摘要
目的：评价角膜厚度低于400μm 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400μm 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400μm 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（3069±202）／mm2，术后3个月为（2910±213）／mm2，6个月为（2935±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。
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 topi-cal 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 chan-ges 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 ±7.33 D, 52.42 ±5.76 Dand 48.12 ±6.6 Dbefore 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 af-ter 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/ribofla-vin corneal crosslinking is safe and effective in the treatment of late keratoconus.
出处
《山东大学耳鼻喉眼学报》
CAS
2015年第2期86-88,共3页
Journal of Otolaryngology and Ophthalmology of Shandong University
