Corneal collagen crosslinking for ectasia after laser in situ keratomileusis: Long-term results

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.

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Corneal Collagen Crosslinking Combined with Phototherapeutic Keratectomy and Photorefractive Keratectomy for Corneal Ectasia after Laser in situ Keratomileusis

Ophthalmic Research ◽

10.1159/000480242 ◽

2018 ◽

Vol 59 (3) ◽

pp. 135-141 ◽

Cited By ~ 2

Author(s):

Wei Zhu ◽

Yunfei Han ◽

Changxia Cui ◽

Wenwen Xu ◽

Xuan Wang ◽

...

Keyword(s):

Laser In Situ Keratomileusis ◽

Photorefractive Keratectomy ◽

Collagen Crosslinking ◽

Phototherapeutic Keratectomy ◽

Corneal Ectasia ◽

Corneal Collagen Crosslinking ◽

Corneal Collagen

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Corneal Collagen Crosslinking for Keratectasia after Laser in situ Keratomileusis: A Review of the Literature

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1063 ◽

2013 ◽

Vol 2 (3) ◽

pp. 113-120

Author(s):

Leopoldo Spadea ◽

Francesca Verboschi ◽

Stefano Valente ◽

Enzo Maria Vingolo

Keyword(s):

Corneal Thickness ◽

Laser In Situ Keratomileusis ◽

Lamellar Keratoplasty ◽

Review Of The Literature ◽

Covalent Bonds ◽

Collagen Crosslinking ◽

Corneal Ectasia ◽

Corneal Collagen Crosslinking ◽

Corneal Collagen

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.

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