摘要
目的应用Pentacam三维眼前节分析系统获取并分析角膜交联手术(corneal collagen crosslinking,CXL)对圆锥角膜(keratoconus,KC)患者角膜光密度(corneal densitometry,CD)的影响。方法选取2017年1月至2019年12月就诊于解放军总医院第一医学中心眼科并接受CXL的KC患者28例,纳入圆锥角膜-角膜光密度组(KC-CD组);选取其中所有接受单眼CXL患者共14例,将术眼纳入CXL组,非术眼纳入Non-CXL组;利用Pentacam三维眼前节分析系统获取并分析角膜交联手术前、术后1个月、术后3个月、术后1年CD值和角膜形态数据、角膜最薄点(thinnest corneal thickness,TCT);应用非参数检验、单因素卡方分析、配对t检验等统计方法对交联手术前后角膜光密度进行横向和纵向比较。结果所有接受CXL的圆锥角膜患者在CXL术后1个月其前层、中层、后层以及全层角膜0~2 mm和>2~6 mm的CD值较术前明显升高(P<0.05);在CXL术后3个月前层0~2 mm、中层0~2 mm、全层0~2 mm的CD值较术前升高(P<0.01),而后层0~2 mm则没有统计学差异;在CXL术后1年仅前层0~2 mm的CD值较术前存在统计学差异(P=0.011);在单眼接受CXL的圆锥角膜患者中,Non-CXL组的CD值在CXL手术前后无明显变化,CXL组的CD值变化趋势同KC-CD组;在术后1个月,CXL组的前层0~2 mm、>2~6 mm,中层0~2 mm、>2~6 mm,后层>2~6 mm,全层0~2 mm、>2~6 mm的CD值均较Non-CXL组明显升高(P<0.05);术后3个月上述CXL组各层CD值与Non-CXL组相比仍偏高(P<0.05),但其平均CD值较CXL术后1个月下降;在接受CXL术后1年,CXL组和Non-CXL组的各层CD值无明显差异。Non-CXL组和CXL组的角膜形态等数据较术前无变化。结论角膜交联手术会导致圆锥角膜患者角膜光密度升高,在术后1个月达到峰值,而后逐渐下降,在术后1年恢复正常。
Objective To obtain and analyze the effect of corneal collagen crosslinking(CXL)on corneal densitometry(CD)in patients with keratoconus(KC)by using the Pentacam 3D anterior segment analysis system.Methods Twenty-eight KC patients who visited the Chinese PLA General Hospital and underwent CXL from January 2017 to December 2019 were subjected and included in the KC-CD group.There were 14 patients who underwent monocular CXL,and the operated eyes were included in the CXL group and the non-operated eyes in the non-CXL group.CD values and data of corneal morphology,and the thinnest corneal thickness(TCT)were obtained and analyzed before and in 1 and 3 months,and 1 year after the CXL using the Pentacam 3 D anterior segment analysis system.Nonparametric test,one-way Chi-square analysis,paired t-test and other statistical analyses were applied to compare CD before and after surgery in a cross-sectional and longitudinal manner.Results The CD values of 0~2 mm and 2~6 mm zones in the anterior,central,and posterior layers as well as in the total cornea were significantly higher(P<0.05)in all KC patients undergoing CXL(KC-CD group)at 1 month after CXL when compared to the preoperative period.At 3 months after CXL,the CD values were higher in the 0~2 mm zones of the anterior layer,the central layer,and the total layer 0~2 mm than the values preoperatively(P<0.01),whereas there was no statistical differences in the values in the 0~2 mm zone of the posterior layer.Only the CD values of the 0~2 mm zone in the anterior layer differed at 1 year after CXL when compared to the preoperative values(P=0.011).In the KC patients undergoing CXL in one eye,CD values in the non-CXL group did not change significantly before and after the CXL surgery,and the trend of CD values was the same in the CXL group as that in the KC-CD group.At 1 month postoperatively,a significantly higher CD value(P<0.05)was observed in the CXL group compared to the non-CXL group in the 0~2 mm and>2~6 mm zones of the anterior layer,the central layer,the posterior layer,and the total layer.Compared with the Non-CXL group,the CD values of the above-mentioned layer of CXL group were still higher at 3 months after surgery(P<0.05),but their mean CD values were decreased at 1 month after CXL.At 1 year after undergoing CXL,there were no significant changes in CD values in each layer between the CXL and non-CXL groups.Conclusion CXL causes an increase in CD value in KC patients with keratoconus,which peaks at 1 month postoperatively and then gradually decreased to normal level at 1 year after surgery.
作者
杨昆昆
葛梅
方逸凡
王丽强
YANG Kunkun;GE Mei;FANG Yifan;WANG Liqiang(Graduate School of PLA Medical Hospital,Beijing,100853;Senior Department of Ophthalmology,Third Medical Center of Chinese PLA General Hospital,Beijing 100039;First Medical Center of Chinese PLA General Hospital,Beijing,100853,China)
出处
《陆军军医大学学报》
CAS
CSCD
北大核心
2022年第11期1169-1176,共8页
Journal of Army Medical University
基金
北京市自然科学基金(L182064)
作者简介
通信作者:王丽强,E-mail:liqiangw301@163.com
