Impact of Simultaneous TG-PRK on Corneal Haze After Cross-Linking for Keratoconus: A Quantitative Densitometry Analysis.

IF 1.9 3区医学 Q2 OPHTHALMOLOGY

Cornea Pub Date : 2025-03-25 DOI:10.1097/ICO.0000000000003862

João Q Gil, Pedro Gil, Sara Geada, Esmeralda Costa, Cristina Tavares, Andreia Rosa, Maria J Quadrado, Joaquim N Murta

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Abstract

Purpose: To compare the impact of simultaneous topography-guided photorefractive keratectomy (TG-PRK) on corneal haze in patients undergoing accelerated corneal cross-linking (CXL) for keratoconus, using corneal densitometry.

Methods: Retrospective, case-control study comparing patients undergoing accelerated CXL alone (CXL group) or combined CXL and TG-PRK (TG-PRK group). All patients performed PTK-assisted 50-μm deepithelization, followed by 10-minute ultraviolet-A exposure at 10 mW/cm2 (6 J/cm2 total dose). In the TG-PRK group, patients had simultaneous TG-PRK ablation for topographic regularization. Corneal densitometry was measured preoperatively, at 3 months, and at 1 year postoperatively using a Scheimpflug device. Changes in densitometry values across different corneal regions were analyzed to assess haze evolution.

Results: A total of 106 eyes were included, with 50 eyes in the CXL group and 56 eyes in the TG-PRK group. At 3 months and 1 year postoperatively, patients in the TG-PRK group exhibited significantly higher corneal densitometry values across all areas of the anterior and central middle stroma (P < 0.001). By 1 year, densitometry values in both groups had largely returned to baseline, except for the central 2 mm of the anterior cornea in the TG-PRK group. Patients with greater flattening had significantly more haze after CXL with TG-PRK, but no correlation was found between haze formation and changes in visual acuity in both groups.

Conclusions: Simultaneous TG-PRK and CXL result in more significant and prolonged corneal haze compared with CXL alone. Haze improves over time but persists longer in the combined procedure. Corneal densitometry is valuable for assessing haze and optimizing patient management.

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同时TG-PRK对圆锥角膜交联后角膜雾度的影响：定量密度分析。

目的：利用角膜密度测定法比较同时行地形引导光屈光性角膜切除术（TG-PRK）对圆锥角膜加速交联（CXL）患者角膜雾度的影响。方法：回顾性、病例对照研究，比较单独加速CXL （CXL组）和CXL联合TG-PRK （TG-PRK组）的患者。所有患者都进行了ptk辅助的50 μm深度去皮，然后以10 mW/cm2 （6 J/cm2总剂量）的紫外线照射10分钟。在TG-PRK组中，患者同时进行TG-PRK消融以使地形规范化。术前、术后3个月和1年分别使用Scheimpflug装置测量角膜密度。分析了不同角膜区域密度测量值的变化，以评估雾霾的演变。结果：共纳入106只眼，CXL组50只眼，TG-PRK组56只眼。术后3个月和1年，TG-PRK组患者在前间质和中间质所有区域的角膜密度测量值均显著升高（P < 0.001）。1年后，除了TG-PRK组前角膜中央2mm外，两组的密度测量值基本恢复到基线水平。压扁程度较高的患者在TG-PRK CXL后雾度明显增加，但两组患者雾度的形成与视力变化无相关性。结论：与单独使用CXL相比，TG-PRK和CXL同时使用可导致更明显和更持久的角膜雾霭。雾霾随着时间的推移而改善，但在联合过程中持续时间更长。角膜密度测量对于评估雾霾和优化患者管理是有价值的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cornea 医学-眼科学

CiteScore

5.20

自引率

10.70%

发文量

354

审稿时长

3-6 weeks

期刊介绍： For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.