摘要
Abstract
Objective To investigate the safety,stability and long-term clinical efficacy of transepithelial and deepithelialized rapid corneal collagen crosslinking in the treatment of keratoconus.Methods A retrospective case-control study.84 eyes of 59 patients(including 40 males and 19 females,aged 21.68±2.18)with advanced keratoconus admitted to Southeast Eye Hospital of Fuzhou from June 2017 to June 2024 were enrolled.According to the minimum corneal thick-ness>450 μm(42 eyes),deepithepithelial corneal collagen cross-linking was performed.The thinnest point corneal thickness<450 μm,but>400 μm(42 eyes)was transepithelial corneal crosslinking.The changes in corneal crosslink-ing,visual acuity,diopter,maximum corneal curvature value(Kmax),corneal endothelial cell count and morphology,and corneal thickness at the thinnest point were observed and compared between the two groups before,at 1 and 6 months after keratoconus treatment with corneal collagen crosslinking in different paths.Results Compared with transepithelial corneal collagen crosslinking,the corneal crosslinking appeared earlier and deeper than that after transepithelial corneal collagen crosslinking.Group of cross-linking of collagen in the corneal epithelium:the maximum corneal curvature was from preoperative(52.61±4.23)D,to postoperative 3 years(51.23±5.42)D(P<0.001).The thinnest thickness of the cornea was from preoperative(452.01±39.70)μm,to postoperative years(450.32±36.82)μm(P<0.001).Corneal bio-mechanics corneal hysteresis(CH)was from preoperative(7.69±2.56)mmHg,to postoperative 3 years(8.24±2.81)mmHg,(P<0.001).The corneal endothelial cell count was from preoperative(2 926.5±213.88)cells/mm2 to postopera-tive 3 years(2 692.14±267.19)cells/mm2,which was statistically significant(P<0.001),and the morphology of corneal endothelial cells was hexagonal and moderate in.The cross-linking group:the maximum corneal curvature was signifi-cantly lower preoperative(56.24±6.42)D,postoperatively at 3 years(54.02±5.72)D(P<0.001).The thinnestachymetry of the cornea was significantly thinner preoperative(412.01±37.25)μm,than postoperatively at 3(424.13±29.01)μm(P<0.001).Corneal biomechanics(neal hysteresis CH)was significantly lower preoperatively(7.02±1.21)mmHg,than postoperatively at 3 years(7.64±2.42)mmHg(P<0.001).The corneal endothelial cell counts were significantly lower preoperative(2 684.45±324.81)cells/mm2,than postoperatively at 3 years(2 552.74±28.72)cells/mm2,difference was statistically significant(P<0.001).Conclusions Transepithelial and deepithelalized rapid corneal collagen crosslinking in the treatment of keratoconus has long-term stability and safety.The thickness of the thinnest point of the cornea and the curvature of the cornea have certain stability and improvement in long-term follow-up.The corneal thickness is strictly con-trolled to reduce the influence on the corneal endothelium.关键词
跨上皮角膜胶原交联术/去上皮角膜胶原交联术/圆锥角膜/角膜曲率/角膜厚度Key words
Cross epithelial corneal collagen cross-linking/Epithelial corneal collagen cross-linking/Keratoco-nus/Corneal curvature/Corneal thickness
