简介:AIM:Toevaluatetheefficacyandsafetyofcornealcollagencrosslinking(CXL)topreventtheprogressionofpost-laserinsitukeratomileusis(LASIK)cornealectasia.·METHODS:Inaprospective,nonrandomized,single-centrestudy,CXLwasperformedin20eyesof11patientswhohadLASIKformyopicastigmatismandsubsequentlydevelopedkeratectasia.Theprocedureincludedinstillationof0.1%riboflavin-20%dextranesolution30minutesbeforeUVAirradiationandevery5minutesforanadditional30minutesduringirradiation.Theeyeswereevaluatedpreoperativelyandat1-,3-,6-,and12-monthintervals.Thecompleteophthalmologicexaminationcompriseduncorrectedvisualacuity,bestspectacle-correctedvisualacuity,endothelialcellcount,ultrasoundpachymetry,cornealtopography,andinvivoconfocalmicroscopy.·RESULTS:CXLappearedtostabiliseorpartiallyreversetheprogressionofpost-LASIKcornealectasiawithoutapparentcomplicationinourcohort.UCVAandBCVAimprovementswerestatisticallysignificant(P<0.05)beyond12monthsaftersurgery(improvementof0.07and0.13logMARat1year,respectively).Meanbaselineflattestmeridiankeratometryandmeansteepestmeridiankeratometryreduction(improvementof2.00and1.50diopters(D),respectively)werestatisticallysignificant(P<0.05)at12monthspostoperatively.At1yearafterCXL,meanendothelialcellcountdidnotdeteriorate.Meanthinnestcorneapachymetryincreasedsignificantly.·CONCLUSION:Theresultsofthestudyshowedalong-termstabilityofpost-LASIKcornealectasiaaftercrosslinkingwithoutrelevantsideeffects.Itseemstobeasafeandpromisingproceduretostoptheprogressionofpost-LASIKkeratectasia,therebyavoidingordelayingkeratoplasty.
简介:AIM:Topresenttheoutcomeofmodifiedgridlaserphotocoagulation(GLP)indiffusediabeticmacularedema(DDME)ineyeswithoutextrafovealand/orvitreofovealtraction.METHODS:InclusioncriteriafortheretrospectivestudywereDDMEeyesofpatientswithtypeⅡdiabetesmellitusthathad≥4monthsoffollow-upfollowingGLP.Onlyoneeyeperpatientwasanalyzed.Using3-Dspectral-domainopticalcoherencetomography(3-DSDOCT),eyesthathadeitherextrafovealorvitreofovealtraction,orhadbeenpreviouslytreatedbyanintravitrealmedication(s)wereexcluded.TreatedDDMEeyesweredividedinto4groups:A)'Classic'DDMEthatinvolvedthecentralmacula;B)edemadidnotinvolvethemacularcenter;C)eyesassociatedwithcentralepiretinalmembrane(ERM);D)DDMEthatwasassociatedwithmacularcapillarydropout≥2disc-diameter(DD).RESULTS:GLPoutcomein35DDMEeyesafter4-24(mean,13.1±6.9)monthswasasfollows:GroupA)18eyeswith'classic'DDME.Followingoneor2(mean,1.2)GLPtreatments,best-correctedvisualacuity(BCVA)improvedby1-2Snellenlinesin44.4%(8/18)ofeyes,andworsenedby1linein11.1%(2/18).Centralmacularthickness(CMT)improvedby7%-49%(mean,26.6%)in77.8%(14/18)ofeyes.CausesofCMTworsening(n=4)werecommonlyexplainable,predominantly(n=3)associatedwithemergenceofextrafovealtraction,5-9monthspost-GLP.GroupB)GLP(s)inDDMEthatdidnotinvolvethemacularcenter(n=6)resultedinimprovedBCVAby1-2linesin2eyes.However,thecentralmaculabecameinvolvedintheedemaprocessaftertheGLPin3(50%)eyes,associatedwithanemergenceofextrafovealtractioninoneoftheseeyes4monthsfollowingtheGLP.GroupC)GLPfailedinall5eyesassociatedwithcentralERM.GroupD)GLPwasofpartialbenefitin2of6treatedeyeswithmacularcapillarydropout≥2DD.CONCLUSION:EyeswithDDMEthatinvolvedthemacularcenterwerefoundtoachievefavourableoutcomesafterGLP(s)duringmid-termfollow-up,unlesscomplicatedpre-GLPorpost-GLPbyvltreoretinalinterfaceabnormalities,oftenextrafovealtra