Clinical research on corneal biomechanical changes after keratoconus collagen cross-linking

Hongchao Zhao
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Abstract

Objective To observe corneal biomechanical changes in patients with keratoconus after corneal collagen cross-linking. Methods Prospective self-control study. Twenty-three eyes of 17 patients with primary keratoconus from Jan. 2018 to Jun. 2018 in Zhengzhou Second Hospital were analyzed. The age of patients ranged from 13 to 28 years, with average of (16.4±2.8) years. All cases were treated with riboflavin/ultraviolet A (UVA)-induced rapid epithelium-off corneal collagen cross-linking. All cases were observed with Corvis ST visualized corneal biomechanical measurement instrument and followed up for 12 months. Results The best corrected visual acuity (LogMAR) after operation increased from 0.42±0.19 to 0.29±0.15 (t=-8.043, P=0.000). The equivalent spherical diopter and the maximum curvature of the anterior corneal surface were decreased (t=-4.183, -5.188, P=0.000, 0.000). The thinnest corneal thickness postoperative was decreased compared with that before operation(t=-3.984, P=0.001). The first flattening time postoperative increased (t=7.793, P=0.000). The second flattening time and the maximum indentation depth decreased (t=-9.075, P=0.000, t=-3.280, P=0.003). Conclusion The visual acuity, corneal morphology and biomechanical parameters after the rapid epithelium-off corneal collagen cross-linking in patients with primary keratoconus are ameliorated significantly. Key words: Keratoconus; Cross-linking, collagen, corneal; Biomechanics, cornea
圆锥角膜胶原交联后角膜生物力学变化的临床研究
目的观察圆锥角膜患者角膜胶原交联后角膜的生物力学变化。方法前瞻性自我控制研究。对郑州市第二医院2018年1月至2018年6月17例原发性圆锥角膜患者23只眼进行分析。患者年龄13 ~ 28岁,平均(16.4±2.8)岁。所有病例均采用核黄素/紫外线A (UVA)诱导的角膜胶原快速交联治疗。所有病例均采用Corvis ST可视化角膜生物力学测量仪进行观察,随访12个月。结果术后最佳矫正视力(LogMAR)由0.42±0.19提高至0.29±0.15 (t=-8.043, P=0.000)。等效球面屈光度和角膜前表面最大曲率降低(t=-4.183, -5.188, P=0.000, 0.000)。术后最薄角膜厚度较术前降低(t=-3.984, P=0.001)。术后第一次平化时间增加(t=7.793, P=0.000)。第二次压平时间和最大压痕深度减小(t=-9.075, P=0.000, t=-3.280, P=0.003)。结论角膜胶原快速交联后,原发性圆锥角膜患者的视力、角膜形态及生物力学参数均有明显改善。关键词:圆锥角膜;交联,胶原蛋白,角膜;生物力学,角膜
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