摘要
目的:研究核黄素和紫外线(UVA)交联疗法对晚期大泡性角膜病的疗效。方法:15例人工晶状体大泡性角膜病变(PBK)患者参与研究。分别于角膜交联前和干预后1,6mo,对患者行裂隙灯检查、视敏度、异物调查表、角膜透明度分级、眼部疼痛度范围、分析仪角膜厚度分析及超声波角膜厚度测量。氯化钠溶液处理1wk后,去除8mm直径范围的中央角膜上皮,在角膜上频繁点滴核黄素30min,后行3min紫外线(UVA)照射交联疗法。结果:15例患者(5男,10女),平均年龄为66±13岁。平均随访时间6.2mo。治疗后1mo全眼角膜透明度统计结果明显优于术前(P<0.05)。6mo时8眼角膜透明度较术前更佳,5眼持平,2眼低于术前(P=0.218)。70%病患异物感减弱。处理后1mo平均中央角膜厚度(CCT)减少(P<0.05)。6mo时,除3眼外均出现渐进性肿胀,但统计显示CCT明显薄于术前(P=0.006)。统计显示术后1mo平均矫正远视力(CDVA)明显优于术前(P=0.010)。6mo后无显著差异(P=0.130)。1mo痛值统计结果明显优于术前(P=0.007)。但6mo平均痛值较1mo高,较术前无明显差异(P=0.070)。结论:术后1mo结果显示角膜胶原交联疗法可显著改善角膜透明度、角膜厚度和眼痛。但是,它对减少PBK患者疼痛和维持角膜透明度方面似乎并无长期持久的效果。这种方法延长了角膜移植的时间间隔,并提高了角膜内皮移植术(DSAEK)过程的可视化。
AIM： To evaluate the efficacy of riboflavin administration and ultraviolet A （ UVA ） cross - linking on advanced symptomatic bullous keratopathy. METHODS：Fifteen patients with symptomatic pseudophakic bullous keratopathy （ PBK ） were included. Slit - lamp examination, visual acuity, foreign body sensation（ FBS） questionnaire, corneal clarity grading, ocular pain intensity scale and corneal thickness measures with Pentacam and ultrasound pachymetry （ UP ） , were performed before corneal cross-linking and 1 and 6mo thereafter. After using sodium chloride solution, for one week, the central 8mm （ diameter ） of the corneal epithelium was removed, and cross - linking, with riboflavin instillation every 3min for 30min, and UVA irradiation for 30min was performed. RESULTS：Five males and 10 females with mean age of 66±13y were included. Mean follow up time was 6. 2mo. Corneal transparency in all eyes was statistically significantly better 1 month after treatment than preoperatively （ P〈 0. 05 ）. At 6mo, however, corneal transparency was better in 8 eyes, the same in 5 eyes, and worse in 2 eyes compared with preoperative levels （ P=0. 218 ）. Foreign body sensation subsided in 70% of patients. The average CCT decreased within 1mo after the procedure （ P 〈 0. 05 ）. At 6mo, all but 3 eyes had progressive swelling, and the CCT increased; however, the CCT was still statistically significantly thinner than preoperatively （P = 0. 006）. The improvement in mean CDVA from preoperatively to 1mo postoperatively was statistically significant （P=0. 010）. At 6mo, no significant＆amp;nbsp;differences were observed （P=0. 130）. The pain scores at 1mo were statistically significantly better than preoperatively （P=0. 007）. At 6mo, however the mean pain score was higher than at 1mo and not statistically significantly different from the preoperative score （P=0. 070）. CONCLUSION： Corneal CXL significantly improved corneal transparency, corneal thickness, and ocular pain 1 month
出处
《国际眼科杂志》
CAS
2014年第5期785-789,共5页
International Eye Science
基金
supported by the vice-chancellor of the researchcenter of Tabriz University of Medical Sciences,Tabriz,Iranthrough a grant
关键词
大泡性角膜病变
角膜胶原交联
角膜水肿
测厚仪
bullous keratopathy
corneal collagen cross-linking
corneal edema
pachymetry
