角膜交联手术对圆锥角膜患者角膜光密度的影响

杨昆昆; 葛梅; 方逸凡; 王丽强

doi:10.16016/j.2097-0927.202111102

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角膜交联手术对圆锥角膜患者角膜光密度的影响

临床医学 | 更新时间：2026-01-09

- 角膜交联手术对圆锥角膜患者角膜光密度的影响
- Effect of corneal cross-linking surgery on corneal densitometry in patients with keratoconus
- 陆军军医大学学报 2022年44卷第11期页码：1169-1176
- 作者机构：
  
  1.100853 北京，解放军医学院研究生院
  2.100039 北京，解放军总医院第三医学中心眼科医学部
  3.100853 北京，解放军总医院第一医学中心
- 作者简介：
  
  [王丽强，E-mail：liqiangw301@163.com WANG Liqiang, E-mail: liqiangw301@163.com
- 基金信息：
  
  北京市自然科学基金(L182064)
- DOI：10.16016/j.2097-0927.202111102
  中图分类号： R770.43;R772.2;R779.6
- 收稿：2021-11-14，
  
  修回：2022-01-09，
  
  纸质出版：2022-06-15
- 稿件说明：
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杨昆昆, 葛梅, 方逸凡, 等. 角膜交联手术对圆锥角膜患者角膜光密度的影响[J]. 陆军军医大学学报, 2022,44(11):1169-1176.

Kunkun YANG, Mei GE, Yifan FANG, et al. Effect of corneal cross-linking surgery on corneal densitometry in patients with keratoconus[J]. Journal of Army Medical University, 2022, 44(11): 1169-1176.
杨昆昆, 葛梅, 方逸凡, 等. 角膜交联手术对圆锥角膜患者角膜光密度的影响[J]. 陆军军医大学学报, 2022,44(11):1169-1176. DOI： 10.16016/j.2097-0927.202111102.

Kunkun YANG, Mei GE, Yifan FANG, et al. Effect of corneal cross-linking surgery on corneal densitometry in patients with keratoconus[J]. Journal of Army Medical University, 2022, 44(11): 1169-1176. DOI： 10.16016/j.2097-0927.202111102.

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

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(

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(

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(

=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(

0.05)；术后3个月上述CXL组各层CD值与Non-CXL组相比仍偏高(

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。

Abstract

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 3D anterior segment analysis system. Nonparametric test

one-way

Chi

-square analysis

paired

-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 (

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 (

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 (

=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 (

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 (

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.

关键词

Keywords

references

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