Long-term Results of Riboflavin Ultraviolet A Corneal Collagen Cross-linking for Keratoconus in Italy: The Siena Eye Cross Study

Purpose: To evaluate the long term visual, refractive, and corneal tomographic outcomes of epithelium-off accelerated corneal collagen cross-linking (ACXL) in the management of pediatric keratoconus (KC). Methods: This retrospective study included patients under 18 years old with progressive KC who underwent ACXL between 2012 and 2019 at Dicle University Hospital. Complete ophthalmic examination was performed including uncorrected distance visual acuity (UDVA), best spectacle-corrected distance visual acuity (CDVA), manifest refraction, and corneal tomography. Evaluations were performed preoperatively and at 6 months intervals postoperatively. Results: Forty-nine eyes of 49 patients were included in the study. The mean age of patients at the time of ACXL was 14.2 ± 1.8 (range: 9.5–17.3) years. Mean follow up was 4.61 ± 1.90 (range: 2.0–8.1) years. The mean LogMAR UDVA improved from 0.94 ± 0.41 to 0.81 ± 0.43, 0.69 ± 0.41, and 0.67 ± 0.33 after 1, 3, and 5 years respectively ( p = 0.001). The mean LogMAR CDVA improved from 0.58 ± 0.36 to 0.46 ± 0.31, 0.34 ± 0.23, and 0.39 ± 0.27 after 1, 3, and 5 years respectively ( p = 0.015). The mean refractive cylinder improved significantly from 6.01 ± 2.07 diopters (D) to 5.46 ± 1.87, 5.38 ± 2.18, and 5.02 ± 2.31 D after 1, 3, and 5 years respectively ( p = 0.005). As compared to preoperative values, steep keratometry and maximum keratometry were not significantly different ( p = 0.805 and 0.448, respectively) following ACXL, while flat keratometry significantly improved after ACXL ( p = 0.012). Although central corneal thicknesses decreased significantly ( p = 0.029), the decrease in thinnest corneal thickness was not statistically significant ( p = 0.205). Conclusion: Epithelium-off ACXL seems to be effective for halting KC progression with long term clinical benefits in pediatric patients.

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Analysis of long-term results of collagen corneal cross-linking in patients with ectatic forms of corneal dystrophy

Ophthalmology journal ◽

10.17816/ov1126-12 ◽

2018 ◽

Vol 11 (2) ◽

pp. 6-12 ◽

Cited By ~ 1

Author(s):

Oleg A. Frolov ◽

Sergey Yu. Astakhov ◽

Pavel A. Danilov ◽

Sergey A. Novikov

Keyword(s):

Corneal Dystrophy ◽

Asymmetry Index ◽

Long Term Results ◽

Cross Linking ◽

Periodical Literature ◽

Intermediate Data ◽

Collagen Cross Linking ◽

Corneal Collagen

Corneal collagen cross-linking became a permanent part of complex treatment for patients with different forms of corneal ectasia. In periodical literature, there are anecdotal reports concerning long-term results of this corneal disease therapy method, which is an isolated variant of photodynamic therapy. Purpose. To carry out a retrospective study of corneal collagen cross-linking long-term results in various ectatic corneal diseases. Materials and methods. Results of corneal collagen cross-linking in patients with ectatic forms of corneal dystrophy 6 years after surgery were analyzed. The nosological structure of the study included a group of patients with primary keratoconus, pellucid marginal corneal degeneration, secondary ectasias. The group with primary keratoconus includes 30 patients (31 eyes), that with pellucid marginal degeneration 10 patients (10 eyes), that with secondary ectasias – 10 patients (10 eyes). Data of the diagnostic examination before surgery, intermediate data of the dynamic follow-up during 6 years of observation were used for the analysis. Corneal collagen cross-linking was performed in the first or second year of follow-up, followed by monitoring of changes in the state of the cornea after corneal collagen cross-linking for 4-5 years. Results. A statistically significant increase in visual acuity was observed after the corneal collagen cross-linking in patients with primary and secondary ectasias. In patients diagnosed with pellucid marginal degeneration, there was no statistically significant increase of visual function. A decrease in the corneal asymmetry index was revealed in all groups and confirmed by statistical analysis.

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Long‐term results of simultaneous topo‐guided photorefractive keratectomy followed by corneal collagen cross‐linking for keratoconus

Acta Ophthalmologica ◽

10.1111/j.1755-3768.2011.2177.x ◽

2011 ◽

Vol 89 (s248) ◽

pp. 0-0

Author(s):

V DIAKONIS ◽

M GRENTZELOS ◽

D PORTALIOU ◽

G KOUNIS ◽

A LIMNOPOULOU ◽

...

Keyword(s):

Long Term Results ◽

Photorefractive Keratectomy ◽

Cross Linking ◽

Collagen Cross Linking ◽

Corneal Collagen

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Long-Term Results of Phototherapeutic Keratectomy Versus Mechanical Epithelial Removal Followed by Corneal Collagen Cross-Linking for Keratoconus

Cornea ◽

10.1097/ico.0000000000000679 ◽

2016 ◽

Vol 35 (2) ◽

pp. 157-161 ◽

Cited By ~ 14

Author(s):

Mustafa Kapasi ◽

Amanpreet Dhaliwal ◽

George Mintsioulis ◽

W. Bruce Jackson ◽

Kashif Baig

Keyword(s):

Long Term Results ◽

Cross Linking ◽

Phototherapeutic Keratectomy ◽

Collagen Cross Linking ◽

Corneal Collagen

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The efficacy and safety of corneal collagen cross-linking in progressive keratoconus with regard to long-term results

Fyodorov journal of ophthalmic surgery ◽

10.25276/0235-4160-2016-1-31-38 ◽

2016 ◽

pp. 31-38

Author(s):

E.G. Solodkova ◽

◽

V.P. Fokin ◽

S.V. Balalin ◽

I.A. Melikhova ◽

...

Keyword(s):

Long Term Results ◽

Cross Linking ◽

Efficacy And Safety ◽

Collagen Cross Linking ◽

Corneal Collagen

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Five Years Follow-up of Riboflavin/Ultraviolet A (370 nm) Corneal Collagen Cross-linking to Halt the Progression of Keratoconus

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1081 ◽

2014 ◽

Vol 3 (2) ◽

pp. 63-68

Author(s):

PS David O’Brart ◽

Parul Patel ◽

Naomi A O’Brart

Keyword(s):

Cross Linking ◽

Spherical Equivalent ◽

Efficacy And Safety ◽

Ultraviolet A ◽

Cone Apex ◽

Collagen Cross Linking ◽

Corneal Collagen ◽

Fellow Eyes

ABSTRACT Aims To determine the long-term efficacy and safety of riboflavin/ultraviolet a corneal cross-linking (CXL) to halt the progression of keratoconus. Materials and methods Thirty-five patients (35 eyes) who had undergone CXL with epithelial removal 5 or more years previously were examined. Results At 5 years, mean spherical equivalent (SEQ) increased by 0.78 diopters (D) (p < 0.001), mean simulated K (Sim K) reduced by 0.86D (p < 0.00001), cone apex power (CAP) reduced by 1.1D (p < 0.0002) and root mean square (RMS) (p < 0.0001), coma (p < 0.0001), and secondary astigmatism (p < 0.001) decreased compared to preoperative values. Compared to values at 1 year, mean refractive cylinder reduced by 0.26D (p < 0.05), mean Sim K reduced by 0.46D (p < 0.0005), CAP reduced by 0.81D (p < 0.01), RMS (p < 0.001), coma (p < 0.002) and secondary astigmatism (p < 0.02) reduced and central pachymetry increased (p < 0.05) at 5 years. No treated eyes showed evidence of progression at 5 years. None lost >1 line of CDVA. Eight untreated fellow eyes progressed during the follow-up period and underwent CXL. Conclusions Corneal cross-linking is an effective treatment to halt the progression of keratoconus at 5 years, with no sight-threatening complications. Improvements in topographic and wave-front indices present at 1 year continue to improve at 5 years. How to cite this article O’Brart PSD, Patel P, O’Brart NA. Five Years Follow-up of Riboflavin/Ultraviolet A (370 nm) Corneal Collagen Cross-linking to Halt the Progression of Keratoconus. Int J Kerat Ect Cor Dis 2014;3(2):63-68.

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