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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Int+J+Ophthalmol
2017 ; 10
(9
): 1419-1429
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Systematic review and Meta-analysis comparing modified cross-linking and standard
cross-linking for progressive keratoconus
#MMPMID28944203
Liu Y
; Liu Y
; Zhang YN
; Li AP
; Zhang J
; Liang QF
; Jie Y
; Pan ZQ
Int J Ophthalmol
2017[]; 10
(9
): 1419-1429
PMID28944203
show ga
AIM: To compare the effectiveness and safety between modified cross-linking (MC)
and standard cross-linking (SC) in mild or moderate progressive keratoconus.
METHODS: Eligible studies were retrieved from four electronic databases,
including CENTRAL, Clinical Trials gov, PupMed and OVID MEDLINE. We set
post-surgical maximum K value (Kmax) as the primary outcome. In addition,
uncorrected and corrected distant visual acuity (UDVA and UDVA), spherical
equivalent (SE), endothelial cell density (ECD), central cornea thickness (CCT)
and depth of demarcation line (DDL) were Meta-analyzed as secondary outcomes.
Mean differences for these outcomes were pooled through either a random-effect
model or fixed-effect model according to data heterogeneity. RESULTS: Twenty-four
comparative studies either on accelerated cross-linking (AC) compared with SC or
on trans-epithelial cross-linking (TC) compared with SC were included and pooled
for analysis. The results indicated that MC was significantly inferior to SC at
delaying Kmax deterioration [AC vs SC 0.49 (95% CI: 0.04-0.94, I(2)=75%, P=0.03);
TC vs SC 1.15 (95% CI: 0.54-1.75, I(2)=50%, P=0.0002)]. SE decreased
significantly for SC when compared to AC [0.62 (95% CI: 0.38-0.86, I(2)=22%,
P<0.00001)]. DDL of SC was more significantly deeper than that of TC [-133.49
(95% CI: -145.94 to -121.04, I(2)=33%, P<0.00001)]. Other outcomes demonstrated
comparable results between MC and SC. CONCLUSION: SC is more favorable at halting
the progression of keratoconus, but visual acuity improvement showed comparable
results between MCs and SC.
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