针对过薄圆锥角膜的角膜胶原交联术治疗进展

The progress of corneal collagen cross-linking for thinner keratoconus

角膜胶原交联术(Corneal collagen cross linking,CXL),是一种可有效阻止圆锥角膜(Keratoconus,KC)进展的手术方式。为防止角膜内皮的损伤,手术标准要求去上皮后角膜厚度大于400μm的圆锥角膜可行标准的角膜胶原交联术。然而,大多数需要CXL的圆锥角膜患者不能达到这一手术标准。因此,对标准的角膜胶原交联术进行改进,使较薄圆锥角膜能够完成角膜交联或通过其他手术方式得到治疗,尤为重要。目前针对较薄型圆锥角膜的治疗方法有:使用低渗性核黄素行CXL、保留上皮瓣的CXL、个性化上皮清创术联合CXL、跨上皮角膜胶原交联术、离子电渗介导的跨上皮角膜角膜胶原交联术、角膜接触镜辅助角膜胶原交联术等多种手术方式。本文针对较薄圆锥角膜治疗进展进行综述。

Corneal collagen cross-linking(CXL)is an effective method to prevent the progress of Keratoconus(KC).In order to prevent the damage of corneal endothelium,the corneal thickness after epithelial-peeled is required to be greater than 400μm.However,most keratoconus patients who need CXL cannot meet this surgical standard.Therefore,it is important to improve the standard corneal collagen cross-linking so that the thinner keratoconus can complete corneal crosslinking or be treated by other surgical methods.At present,the treatment methods for thinner keratoconus include CXL with hypotonic riboflavin,CXL with upper flap retained,personalized epithelial debridement combined with CXL,transepithelial corneal collagen cross-linking,transepithelial corneal collagen cross-linking by iontophoresis,Contact lens-assisted collagen cross-linking and so on.This article reviews the progress in the treatment of thinner keratoconus.