Clinical observation of corneal collagen cross-linking and laser-assisted in situ keratomileusis for refractive error / 眼科新进展

ABSTRACT

Objective To observe the clinical outcomes of corneal collagen cross-linlIng (CLX) and laser-assisted in situ keratomileusis (LASIK) for refractive error.Methods Together 100 patients (200 eyes) with myopia and/or astigmatism who underwent LASIK were admitted from December 2015 to January 2016,and divided into treatment group (50 patients,100 eyes),in which patient received CXL-LASIK,and control group (50 patients,100 eyes),in which the controls were given LASIK alone.Then the optical variables,including visual acuity,diopter,cornea endothelium cell counting,corneal transparency,corneal collagen cross-linking line,were examined and analyzed before operation and 1 week,1 month,3 months,6 months and 12 months after opera tion.Results As for postoperative time points,the uncorrected visual acuity after operation was better than the best corrected visual acuity before surgery in the two groups,but the differences in diopter between the two groups were statistically significant (all P ＜ 0.05).There was no significant difference in diopter 1 month and 12 months postoperatively in the treatment group (t =0.021,P =0.070),while its difference in the control group 1 month and 12 months postoperatively(t =4.857,P =0.010).The differences of the cornea endothelium cell counting in the treatment group between before and after surgery were not statistically significant (F =1.163,P =0.327).Moreover,slightly opacification apPeared in anterior corneal stromal in the early stage after surgery in the treatment group,and the average thickness of corneal collagen cross-linking line was 210.00-340.00 (270.48 + 37.80) μm 1 month postoperatively,accounting for 63％ of the central cornea thickness.There were not flap-related complications in the treatment group,but the control group had corneal flap wrinkle in 3 eyes and displacement in 1 eye in the controls.Conclusion Corneal collagen cross-linlIng and laser-assisted in situ keratomileusis for refractive error can obtain better outcomes,including sound uncorrected visual acuity and stable diopter after surgery,without the loss of the corneal endothelial cells.