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

2011 ◽  
Vol 37 (4) ◽  
pp. 691-700 ◽  
Author(s):  
Steven A. Greenstein ◽  
Vinnie P. Shah ◽  
Kristen L. Fry ◽  
Peter S. Hersh
Author(s):  
Leopoldo Spadea ◽  
Francesca Verboschi ◽  
Stefano Valente ◽  
Enzo Maria Vingolo

ABSTRACT Corneal ectasia is a serious vision-threatening complication of laser in situ keratomileusis (LASIK). It is associated with progressive corneal steepening, an increase in myopia and astigmatism, and decrease in uncorrected visual acuity. Before LASIK presence of risk factors (corneal thickness, refractive error, presence of clinical and subclinical corneal pathologies) should be studied so patients should be risk-stratified. Forme fruste keratoconus or marginal pellucid degeneration should be investigated before LASIK in order to inform the patients of the possibility to develop a corneal complication. Management of post-LASIK ectasia enlists crosslinking, INTACTS, contact lenses and, in the most serious cases, lamellar keratoplasty and corneal transplantation. Crosslinking is a technique to treat and even prevent post-LASIK corneal ectasia. LASIK is a technique that reduces the corneal strength and stability. Crosslinking increases the number of collagen interfibrillar covalent bonds, using ultraviolet A and riboflavin. This result increases stability in corneal strength, reducing the risk to develop corneal ectasia (if performed simultaneously with LASIK) or it treats ectasia (if performed after LASIK keratectasia). How to cite this article Spadea L, Verboschi F, Valente S, Vingolo EM. Corneal Collagen Crosslinking for Keratectasia after Laser in situ Keratomileusis: A Review of the Literature. J Kerat Ect Cor Dis 2013;2(3):113-120.


Author(s):  
B.E. Malugin ◽  
◽  
E.G. Solodkova ◽  
S.V. Balalin ◽  
V.S. Kulikov ◽  
...  

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.


2021 ◽  
Vol 18 (4) ◽  
pp. 840-844
Author(s):  
E. Yu. Markova ◽  
G. V. Avakyants ◽  
E. V. Kechin

Objective: to evaluate the results of corneal collagen crosslinking in children with keratoconus.Patients and methods. Since 2017, 125 children aged 4 to 17 years have been under observation, who have applied to the Eye Microsurgery named after Academician S.N. Fedorov with complaints of reduced visual acuity and, in some cases, the inability to select optical correction. All patients were examined, including using high-tech methods (Sheimpflug camera, OCT). Based on the anamnesis and the data obtained, the diagnosis of keratoconus stage I–III was made. Corneal collagen crosslinking was performed in 30 patients with stage II–III.Results. The study included 30 eyes of 30 patients (21 (68 %) boys, 9 (32 %) girls) with a median age — 16 (15; 17) years (12 to 17 years), who underwent accelerated “epi-off” crosslinking. No intra-and postoperative complications were observed. 12 months after CXL, there was a slowdown in the progression of keratoconus in children (minimum corneal thickness before surgery 460.00 (445.00; 477.00), after surgery 457.00 (441.00; 477.00), p = 0.112; K1 before surgery 44.60 (43.20; 46.90), after surgery 44.60 (42.90; 46.50), p = 0.481; K2 before surgery 48.30 (47.30; 51.25), after surgery 48.20 (47.21; 49.20), p = 0.779; elevation of the posterior surface before surgery 25.00 (18.00; 42.00), after surgery 26.00 (21.00; 42.00), p = 0.074, and increased visual acuity (NCOZ from 0.30 (0.05; 0.40) to 0.30 (0.20; 0.40) (p = 0.039) and MCOZ from 0.60 (0.40; 0.80) to 0.60 (0.50; 1.00) (p = 0.010)).Conclusion. 1. Keratoconus is also found in the child population. 2. Timely cross-linking of corneal collagen can slow the progression of keratoconus in children


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