准分子激光治疗性角膜切削术联合角膜胶原交联术治疗原发性圆锥角膜

doi:10.3760/cma.j.issn.1674-845X.2018.05.008

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摘要

目的：评估准分子激光治疗性角膜切削术（PTK）联合角膜胶原交联术（CXL）治疗原发性圆锥角膜的临床效果。方法：前瞻性自身对照临床研究。2014年9-10月期间在温州医科大学附属眼视光医院接受PTK联合CXL治疗的进展期圆锥角膜患者11例（11眼），评估比较术前与术后12个月裸眼视力（UCVA）、最佳矫正视力（BCVA）、屈光状态、角膜形态、角膜最薄点厚度和角膜内皮细胞密度的差异。手术前后数据的比较采用配对t检验。结果：术后12个月时，UCVA较术前有所提高（t=3.692，P=0.008），球镜度、等效球镜度（SE）、角膜前表面最大曲率值较术前均有所改善（t=-1.397，P=0.039；t=-2.363，P=0.040；t=2.941，P=0.007），角膜最薄点厚度较术前降低（t=3.839，P=0.003），内皮细胞计数无明显变化（t=-1.615，P=0.172）。结论：PTK联合CXL治疗进展中的原发性圆锥角膜是安全和有效的。

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	张佳
	刘畅
	李旖旎
	丁萍
	文佩
	王春梦
	郑雅汝
	王勤美
	陈世豪

关键词 ：准分子激光治疗性角膜切削术, 角膜胶原交联术, 圆锥角膜

Abstract：

Objective: To evaluate the efficacy and safety of phototherapeutic keratectomy (PTK) and corneal collagen cross-linking (CXL) combined therapy on primary keratoconus. Methods: In this prospective,self-controlled clinical study, 11 patients (11 eyes) underwent treatment with combined PTK and CXL.Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refractive error, topography,corneal thickness, and endothelial cell density were evaluated preoperatively and at 12 months postoperatively. Data were analyzed using paired t-tests. results: At 12 months postoperatively, UCVA,sphere, and spherical equivalent improved significantly (t=3.692, P=0.008; t=-1.397, P=0.039; t=-2.363,P=0.040 respectively). Maximum K-value (Kmax) and corneal thinnest thickness decreased significantly
(t=2.941, P=0.007; t=3.839; P=0.003). There were no significant changes in endothelial cell density (t=-1.615, P=0.172). conclusions: PTK and CXL combined therapy was effective and safe in the treatment of progressive primary keratoconus.

Key words： phototherapeutic keratectomy corneal collagen cross-linking keratoconus

收稿日期: 2017-08-15

通讯作者: 张佳（ORCID：0000-0002-3171-0836），Email：653321886@qq.com 陈世豪（ORCID：0000-0001-7646-8003），Email：chenle@rocketmail.com

引用本文:

张佳,刘畅,李旖旎,丁萍,文佩,王春梦,郑雅汝,王勤美,陈世豪. 准分子激光治疗性角膜切削术联合角膜胶原交联术治疗原发性圆锥角膜[J]. 中华眼视光学与视觉科学杂志, 2018, 20(5): 292-296. Jia Zhang,Chang Liu,Yini Li,Ping Ding,Pei Wen,Chunmeng Wang,Yaru Zheng,Qinmei Wang,Shihao Chen. Efficacy and Safety of Phototherapeutic Keratectomy and Corneal Collagen cross-Linking combined Therapy on Primary Keratoconus. Chinese Journal of Optometry Ophthalmology and Visual science, 2018, 20(5): 292-296. DOI: 10.3760/cma.j.issn.1674-845X.2018.05.008

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https://www.cjoovs.com/CN/10.3760/cma.j.issn.1674-845X.2018.05.008 或 https://www.cjoovs.com/CN/Y2018/V20/I5/292

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