从被动到主动——圆锥角膜诊疗思路的改变

摘要

圆锥角膜是一种常见的角膜变性疾病,随着角膜屈光手术的广泛开展,圆锥角膜的早期诊断和合理治疗变得更为重要.传统依靠临床表现或角膜地形图变化进行诊断往往已为时过晚且不能阻止病情进展;而目前除角膜地形图外,综合利用三维眼前节分析系统、共聚焦显微镜、生物力学眼反应分析仪、OCT等仪器分析可以在早期筛查出圆锥角膜或疑似病例,通过主动进行角膜胶原交联术等预防性治疗可在早期阻止病情进展.现就目前圆锥角膜的诊断及治疗新进展进行简要评述.%Keratoconus is a common degenerative disorder of the cornea.This article describes new methods for the diagnosis and treatment of keratoconus.Since corneal refractive surgery is widely used,the early diagnosis and rational treatment of keratoconus have become more important.Traditional diagnosis always depends on clinical manifestations and changes in corneal topography but it cannot stop the progression of the disorder.Currently,in addition to corneal topography,a three-dimensional anterior segment analyzer,confocal microscope,ocular response analyzer,OCT and other instruments are being used to screen keratoconus or suspected keratoconus.Active,preventive treatments like corneal collagen cross-linking can stop progression.