scholarly journals Combined small-incision lenticule extraction and intrastromal corneal collagen crosslinking to treat mild keratoconus: Long-term follow-up

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 ◽  
...  
Keyword(s):  
Small Incision Lenticule Extraction ◽  
Collagen Crosslinking ◽  
Small Incision ◽  
Long Term Follow Up ◽  
Lenticule Extraction ◽  
Corneal Collagen Crosslinking ◽  
Corneal Collagen

scholarly journals Two-year observation of posterior corneal elevations after small incision lenticule extraction (SMILE) for myopia higher than −10 dioptres

2019 ◽  
Vol 104 (1) ◽  
pp. 142-148 ◽  
Author(s):  
Xueyi Zhou ◽  
Jianmin Shang ◽  
Bing Qin ◽  
Yu Zhao ◽  
Xingtao Zhou
Keyword(s):  
Central Area ◽  
Control Group ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Long Term Follow Up ◽  
Lenticule Extraction ◽  
Measured Change

AimTo investigate the change in posterior corneal elevations (PCEs) of eyes with extremely high myopia 2 years after small incision lenticule extraction (SMILE).MethodsWe evaluated 39 eyes of 39 patients with spherical equivalent higher than −10.00 dioptres (D). Using a Scheimpflug camera (Pentacam), we measured change in PCEs at 1 day, 3 months, 6 months and 2 years after SMILE. Another 34 eyes of 34 patients who underwent femtosecond laser-assisted in situ keratomileusis (FS-LASIK) were examined before, at 1 day and long-term after surgery as the control group. For each eye, elevations at central, thinnest, maximal points and 24 other predetermined points were measured.ResultsNo significant forward displacements of PCEs were observed in both surgeries. The maximal but not significant forward displacement occurred around 3–6 months following SMILE, and all returned to original levels 6 months postoperatively except superior area. The peripheral area tended to displace backward, while the central area tended forwardly. In both procedures, elevations along horizontal meridians, inferior and temporal hemispheres were significantly higher than those along vertical meridians, superior and nasal hemispheres, respectively (p<0.05). Elevation on the 4 mm, 6 mm diameters at 1 day and on the 6 mm diameter and temporal hemisphere at long-term follow-up postoperatively were significantly higher in FS-LASIK than SMILE (p<0.05). Change in elevations on the 6 mm diameter circle correlated with residual bed thickness (p=0.047).ConclusionsSMILE is a safe way to correct for myopia higher than −10 D, with PCEs remaining stable 2 years after surgery.

Corneal Collagen Crosslinking for Corneal Ectasias: A Review

2016 ◽  
Vol 27 (3) ◽  
pp. 253-269 ◽  
Author(s):  
David P.S. O’Brart
Keyword(s):  
Case Series ◽  
Collagen Crosslinking ◽  
Randomized Controlled Clinical Trials ◽  
Long Term Follow Up ◽  
Corneal Collagen Crosslinking ◽  
Meta Analyses ◽  
Term Data ◽  
Corneal Collagen

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.

Small-incision lenticule extraction and corneal collagen crosslinking in keratoconus

2016 ◽  
Vol 42 (3) ◽  
pp. 506 ◽  
Author(s):  
Virgilio Galvis ◽  
Alejandro Tello ◽  
Nestor I. Carreño ◽  
Ruben D. Berrospi ◽  
Camilo A. Niño
Keyword(s):  
Small Incision Lenticule Extraction ◽  
Collagen Crosslinking ◽  
Small Incision ◽  
Lenticule Extraction ◽  
Corneal Collagen Crosslinking ◽  
Corneal Collagen

scholarly journals Long-term results of corneal collagen crosslinking with ectatic forms of corneal dystrophy

2020 ◽  
Vol 12 (4) ◽  
pp. 29-34 ◽  
Author(s):  
Oleg A. Frolov ◽  
Sergey Yu. Astakhov ◽  
Sergey Yu. Astakhov ◽  
Sergey A. Novikov ◽  
Sergey A. Novikov
Keyword(s):  
Corneal Dystrophy ◽  
Treatment Method ◽  
Long Term Results ◽  
Corneal Surface ◽  
Collagen Crosslinking ◽  
Corneal Ectasia ◽  
Corneal Collagen Crosslinking ◽  
Corneal Collagen

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.

scholarly journals Three-year outcomes of small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia and myopic astigmatism

2018 ◽  
Vol 103 (4) ◽  
pp. 565-568 ◽  
Author(s):  
Tian Han ◽  
Ye Xu ◽  
Xiao Han ◽  
Li Zeng ◽  
Jianmin Shang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Laser In Situ Keratomileusis ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Lenticule Extraction ◽  
Myopic Astigmatism

AimsTo compare long-term clinical outcomes following small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia and myopic astigmatism correction.MethodsIn this retrospective study, we enrolled a total of 101 patients (101 eyes) who underwent SMILE or FS-LASIK 3 years prior. Measured parameters included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction and corneal wavefront aberrations.ResultsNo significant differences in patient characteristics were found between the two groups. At the 3-year follow-up, UDVA was better than or equal to 20/20 in 90% and 85% (p=0.540) of the eyes; the efficacy indexes were 1.05±0.19 and 1.01±0.21 in the SMILE and FS-LASIK groups, respectively (p=0.352). Safety indexes were 1.19±0.17 and 1.15±0.20 in the SMILE and FS-LASIK groups, respectively (p=0.307). Eighty per cent and 65% of eyes were within ±0.50 D of the attempted spherical equivalent correction after SMILE and FS-LASIK, respectively (p=0.164). Vector analysis revealed no significant differences in astigmatic correction between the two groups (p>0.05). Surgically induced spherical aberration was higher in the FS-LASIK group than in the SMILE group (p<0.001).ConclusionLong-term follow-up analysis suggested that both SMILE and FS-LASIK were safe and equally effective for myopic and astigmatic correction.

Long-term (5 years) follow-up of small-incision lenticule extraction in mild-to-moderate myopia

2019 ◽  
Vol 45 (4) ◽  
pp. 421-426 ◽  
Author(s):  
Alper Ağca ◽  
Beril Tülü ◽  
Dilek Yaşa ◽  
Yusuf Yıldırım ◽  
Burçin K. Yıldız ◽  
...  
Keyword(s):  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Lenticule Extraction

scholarly journals Long-term efficacy and safety after corneal collagen crosslinking in pediatric patients: Three-year follow-up

2018 ◽  
Vol 28 (4) ◽  
pp. 415-418 ◽  
Author(s):  
Maria A Henriquez ◽  
Sandra Villegas ◽  
Mirel Rincon ◽  
Carmen Maldonado ◽  
Luis Izquierdo
Keyword(s):  
Visual Acuity ◽  
Progression Rate ◽  
Collagen Crosslinking ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Corneal Collagen Crosslinking ◽  
Best Corrected Visual Acuity ◽  
Corneal Collagen

Purpose: To evaluate the effectiveness of standard corneal collagen crosslinking for children with progressive keratoconus. Methods: Prospective study including 26 eyes of 26 patients younger than 18 years old with progressive keratoconus at Oftalmosalud Instituto de Ojos, Lima, Peru. Standard epi-off corneal crosslinking was performed in all eyes between January 2012 and January 2013. Pre- and postoperative evaluation (at 3 years) included uncorrected and best-corrected visual acuity and Scheimpflug analysis. Crosslinking failure was defined as an increase in maximum keratometry (Kmax) of more than 1 diopter after 1 year or more. Results: Mean uncorrected visual acuity improvement was 0.24 LogMAR (p = 0.07) and mean best-corrected visual acuity improvement was 0.18 LogMAR (p = 0.01). None of the eyes lost more than one line in the best-corrected visual acuity. Four eyes (15.38%) lost two lines in the uncorrected visual acuity at 3 years postoperative. Mean steeper keratometry improvement was 1.14 diopters (p = 0.60). Progression rate was 23.07%. Conclusion: Standard epi-off corneal collagen crosslinking is safe and effective to halt the progression of the keratoconus with significant improvement in the best-corrected visual acuity at 3-year follow-up.

scholarly journals Five-years Results of Small-incision Lenticule Extraction in High Myopia

2020 ◽  
Author(s):  
Min Lang ◽  
Kaiwei Cao ◽  
Ting Liu ◽  
Jiao Pan ◽  
Jian Ye
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Control Group ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Related Quality ◽  
Lenticule Extraction

Abstract Background To investigate long-term refractive visual quality outcomes and vision-related quality of life after small-incision lenticule extraction (SMILE) in the treatment of high myopia.Methods Thirty patients (60 eyes) with high myopia who underwent SMILE more than 5 years previously were selected as the SMILE group. Another 30 high myopia patients (60 eyes) who had worn corrective spectacles for more than 5 years were selected as the control group. In the SMILE group, the postoperative follow-up times were 3 months, 6 months, 1 year and 5 years. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), and ocular axial length (AL) were analysed. The Chinese version of the National Eye Institute Visual Function Questionnaire-25 (CHI-NEI-VFQ-25) was used to evaluate the vision-related quality of life in the SMILE group and the control group.Results In the SMILE group, the mean preoperative SE was -7.29±0.87 D (range -6.00 to -9.125 D). The efficacy index and safety index of SMILE were 1.09±0.18 and 1.19±0.12, respectively. Five years postoperatively, 44 eyes (73%) obtained a visual acuity of 20/20 or better. There were no eyes with CDVA loss of one or more Snellen lines. Forty-nine eyes (82%) and 57 eyes (95%) were within ±0.50 D and ±1.00 D of attempted correction, respectively. Forty-eight eyes (80%) had astigmatism < 0.50 D. The postoperative mean SE values at 3 months, 6 months, 1 year, and 5 years were 0.11±0.44 D, 0.07±0.45 D, -0.02±0.41 D, and -0.15±0.46 D, respectively. No significant change was observed in the ocular axial length from before operation to 5 years postoperatively (26.08±0.96 mm vs 26.01±0.94 mm, p>0.05). Compared to the control group, the SMILE group showed a significantly higher total score on the CHI-NEI-VFQ-25 (90.14 vs 81.43, p < 0.001).Conclusions In the present study, in a long-term follow-up, we demonstrated that correcting high myopia with SMILE is safe, effective, and predictable. In addition, there is slight undercorrection.

scholarly journals Long-term Follow-up of Pachymetric and Topographic Alterations after Corneal Collagen Cross-Linking for Keratoconus

2012 ◽  
Vol 1 (1) ◽  
pp. 22-25
Author(s):  
Paraskevi G Zotta ◽  
Diamantis D Almaliotis ◽  
George D Kymionis ◽  
Vasilios F Diakonis ◽  
Kostas A Moschou ◽  
...  
Keyword(s):  
Corneal Thickness ◽  
Case Series ◽  
Cross Linking ◽  
Retrospective Case ◽  
Time Intervals ◽  
Long Term Follow Up ◽  
Collagen Cross Linking ◽  
Corneal Collagen

ABSTRACT Purpose To determine the long-term alterations of corneal thickness, along with topographic outcomes, after corneal collagen cross-linking treatment (CXL) for keratoconus. Materials and methods In this retrospective case series, 46 patients (52 eyes), 32 males and 14 females, with progressive keratoconus were included. All eyes underwent CXL in accordance with the standard protocol (Dresden) for the treatment of their ectatic corneal disorder between January 2006 and June 2007. Pachymetric and topographic outcomes were evaluated preoperatively and at 1, 3, 6, 12, 24 and 36 months postoperatively. Results Mean follow-up was 28.08 ± 8.39 months (range, from 12 to 36 months). A statistically significant decline in corneal pachymetric values (at the thinnest location) when compared with preoperative values (467.65 ± 41.08 µm) was demonstrated at 1 (437.63 ± 50.57 µm), 3 (439.08 ± 52.27 µm), 6 (449.37 ± 52.73 µm), 12 (449.63 ± 83.53 µm) and 24 (459.97 ± 47.32 µm) months after CXL (p < 0.05, for all mentioned time intervals). Return to preoperative pachymetric values (469.52 ± 40.52 µm) was revealed 36 months post-CXL (p > 0.05). With respect to topographic (flat and steep keratometric values, keratoconus index), no statistically significant differences between preoperative and all postoperative intervals were found (p > 0.05, for all values for all time intervals). Conclusion Corneal pachymetric values reduce significantly up to 24 months after CXL treatment, while a return to preoperative values was revealed 36 months after the procedure. No significant changes’ concerning topographic outcomes was demonstrated after CXL, indicating stability of these parameters. How to cite this article Zotta PG, Almaliotis DD, Kymionis GD, Diakonis VF, Moschou KA, Karampatakis VE. Long-term Follow-up of Pachymetric and Topographic Alterations after Corneal Collagen Cross-Linking for Keratoconus. Int J Keratoco Ectatic Corneal Dis 2012;1(1):22-25.

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