目的：评估经上皮角膜交联(Epi-on CXL)术中采用角膜缘保护技术治疗圆锥角膜的临床应用效果。方法：前瞻性临床研究。选取2019-01/12我院收治拟行Epi-on CXL手术的双眼进展期圆锥角膜患者15例30眼，将右眼15眼纳入试验组，术中采用角膜缘保护技术； 左眼15眼纳入对照组，术中不采用角膜缘保护技术。比较两组患眼术前和术后最佳矫正远视力、散光度、角膜曲率Sim-K平均值(Km)、角膜最薄点厚度、泪膜破裂时间及术后不适感、角膜上皮愈合时间的差异。结果：与术前相比，术后3mo时两组最佳矫正远视力、散光度均改善(P<0.05)，术后角膜最薄点厚度逐渐减小(P<0.05)，术后3mo内泪膜破裂时间变短(P<0.05)，但两组之间最佳矫正远视力、散光度、Km、角膜最薄点厚度、泪膜破裂时间、术后不适感方面均无差异(P>0.05)，且试验组术后角膜上皮愈合时间比对照组短(3.20±0.56d vs 3.73±0.96d，P=0.041)。结论：角膜缘保护技术能够缩短Epi-on CXL术后角膜上皮愈合时间，初步证实了该技术在Epi-on CXL手术中应用的可行性。

AIM: To evaluate the clinical effect of a limbus protection technique during epithelium-on corneal collagen cross-linking(Epi-on CXL)for keratoconus treatment.METHODS: Prospectively clinical study. A total of 15 patients(30 eyes)with diagnosed binocular progressive keratoconus were selected and treated with Epi-on CXL in my hospital from Jan. to Dec. 2019, and divided into 2 groups, Limbus-protecting Group and Control Group. The differences in corrected distance visual acuity, astigmatism, Km, thickness at the thinnest point of cornea, postoperative discomfort score, corneal epithelium healing time, and tear breakup time were compared between the two groups pre- and postoperatively.RESULTS: The corrected distance visual acuity and astigmatism were improved at 3mo postoperatively(P<0.05). The thickness at the thinnest point of cornea and the tear breakup time decreased after Epi-on CXL surgeries(P<0.05). No difference was found in parameters of corrected distance visual acuity, astigmatism, Km, thickness at the thinnest point of cornea, tear break up time, and postoperative discomfort sore between the two groups(P>0.05). However, the postoperative corneal epithelium healing time in Limbus-protecting Group was shorter than in Control Group(3.20±0.56d vs 3.73±0.96d, P=0.041).CONCLUSION:This limbal protection technique can reduce the corneal epithelium healing time after Epi-on CXL surgery, which preliminarily shows the feasibility of this technique.

国家自然科学基金项目(No.81700873); 河北省重点研发计划项目(No.18277754D); 河北省医学科学研究课题计划项目(No.20200842); 河北省中医药管理局科研计划项目(No.2020553); 邢台市科技计划项目(No.2016ZC262)