Shift in progression rate of keratoconus before and after epithelium-off accelerated corneal collagen crosslinking

2017 ◽  
Vol 43 (7) ◽  
pp. 929-936 ◽  
Author(s):  
Yu Meng Wang ◽  
Tommy C.Y. Chan ◽  
Marco Yu ◽  
Vishal Jhanji
Keyword(s):  
Progression Rate ◽  
Collagen Crosslinking ◽  
Before And After ◽  
Corneal Collagen Crosslinking ◽  
Corneal Collagen

Oxidative stress markers dynamics in keratoconus patients’ tears before and after corneal collagen crosslinking procedure

2020 ◽  
Vol 190 ◽  
pp. 107897 ◽  
Author(s):  
Ioana-Miruna Balmus ◽  
Anisia Iuliana Alexa ◽  
Roxana-Elena Ciuntu ◽  
Ciprian Danielescu ◽  
Bogdan Stoica ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Oxidative Stress Markers ◽  
Collagen Crosslinking ◽  
Stress Markers ◽  
Before And After ◽  
Corneal Collagen Crosslinking ◽  
Corneal Collagen

Successful Regression in Patients with Progressive Keratoconus by Corneal Crosslinking

2021 ◽  
Author(s):  
Tobias Röck ◽  
Eva-Maria Konrad ◽  
Daniel Röck ◽  
Matthias Bramkamp ◽  
Gunnar Blumenstock ◽  
...  
Keyword(s):  
Statutory Health Insurance ◽  
Observation Time ◽  
Collagen Crosslinking ◽  
Corrected Visual Acuity ◽  
Before And After ◽  
Study Population ◽  
Corneal Collagen Crosslinking ◽  
The Mean ◽  
The University ◽  
Corneal Collagen

Abstract Background Since 2019, corneal collagen crosslinking (CXL) is included in the catalog of procedures covered by statutory health insurance in Germany. CXL is an established ophthalmological procedure for the last 20 years. The aim of this investigation was the measurement of progression before and after CXL. Material und Methods 65 consecutive eyes with progressive keratoconus from 53 patients were included in the retrospective study, which were observed at the University Eye Hospital Tübingen at least two years before and at least two years after CXL. The time of observation took place from October 2009 until March 2018. Parameters of interest had been the best corrected visual acuity (BCVA) and the keratometric values from the elevation maps measured by a Scheimpflug camera. Results 65 eyes of 53 patients had been documented. The study population included 46 (86.8%) male and 7 (13.2%) female subjects. The mean age was 24 ± 8 years. The averaged observation time between the primary consultation and CXL showed 25 ± 15 months. Preoperatively the mean BCVA pointed out in a significant increase (0.13 ± 0.17 [first visit] vs. 0.23 ± 0.22 [preOP], p < 0.0001) while the mean Kmax resulted in a statistically significant increase (46.34 ± 3.33 dpt [first visit] vs. 48.78 ± 4.17 dpt [preOP], p < 0.0001). The mean thinnest point of the cornea showed a significant decrease (490.48 ± 34.23 µm [first visit] vs. 468.62 ± 29.84 µm [preop], p < 0.0001). Postoperatively the mean BCVA resulted in a significant improvement at the 12th postoperative month in comparison to the preoperative measurement (0.23 ± 0.22 [preOP] vs. 0.16 ± 0.14 [12 months], p = 0.04 respectively 0.17 ± 0.17 [24 months], p = 0.0006). The mean Kmax demonstrated in the 12th postoperative month a significant reduction (48.78 ± 4.17 dpt [preOP] vs. 47.91 ± 3.41 dpt [12 months], p = 0.0009 respectively 48 ± 4.56 dpt [24 months], p = 0.0051). The mean thinnest point of the cornea indicated a decrease at the 12th postoperative month (468.62 ± 29.84 µm [preOP] vs. 459.82 ± 35.88 µm [12 months], p = 0.0078 respectively 453.47 ± 43.39 µm [24 months], p = 0.0227). Conclusion CXL is a successful procedure for the therapy of progressive keratoconus.

Comparative evaluation of progression rate in keratoconus before and after collagen crosslinking

2017 ◽  
Vol 102 (8) ◽  
pp. 1109-1113 ◽  
Author(s):  
Yu Meng Wang ◽  
Tommy CY Chan ◽  
Marco C Y Yu ◽  
Vishal Jhanji
Keyword(s):  
Disease Progression ◽  
Corneal Thickness ◽  
Progression Rate ◽  
Mixed Effect ◽  
Swept Source ◽  
Collagen Crosslinking ◽  
Mixed Effect Models ◽  
Before And After ◽  
Corneal Collagen Crosslinking

PurposeTo compare the rate of disease progression in keratoconus before and after corneal collagen crosslinking (CXL).Methods145 eyes were followed without CXL (no-CXL group) for a median duration of 31 months whereas 45 eyes were followed up for 41 months before (pre-CXL) and after (post-CXL) accelerated, epithelium-off crosslinking. Progression was defined based on significant slope found in linear mixed effect models against time. Swept-source optical coherence tomography was used for measurement of anterior steep keratometry, anterior flat keratometry (Ant Kf), anterior average keratometry (Ant Avg K); posterior steep keratometry, posteriorflat keratometry (Post Kf), posterior average keratometry (Post Avg K) and corneal thickness.ResultsThe patients in pre-CXL group were significantly younger (26.3±5.48 years) compared with the patients in no-CXL group (32.7±10.24 years) (P=0.004). Significant differences were observed during baseline examination for all parameters (P≤0.035) between pre-CXL and no-CXL groups except Ant Cyl and Post Cyl. During observation period, statistically significant differences were noted between pre-CXL and no-CXL groups in the progression rate of Ant Kf, Ant Avg K, Post Kf and Post Avg K (P≤0.045). After CXL, the progression rate in post-CXL group was comparable to that in no-CXL group. All corneal parameters remained stable in no-CXL group throughout the follow-up period.ConclusionsSerial tomographic examination is useful to document disease progression before and after CXL. In our study, a decrease in progression rate of corneal parameters was noted after CXL. In cases with stable corneal parameters over time, careful monitoring can be considered instead of collagen crosslinking.

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 Risk Factors For Progression Following Corneal Collagen Crosslinking In Keratoconus

2021 ◽  
Author(s):  
Ayhan Saglik ◽  
Gökçen Özcan ◽  
Ömür Uçakhan
Keyword(s):  
Risk Factors ◽  
Allergic Conjunctivitis ◽  
Female Gender ◽  
Progression Rate ◽  
Collagen Crosslinking ◽  
Central Cone ◽  
Corneal Collagen Crosslinking ◽  
The Mean ◽  
Corneal Collagen

Abstract Purpose: To assess risk factors for progression following corneal collagen crosslinking (CXL) in eyes with keratoconus. Methods: Charts of patients who developed progression following conventional CXL treatment (Dresden protocol) were retrospectively evaluated in two centers (Center 1, and Center 2). 871 eyes of a total of 676 patients were analyzed. Progression was defined as >1 diopter (D) increase in maximum keratometry (Kmax) readings compared to baseline. Results: Progression was noted in 20 eyes of 20 patients (progression rate 3%). The mean age of the patients was 17.65 ± 5.76 (11–34) years and the mean follow-up following CXL was 36.70 ± 25.72 (12–84) months. The gender distribution was 13 (65%) females, and seven (35%) males. Four eyes (20%) had mild, 13 eyes (65%) had moderate, and three eyes (15%) had severe keratoconus at baseline. Fifteen eyes (75%) had allergic conjunctivitis and 20 eyes (100%) reported eye-rubbing. Cone location was central in 17 (85%) eyes and peripheral in 3 (15%) eyes. A mean of 2.21 ± 1.30 D (1.00 – 5.30 D) steepening was determined at Kmax 6 to 82 months following CXL treatment. Conclusions: Progression rate was found to be higher in the patients under the age of 17 years, female gender, allergic conjunctivitis, high preoperative Kmax (>57 D), thin corneas (<430 µm) . The majority of progressive patients were central cone and moderate keratoconus.

scholarly journals Outcome of Corneal Collagen Crosslinking for Progressive Keratoconus in Paediatric Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Deepa Viswanathan ◽  
Nikhil L. Kumar ◽  
John J. Males
Keyword(s):  
Young Patients ◽  
Ultraviolet A ◽  
Effective Treatment Option ◽  
Collagen Crosslinking ◽  
Paediatric Patients ◽  
Corneal Grafting ◽  
Minimum Angle ◽  
Corneal Collagen Crosslinking ◽  
The Mean ◽  
Corneal Collagen

Purpose. To evaluate the efficacy of corneal collagen crosslinking for progressive keratoconus in paediatric patients.Methods. This prospective study included 25 eyes of 18 patients (aged 18 years or younger) who underwent collagen crosslinking performed using riboflavin and ultraviolet-A irradiation (370 nm, 3 mW/cm2, 30 min).Results. The mean patient age was 14.3 ± 2.4 years (range 8–17) and mean followup duration was 20.1 ± 14.25 months (range 6–48). Crosslinked eyes demonstrated a significant reduction of keratometry values. The mean baseline simulated keratometry values were 46.34 dioptres (D) in the flattest meridian and 50.06 D in the steepest meridian. At 20 months after crosslinking, the values were 45.67 D (P=0.03) and 49.34 D (P=0.005), respectively. The best spectacle corrected visual acuity (BSCVA) and topometric astigmatism improved after crosslinking. Mean logarithm of the minimum angle of resolution (logMAR) BSCVA decreased from 0.24 to 0.21 (P=0.89) and topometric astigmatism reduced from mean 3.50 D to 3.25 D (P=0.51).Conclusions. Collagen crosslinking using riboflavin and ultraviolet-A is an effective treatment option for progressive keratoconus in paediatric patients. Crosslinking stabilises the condition and, thus, reduces the need for corneal grafting in these young patients.

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