Long-term results of combined transepithelial phototherapeutic keratectomy and corneal collagen crosslinking for keratoconus: Cretan protocol

2014 ◽  
Vol 40 (9) ◽  
pp. 1439-1445 ◽  
Author(s):  
George D. Kymionis ◽  
Michael A. Grentzelos ◽  
Vardhaman P. Kankariya ◽  
Dimitrios A. Liakopoulos ◽  
Alexandra E. Karavitaki ◽  
...  
2015 ◽  
Vol 8 (3) ◽  
pp. 180-186 ◽  
Author(s):  
Maddalena De Bernardo ◽  
Luigi Capasso ◽  
Michele Lanza ◽  
Antonia Tortori ◽  
Stefania Iaccarino ◽  
...  

2020 ◽  
Vol 12 (4) ◽  
pp. 29-34 ◽  
Author(s):  
Oleg A. Frolov ◽  
Sergey Yu. Astakhov ◽  
Sergey Yu. Astakhov ◽  
Sergey A. Novikov ◽  
Sergey A. Novikov

Corneal collagen crosslinking is one of the most effective methods of prophylactics and treatment of progressive corneal ectasias. In the literature, there are occasional data related to remote results concerning only the most common form of ectasias keratoconus. In published studies, no remote results are met concerning the efficacy of corneal collagen crosslinking in other forms of corneal ectasias, which are now on the rise, including secondary ectasias that became more frequent with refractive surgery. The number of diagnosed cases of pellucid marginal degeneration increased as well. The literature shows no data on comparative analysis of remote results concerning the efficacy of this method in treatment of various forms of corneal ectasias. The aim of the investigation was to evaluate the efficacy of corneal collagen crosslinking based on the analysis of long-term results of this treatment method for various forms of corneal ectasias. Materials and methods. The results of corneal collagen crosslinking in patients with various forms of corneal ectasia 6 years after surgery were analyzed. The nosological structure of the study included patients with keratoconus, pellucid marginal degeneration, and secondary ectasia. The group of patients with keratoconus included 30 patients (30 eyes), that with pellucid marginal degeneration 30 patients (30 eyes), and that with secondary ectasia 30 patients (30 eyes). Corneal collagen crosslinking was performed by the same specialist, during the first or the second year of follow-up. Then changes in the state of the cornea and visual functions were monitored for 6 years. To assess the efficacy, preoperative examination results and interim data were used. Results. In all groups, there was an increase in the best corrected visual acuity, a decrease in the index of asymmetry of the corneal surface and its refractive power in the center of ectasia. However, best corneal collagen crosslinking results were obtained in groups of patients with keratoconus and secondary corneal ectasia.


2014 ◽  
Vol 40 (10) ◽  
pp. 1591-1596 ◽  
Author(s):  
Aydin Yildirim ◽  
Hanefi Cakir ◽  
Necip Kara ◽  
Hasim Uslu ◽  
Bulent Gurler ◽  
...  

2015 ◽  
Vol 41 (11) ◽  
pp. 2524-2532 ◽  
Author(s):  
Enrique O. Graue-Hernandez ◽  
Gabriela L. Pagano ◽  
Guillermo Garcia-De la Rosa ◽  
Arturo Ramirez-Miranda ◽  
Jesus Cabral-Macias ◽  
...  

Cornea ◽  
2016 ◽  
Vol 35 (2) ◽  
pp. 157-161 ◽  
Author(s):  
Mustafa Kapasi ◽  
Amanpreet Dhaliwal ◽  
George Mintsioulis ◽  
W. Bruce Jackson ◽  
Kashif Baig

2016 ◽  
Vol 27 (3) ◽  
pp. 253-269 ◽  
Author(s):  
David P.S. O’Brart

Purpose To review the published literature on corneal collagen crosslinking (CXL). Methods Importance has been placed on seminal publications, systemic reviews, meta-analyses, and randomized controlled clinical trials. Where such evidence was not available, cohort studies, case-controlled studies, and case series with follow-up greater than 12 months were examined. Results Corneal collagen crosslinking with riboflavin and ultraviolet A (UVA) 370 nm radiation appears to be capable of arresting the progression of ectatic corneal disorders, with most studies reporting significant improvements in visual, keratometric, and topographic measurements. Its mode of action at the molecular level is undetermined. Follow-up is limited to 5-10 years but suggests sustained stability and enhancement in corneal shape with time. Nearly all published long-term data and comparative studies are with epithelium-off techniques. Epithelium-on investigations suggest some efficacy but less than with epithelium-off treatments and long-term data are unavailable. Accelerated techniques with higher UVA fluencies and shorter treatments times, delivering the same UVA energy dosage, are the subject of recent investigation, with some laboratory and clinical studies suggesting reduced efficacy compared to the standard 3 mW/cm2 for 30 minutes irradiation procedure. Combined methodologies of CXL with techniques such as photorefractive keratectomy and intrastromal rings show promise but long-term follow-up is indicated. Sight-threatening complications of CXL are rare. Conclusions Studies of epithelium-off CXL with irradiation at 3 mW/cm2 for 30 minutes support its efficacy. Refinement in techniques may allow for safer and more rapid procedures with less patient discomfort but require further investigation.


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