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目的:观察角膜胶原交联技术(CXL)的临床应用及治疗效果。方法:回顾性分析郑州市第二人民医院2019年1至6月行CXL或屈光手术联合CXL者62例(84只眼)的临床资料。其中圆锥角膜42例(46只眼),采用核黄素及紫外线诱导的快速去上皮CXL;薄角膜及高度近视20例(38只眼),进行角膜屈光手术联合CXL。术后随访12个月,观察并发症并进行对症治疗。结果:随访期末,裸眼视力和最佳矫正视力(logMAR)分别由术前的0.95±0.36和0.43±0.21,提高至0.82±0.33和0.31±0.22(n t=8.668,8.471;均n P<0.05),角膜前表面最大曲率值下降(2.65±2.49)D,手术前后差异有统计学意义(n t=7.178,n P<0.05)。安全性指数(术后最佳矫正视力/术前最佳矫正视力)为1.05±0.03、有效性指数(术后裸眼视力/术前最佳矫正视力)为1.01±0.02。术后并发症:圆锥角膜46只眼中,术后发生高眼压4只眼、角膜上皮延迟愈合2只眼、边缘性角膜浸润1只眼、角膜内皮细胞密度减少1只眼;联合手术38只眼中术后发生边缘免疫性角膜炎1只眼、短期类圆锥角膜改变1只眼。各种并发症经对症治疗后均治愈或减轻。n 结论:临床上CXL首选治疗进展期圆锥角膜,联合角膜屈光手术治疗薄角膜以及高度近视效果良好。“,”Objective:To observe the clinical application and the treatment efficacy of corneal collagen cross-linking(CXL) technology.Methods:The clinical data of 84 eyes of 62 patients who underwent CXL or CXL combined refractive surgery from Jan.to Jun.2019 in Zhengzhou Municipal Second People’s Hospital were analyzed retrospectively.Amongst all of them, there were 46 eyes of 42 cases of keratoconus who underwent riboflavin/UVA-induced rapid epithelial CXL, and 38 eyes of 20 cases with thin cornea, high myopia and astigmatism were treated with femosecond laser in situ keratomileusis combined with CXL(FS-CXL). The patients were followed-up for 12 months after surgery.The complications were observed and symptomatic treatment was performed for the patients.Results:At 12-month after-CXL, ucorrected visual acuity (UCVA) were improved from 0.95±0.36 to 0.82±0.33 and BCVA improved from 0.43±0.21 to 0.31±0.22 respectively (n t=8.668, 8.471; all n P<0.05). The corneal topographic measurements revealed the maximum curvature of anterior corneal surface decreased by (2.65±2.49)D.The difference was statistically significant (n t=7.178, n P<0.05). FS-CXL: The safety index (postoperative BCVA/preoperative BCVA) were 1.05±0.03, and the validity index (postoperative UCVA/preoperative BCVA) were 1.01±0.02.Among 46 eyes of keratoconus, 4 eyes had high intraocular pressure, 2 eyes had delayed corneal epithelial healing, 1 case had limbal corneal infiltration, and 1 case had a decrease in corneal endothelial cell density after CXL.In 38 eyes of combined operation, 1 case of marginal immune corneal inflammation and 1 case of short-term keratoconus changes occurred.All complications were cured or alleviated after symptomatic treatment.n Conclusion:Corneal cross-linking is the first choice for the treatment of advanced keratoconus.CXL combined with corneal refractive surgery therapy is effective for the treatment of thin cornea and high myopia.