巩膜胶原交联术在近视中的研究进展

Research advances of scleral collagen cross-linking techniques in prevention of myopia

巩膜的扩张是近视发生、发展的中心环节。如果能对巩膜进行加固,就有望阻止巩膜的扩张,进而控制近视进展,并可能减少病理性近视相关并发症的发生,如后巩膜葡萄肿、脉络膜萎缩、视网膜裂孔及脱落、青光眼和眼内炎。巩膜的主要成分是胶原。胶原交联术可以改变胶原的变性温度、机械强度和抗蛋白降解能力等医学参数,从而增强巩膜抗扩张力。因此,胶原交联术在近视防控领域具有应用前景。本文对巩膜在近视中产生的变化特点,以及核黄素-紫外光、核黄素-蓝光和Tenon囊下注射化学剂交联巩膜胶原的技术干预近视的相关研究进展进行综述。

Posterior sclera expansion is the hallmark of myopia progression. If the scleral rigidity can be increased by collagen cross-linking,which in turn may reduce sclera expansion and axial elongation,then the myopia progression would be expected to reduce or stop. Thus the risk of pathological myopia associated complications such as posterior scleral staphyloma,chorioretinal atrophy,retinal tears and detachment,glaucoma and endophthalmitis may be reduced. The main component of the sclera is collagen. Collagen cross linking can result in scleral rigidity through changes of collagen parameters such as the denaturation temperature,the mechanical strength and the ability of antidegradation of proteinase. Therefore, this technique shows promising application in myopia control. This article summarizes the changes in sclera of myopia and recent findings of researches on scleral collagen cross-linking techniques for prevention of myopia by riboflavin with UVA irradiation,riboflavin with blue light and Sub-Tenon＇s injection of several chemical agents.