Региональные биомеханические и топографические изменения после трансепителиального и эпителиум-офф непрерывного ускоренного кросслинкинга роговичного коллагена при кератоконусе: обновленный индекс напряжение-деформация как более эффективный биомаркер

Regional Biomechanical and Topographic Changes after Transepithelial vs. Epithelium-off Continuous Accelerated Corneal Cross-linking in Keratoconus: Updated Stress-Strain Index as a Superior Biomarker.

Keratoconus is a progressive ectatic corneal disorder characterized by stromal thinning and anterior protrusion, leading to progressive visual impairment. Researchers in the Raine Study reported a prevalence of keratoconus as high as 1 in 84.¹ Corneal collagen cross-linking (CXL) is the primary intervention to halt the progression of keratoconus.^2,3 The accelerated CXL (ACXL) protocol, using reduced exposure time at the same total dose,⁴ is now widely used. Published evidence⁵, ⁶, ⁷ have established that both standard and ACXL protocols are safe and effective for stabilizing keratoconus. The conventional epithelium-off (Epi-off) technique, introduced by Wollensak et al,⁸ is highly efficacious but carries notable risks such as infection and haze.⁸, ⁹, ¹⁰ In contrast, the transepithelial (Epi-on) approach was developed to improve safety and patient comfort, though variable efficacy due to limited riboflavin penetration may necessitate retreatment.^11,12