三种不同方案角膜交联后角膜厚度减小量的比较

发布时间：2018-04-09 17:28

本文选题：角膜交联　切入点：最薄角膜厚度　出处：《眼科新进展》2017年06期

【摘要】：目的评估三种不同方案角膜交联(corneal crosslinking,CXL)治疗进展期圆锥角膜后最薄角膜厚度(thinnest-point corneal thickness,TCT)减小量的差异。方法回顾性临床病例研究。选取2010年8月至2015年11月在海军总医院眼科确诊并行CXL治疗的进展期圆锥角膜连续性病例85例(110眼)。21例(25眼)行标准的去上皮CXL(standard epithelium-off corneal crosslinking,S-CXL)治疗;14例(22眼)行1 g·L~(-1)核黄素乳酸钠林格液离子导入CXL(iontophoresis-assisted CXL,I-CXLa)治疗;50例(63眼)行1 g·L~(-1)核黄素蒸馏水溶液离子导入CXL(iontophoresis-assisted CXL,I-CXLb)治疗。应用ALLEGRO眼前节分析仪测量术前、术后TCT,比较三种CXL方案术后TCT减小量的差异。结果 S-CXL术后3个月、6个月、12个月TCT与术前差值分别为(-14.93±27.16)μm、(-31.94±22.89)μm、(-27.71±26.01)μm;I-CXLa术后3个月、6个月、12个月TCT与术前差值分别为(-20.14±19.09)μm、(-10.10±24.28)μm、(-7.11±22.26)μm;I-CXLb术后3个月、6个月、12个月TCT与术前差值分别为(-28.08±26.14)μm、(-21.08±25.62)μm、(-15.91±19.19)μm。术后3个月时,三组TCT减小量差异没有统计学意义(P=0.188);术后6个月、12个月时,S-CXL组和I-CXLa组比较差异均有统计学意义(均为P0.05),I-CXLb组和S-CXL组、I-CXLb组和I-CXLa组比较差异均无统计学意义(均为P0.05)。结论三种CXL方案治疗术后6个月和12个月,TCT减小量与交联方案相关,反映了交联强度的大小。I-CXLb术后TCT减小量小于S-CXL,但差异不显著,两者交联强度差异亦不显著。
[Abstract]:Objective to evaluate the difference of thinnest-point corneal thicknessTCTs in the treatment of advanced keratoconus with three different protocols.Methods retrospective study of clinical cases.50 patients (63 eyes) with CXL(iontophoresis-assisted CXLI-CXLa) were treated with riboflavin distilled water (CXL(iontophoresis-assisted CXLI-CXLb).ALLEGRO anterior segment analyzer was used to measure TCT before and after operation.缁撴灉 S-CXL鏈悗3涓湀,6涓湀,12涓湀TCT涓庢湳鍓嶅樊鍊煎垎鍒负(-14.93卤27.16)渭m,(-31.94卤22.89)渭m,(-27.71卤26.01)渭m;I-CXLa鏈悗3涓湀,6涓湀,12涓湀TCT涓庢湳鍓嶅樊鍊煎垎鍒负(-20.14卤19.09)渭m,(-10.10卤24.28)渭m,(-7.11卤22.26)渭m;I-CXLb鏈悗3涓湀,6涓湀,12涓湀TCT涓庢湳鍓嶅樊鍊煎垎鍒负(-28.08卤26.14)渭m,(-21.08卤25.62)渭m,(-15.91卤19.19)渭m.At 3 months after operation, there was no significant difference in the decrease of TCT between the three groups (P < 0. 188), but at 6 months and 12 months after operation, there were significant differences between the S-CXL group and the I-CXLa group (P 0. 05%). There was no significant difference between the two groups (P 0. 05).Conclusion the decrease of TCT after 6 and 12 months of treatment with three CXL regimens is related to the crosslinking regimen, which indicates that the decrease of TCT in the crosslinking intensity. I-CXLb is smaller than that of S-CXLb, but the difference is not significant, and the difference of crosslinking strength between them is not significant.
【作者单位】：海军总医院眼科;
【基金】：北京市科学技术委员会资助(编号:Z151100004015217)~~
【分类号】：R772.2

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