 and 6 months after the treatment. Corneal thickness was 318±33 μm, 447±18 μm, 381±72 μm and 354±35 μm before the treatment, after swelling, and 3 and 6 months after crosslinking. Endothelium was 3 069±202/mm², 2 910±213/mm² and 2 935±215/mm² before the treatment, and 3 and 6 months after the treatment. Conclusion By using hypo-osmotic riboflavin to swell thin cornea, UVA/riboflavin corneal crosslinking is safe and effective in the treatment of late keratoconus.

Key words: Corneal thickness, Corneal endothelium, Keratoconus, UVA/riboflavin corneal crosslinking

中图分类号:

R772.2

张春晓, 李志伟, 徐文文, 李凤娇, 陶祥臣, 牟国营. 核黄素/UVA诱导的角膜交联术治疗晚期圆锥角膜的安全性和有效性[J]. 山东大学耳鼻喉眼学报, 2015, 29(2): 86-88.

ZHANG Chun-xiao, LI Zhi-wei, XU Wen-wen, LI Feng-jiao, TAO Xiang-chen, MU Guo-ying. Efficacy and safety evaluation of UVA/riboflavin crosslinking for late and thin cornea keratoconus[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(2): 86-88.

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核黄素/UVA诱导的角膜交联术治疗晚期圆锥角膜的安全性和有效性

Efficacy and safety evaluation of UVA/riboflavin crosslinking for late and thin cornea keratoconus

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