Risk factors for progression following corneal collagen crosslinking in keratoconus

The Mean ◽

Abstract Purpose: To assess risk factors for progression following corneal collagen crosslinking (CXL) in eyes with keratoconus. Methods: Charts of patients who developed progression following conventional CXL treatment (Dresden protocol) were retrospectively evaluated in two centers (Center 1, and Center 2). 871 eyes of a total of 676 patients were analyzed. Progression was defined as >1 diopter (D) increase in maximum keratometry (Kmax) readings compared to baseline. Results: Progression was noted in 20 eyes of 20 patients (progression rate 3%). The mean age of the patients was 17.65 ± 5.76 (11–34) years and the mean follow-up following CXL was 36.70 ± 25.72 (12–84) months. The gender distribution was 13 (65%) females, and seven (35%) males. Four eyes (20%) had mild, 13 eyes (65%) had moderate, and three eyes (15%) had severe keratoconus at baseline. Fifteen eyes (75%) had allergic conjunctivitis and 20 eyes (100%) reported eye-rubbing. Cone location was central in 17 (85%) eyes and peripheral in 3 (15%) eyes. A mean of 2.21 ± 1.30 D (1.00 – 5.30 D) steepening was determined at Kmax 6 to 82 months following CXL treatment. Conclusions: Progression rate was found to be higher in the patients under the age of 17 years, female gender, allergic conjunctivitis, high preoperative Kmax (>57 D), thin corneas (<430 µm) . The majority of progressive patients were central cone and moderate keratoconus.

Rate of Corneal Collagen Crosslinking Redo in Private Practice: Risk Factors and Safety

Journal of Ophthalmology ◽

10.1155/2015/690961 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

Joelle Antoun ◽

Elise Slim ◽

Rami el Hachem ◽

Elias Chelala ◽

Elyse Jabbour ◽

...

Keyword(s):

Risk Factors ◽

Visual Acuity ◽

Private Practice ◽

Allergic Conjunctivitis ◽

Collagen Crosslinking ◽

Factors Associated ◽

Rate Of Progression ◽

History Of ◽

Objective. To report the rate of progression of keratectasia after primary crosslinking (CXL) and evaluate the safety and efficiency of CXL redo.Materials and Methods. We conducted a retrospective analysis of the patients who underwent CXL between 2010 and 2013 at the Beirut Eye Specialist Hospital, Lebanon. Progression of keratectasia was based on the presence of an increase in maximum keratometry of 1.00 D, a change in the map difference between two consecutive topographies of 1.00 D, a deterioration of visual acuity, or any change in the refraction. Primary and redo CXL were done using the same protocol.Results. Among the 221 eyes of 130 patients who underwent CXL, 7 eyes (3.17%) of five patients met the criteria of progression. All patients reported a history of allergic conjunctivitis and eye rubbing and progressed within 9 to 48 months. No complications were noted and all patients were stable 1 year after CXL redo.Conclusion. Allergic conjunctivitis and eye rubbing were the only risk factors associated with keratoconus progression after CXL. A close followup is thus mandatory, even years after the procedure. CXL redo seems to be a safe and efficient technique to halt the progression after a primary CXL.

Faculty Opinions recommendation of Corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.9579957.10240055 ◽

2011 ◽

Author(s):

Renato Ambrosio

Keyword(s):

Collagen Crosslinking ◽

Corneal Ectasia ◽

One Year ◽

Corneal collagen crosslinking for progressive keratoconus in Saudi Arabia: One-year controlled clinical trial analysis

Saudi Journal of Ophthalmology ◽

10.1016/j.sjopt.2015.02.005 ◽

2015 ◽

Vol 29 (4) ◽

pp. 249-254 ◽

Cited By ~ 11

Author(s):

Ashbala Khattak ◽

Fouad R. Nakhli ◽

Haider R. Cheema

Keyword(s):

Clinical Trial ◽

Saudi Arabia ◽

Controlled Clinical Trial ◽

Collagen Crosslinking ◽

Trial Analysis ◽

One Year ◽

Corneal thickness changes after corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2010.10.052 ◽

2011 ◽

Vol 37 (4) ◽

pp. 691-700 ◽

Cited By ~ 101

Author(s):

Steven A. Greenstein ◽

Vinnie P. Shah ◽

Kristen L. Fry ◽

Peter S. Hersh

Keyword(s):

Corneal Thickness ◽

Collagen Crosslinking ◽

Corneal Ectasia ◽

One Year ◽

Outcome of Corneal Collagen Crosslinking for Progressive Keratoconus in Paediatric Patients

BioMed Research International ◽

10.1155/2014/140461 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 14

Author(s):

Deepa Viswanathan ◽

Nikhil L. Kumar ◽

John J. Males

Keyword(s):

Young Patients ◽

Ultraviolet A ◽

Effective Treatment Option ◽

Collagen Crosslinking ◽

Paediatric Patients ◽

Corneal Grafting ◽

Minimum Angle ◽

The Mean ◽

Purpose. To evaluate the efficacy of corneal collagen crosslinking for progressive keratoconus in paediatric patients.Methods. This prospective study included 25 eyes of 18 patients (aged 18 years or younger) who underwent collagen crosslinking performed using riboflavin and ultraviolet-A irradiation (370 nm, 3 mW/cm2, 30 min).Results. The mean patient age was 14.3 ± 2.4 years (range 8–17) and mean followup duration was 20.1 ± 14.25 months (range 6–48). Crosslinked eyes demonstrated a significant reduction of keratometry values. The mean baseline simulated keratometry values were 46.34 dioptres (D) in the flattest meridian and 50.06 D in the steepest meridian. At 20 months after crosslinking, the values were 45.67 D (P=0.03) and 49.34 D (P=0.005), respectively. The best spectacle corrected visual acuity (BSCVA) and topometric astigmatism improved after crosslinking. Mean logarithm of the minimum angle of resolution (logMAR) BSCVA decreased from 0.24 to 0.21 (P=0.89) and topometric astigmatism reduced from mean 3.50 D to 3.25 D (P=0.51).Conclusions. Collagen crosslinking using riboflavin and ultraviolet-A is an effective treatment option for progressive keratoconus in paediatric patients. Crosslinking stabilises the condition and, thus, reduces the need for corneal grafting in these young patients.

Intrastromal corneal rings and corneal collagen crosslinking for progressive keratoconus: comparison of two sequences

Eye ◽

10.1038/eye.2014.285 ◽

2014 ◽

Vol 29 (2) ◽

pp. 294-295 ◽

Cited By ~ 4

Author(s):

N Saib ◽

S Bonnel ◽

J-R Fenolland ◽

M Abrieu ◽

C Rambaud ◽

...

Keyword(s):

Collagen Crosslinking ◽

Evaluation of changes in corneal biomechanics in eyes with keratectasia

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-5-179-187 ◽

2021 ◽

pp. 179-187

Author(s):

B.E. Malugin ◽

◽

E.G. Solodkova ◽

S.V. Balalin ◽

V.S. Kulikov ◽

...

Keyword(s):

Corneal Thickness ◽

Corneal Biomechanics ◽

Corvis St ◽

Collagen Crosslinking ◽

The Third ◽

Corneal Rigidity ◽

Early Features ◽

Healthy Persons ◽

Purpose. To make a comparative analysis of topographic, tomographic and biomechanical values, measured by Pentacam HR and Corvis ST, in healthy multirefractive cohort versus patients with keratectasia of various severity. Material and methods. The prospective study comprised 237 patients aged from 18 to 47 years, subdivided into three groups. The first group included 174 healthy persons with various refraction (174 eyes). The second and the third group embraced 63 patients with keratoconus: 36 patients (36 eyes) with keratoconus of the I degree and 27 eyes with keratoconus of the II and III degrees. Besides the conventional comprehensive ocular examination the following studies were performed in all the patients: evaluation of topographic, tomographic and biomechanical corneal properties with application of Pentacam HR and Corvis ST (OCULUS Optikgerate GmbH; Wetzlar, Germany). Results. It was revealed that the following biomechanical values, assessed by means of Pentacam HR and Corvis ST, exhibited statistically significant changes (p<0,001) in all degrees of ketatoconus: a relative corneal thickness by Ambrosio, inverted radius of applanation curvature (IntRadius), DA Ratio Coefficient, values of corneal rigidity – SP-A 1 and SSI. Conclusion. The detected parameters may be applied as indicators, allowing to evaluate corneal biomechanics, to define early features of ectatic process, to assess effectiveness of the performed corneal collagen crosslinking and intralamellar keratoplasty with implantation of corneal segments. Key words: keratoconus, corneal biomechanics, pachymetry, index of pachymetric progression, corneal viscoelasticity.