国际眼科纵览 ›› 2022, Vol. 46 ›› Issue (3): 242-246.doi: 10.3760/ cma.j.issn.1673-5803.2022.03.009

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角膜胶原交联术治疗超薄圆锥角膜

马瑞珏,  王雁,  梁爽   

  1. 天津市眼科医院 300020
  • 收稿日期:2021-09-15 出版日期:2022-06-22 发布日期:2022-06-22
  • 通讯作者: 王雁,Email: wangyan7143@vip.sina.com

Corneal collagen crosslinking in the treatment of ultra-thin keratoconus

Ma Ruijue, Wang Yan, Liang Shuang   

  1. Tianjin Eye Hospital, Tianjin 300020, China
  • Received:2021-09-15 Online:2022-06-22 Published:2022-06-22
  • Contact: Wang Yan, Email: wangyan7143@vip.sina.com

摘要: 圆锥角膜是一种不伴随炎症的慢性进展性疾病,其特征是形态正常的角膜逐渐变薄并缓慢膨胀成锥形,角膜胶原交联术通过提高角膜生物力学性能从而阻止圆锥角膜的进展,已成为该病重要治疗方法和有效阻止其进展的方法。400 μm的角膜厚度限制了很多超薄圆锥角膜进行角膜交联治疗,近年来,诸多学者在原有标准方案的基础上尝试新的治疗方案:如跨上皮及保留上皮岛等手术方式的改进,利用低渗透性核黄素、角膜接触镜及使用飞秒激光小切口角膜基质透镜取出术中取出的透镜等方式增加角膜总厚度,个性化调整术中能量使用等,这些技术均旨在克服400 μm的限制,从而对超薄圆锥角膜实现安全有效的角膜交联治疗。(国际眼科纵览,2022, 46:242-246)

关键词: 圆锥角膜, 超薄角膜, 角膜扩张, 角膜胶原交联术

Abstract: Keratoconus is a chronic progressive disease without inflammation. It is characterized by the gradual thinning and slow expansion of normal cornea into a cone. Corneal collagen crosslinking has become an important treatment and one of the effective methods to prevent the progress of keratoconus by improving the biomechanical properties of cornea. 400 μm corneal thickness limits many ultra-thin keratoconus from the corneal cross-linking treatment. In view of the good therapeutic effect of corneal crosslinking on corneal dilation diseases, many scholars have tried various new treatment schemes on the basis of the original standard scheme in recent years. For example, the improvement of surgical methods such as transepithelial and epithelial island preservation, the use of low permeability riboflavin, corneal contact lens and lens removed from small incision lenticule extraction to increase the total corneal thickness, and personalized adjustment of intraoperative energy use, personalized adjustment of intraoperative energy use and other improved treatment methods. These technologies are designed to break through the 400 μm limitation of corneal cross-linking surgery, so as to achieve safe and effective corneal cross-linking treatment for ultra-thin keratoconus. (Int Rev Ophthalmol, 2022, 46: 242-246)

Key words: keratoconus, ultra-thin cornea, corneal dilation, corneal collagen crosslinking