Effect of transepithelial accelerated corneal collagen cross-linking on corneal densitometry in progressive keratoconus
Objective To investigate the changes of corneal density and its clinical significance after transepithe-lial riboflavin-ultraviolet A(UVA)accelerated corneal collagen cross-linking(CXL)for progressive keratoconus.Methods A retrospective study.Thirty-four patients(49 eyes)with progressive keratoconus underwent transepithelial accelerated cor-neal collagen cross-linking surgery were included in this study.The pentacam three-dimensional anterior segment analysis system was used to examine the operative eyes before surgery,1 month after surgery and 6 months after surgery.The mea-surement range was selected with the corneal apex as the center,and the average corneal density of each corneal section in the diameter range of 0～2 mm,2～6 mm,6～10 mm,10～12 mm and 0～12 mm were respectively taken from the anterior layer(120 μm),middle layer and posterior layer(60 μm)and the whole cornea.SPSS 22.0 statistical software was used for statistical analysis of the data.Therepeated analysis of measurement variance was used to compare the corneal density be-fore and after surgeryin different groups and diameters.The multiple comparison method(paired comparison)in ANOVA of repeated measurement data was used for comparison between groups at various time periods before and after surgery.Re-sults The corneal density of the anterior layer(120 μm),the middle layer,the posterior layer(60 μm)and the total cor-nea in the diameters of 0～2 mm,2～6 mm,6～10 mm and 0～12 mm were statistically different after keratoconus operation and before operation.The corneal density of the posterior layer(60 μm)with a diameter of 2～6 mm was significantly lower than that before surgery 1 month after surgery(P=0.04),and the corneal density values of the other groups was not statisti-cally different from that before surgery.6 months after surgery,the corneal density value in the range of 0～2 mm and 2～6 mm in the anterior corneal layer was significantly decreased compared with that before surgery and 1 month after surgery(preoperative P=0.00,0.00;1 month after surgery P=0.00,0.00),6～10 mm,0～12 mm diameter range corneal density de-creased compared with 1 month after surgery(P=0.00,0.00);Corneal density in the middle layer with diameters of 0～2 mm,2～6 mm,6～10 mm,0～12 mm decreased compared with preoperative and 1 month after surgery(preoperative P=0.00,0.00,0.00,0.00;1 month after surgery P=0.00,0.00,0.00,0.00);The corneal density in the posterior layer with diameters of 0～2 mm,2～6 mm,6～10 mm,10～12 mm,0～12 mm decreased compared with preoperative and 1 month after surgery(preoperative P=0.00,0.00,0.00,0.00,0.00;1 month after surgery P=0.03,0.00,0.00,0.03,0.00);The 0～2 mm,2～6 mm,6～10 mm and 0～12 mm of the total layer corneal density were decreased before surgery and 1 month after surgery(preoperative P=0.00,0.00,0.00,0.00;1 month after surgery P=0.00,0.00,0.00,0.00),the density of cornea in the range of 10～12 mm diameter decreased with statistical difference compared with that before surgery(P=0.02).Conclu-sions Compared with other methods of corneal collagen cross-linking surgery,transepithelial accelerated corneal collagen cross-linking surgery results in less corneal injury,small and limited changes in corneal density,and faster recovery,which was conducive to the early recovery of vision.
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万方数据
维普
