Comparative study of changes of corneal curvatures and uncorrected distance visual acuity prior to and after corneal collagen crosslinking: 1-year results

ABSTRACT Purpose To evaluate the effect of riboflavin and ultraviolet- A-induced corneal collagen crosslinking (CXL) on high order aberrations (HOA) up to third-order at 6 months using the iTrace wavefront aberrometer in patients with progressive keratoconus and post-LASIK ectasia. Materials and methods Ongoing retrospective chart review of patients having undergone CXL. The iTrace (Tracey Technologies, Houston, TX) was used to evaluate HOA. Patient data was collected from a single clinical site pre- and 6 months postoperatively. Data collected included logMAR uncorrected distance visual acuity (UDVA), logMAR corrected distance visual acuity (CDVA), manifest refraction, and HOA measurements. Data was analyzed with paired two-tailed student's t-test. Results 18 eyes (9M:4F, mean age 29.2 years, range 16-45) had 6 months of follow-up. Total HOAs, total coma and total trefoil were significantly reduced at 6 months by 16, 33 and 26% respectively (p < 0.05). Nonsignificant trends toward improvement were seen in spherical aberration, secondary astigmatism and UDVA. There were no statistically significant changes in manifest refraction or CDVA. Conclusion Improvement in high order aberration profile is one mechanism by which corneal collagen crosslinking enhances visual function in ectatic corneas. Total HOA and total coma measures are the most commonly reported improvements in HOA measures in previous studies, while total trefoil has only been observed in one other study. The improvements seen in HOAs remain fairly modest which likely accounts for the lack of measureable improvement in high-contrast visual acuity measures, such as Snellen UDVA and CDVA. This study is the first to report HOA outcomes with the iTrace wavefront aberrometer. How to cite this article Muzychuk A, Penner V, Rocha G. High Order Aberration Outcomes of Corneal Collagen Crosslinking in Eyes with Keratoconus and Post-LASIK Ectasia. Int J Kerat Ect Cor Dis 2014;3(3):107-112.

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Higher-order aberrations 1 year after corneal collagen crosslinking for keratoconus and their independent effect on visual acuity

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2016.04.021 ◽

2016 ◽

Vol 42 (7) ◽

pp. 1046-1052 ◽

Cited By ~ 8

Author(s):

Robert P.L. Wisse ◽

Stijn Gadiot ◽

Nienke Soeters ◽

Daniel A. Godefrooij ◽

Saskia M. Imhof ◽

...

Keyword(s):

Visual Acuity ◽

Higher Order ◽

Independent Effect ◽

Higher Order Aberrations ◽

Collagen Crosslinking ◽

Corneal Collagen Crosslinking ◽

Corneal Collagen

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Safety and Visual Outcome of Visian Toric ICL Implantation after Corneal Collagen Cross-Linking in Keratoconus: Up to 2 Years of Follow-Up

Journal of Ophthalmology ◽

10.1155/2015/514834 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

Rafic Antonios ◽

Ali Dirani ◽

Ali Fadlallah ◽

Elias Chelala ◽

Adib Hamade ◽

...

Keyword(s):

Visual Acuity ◽

Visual Outcome ◽

Cross Linking ◽

Implantable Collamer Lens ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

Effective Option ◽

Collagen Cross Linking ◽

Corneal Collagen

Purpose. To evaluate the long-term safety and clinical outcome of phakic Visian toric implantable collamer lens (ICL) insertion after corneal collagen cross-linking (CXL) in progressive keratoconus.Methods. This was a retrospective study of 30 eyes (19 patients), with progressive keratoconus, who underwent sequential CXL followed by Visian toric ICL implantation after 6 months.Results. At baseline, 6 eyes had stage I, 14 eyes stage II, and 10 eyes stage III keratoconus graded by Amsler-Krumeich classification. At 6 months after CXL, onlyK(steep) andK(max) decreased significantly from baseline, with no change in visual acuity or refraction. Flattening in keratometric readings was stable thereafter. There was significant improvement in mean uncorrected distance visual acuity (1.57 ± 0.56 to 0.17 ± 0.06 logMAR,P<0.001) and mean corrected distance visual acuity (0.17 ± 0.08 to 0.11 ± 0.05 logMAR,P<0.001) at 12 months after ICL implantation that was maintained at the 2-year follow-up. Mean cylinder power and mean spherical equivalent (SE) also decreased significantly after ICL implantation. A small hyperopic shift in SE (+0.25 D) was observed at 2 years that did not alter visual outcomes.Conclusions. Visian toric ICL implantation following CXL is an effective option for improving visual acuity in patients with keratoconus up to 2 years.

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Keratoconus in Children. Мodern Treatment Options

Ophthalmology in Russia ◽

10.18008/1816-5095-2021-4-840-844 ◽

2021 ◽

Vol 18 (4) ◽

pp. 840-844

Author(s):

E. Yu. Markova ◽

G. V. Avakyants ◽

E. V. Kechin

Keyword(s):

Visual Acuity ◽

Treatment Options ◽

Corneal Thickness ◽

High Tech ◽

Cross Linking ◽

Posterior Surface ◽

Collagen Crosslinking ◽

Optical Correction ◽

Corneal Collagen Crosslinking ◽

Corneal Collagen

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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Impact of COVID-19 on keratoconus patients waiting for corneal cross linking

European Journal of Ophthalmology ◽

10.1177/11206721211001315 ◽

2021 ◽

pp. 112067212110013

Author(s):

Haider Shah ◽

Luca Pagano ◽

Anuj Vakharia ◽

Giulia Coco ◽

Kunal A Gadhvi ◽

...

Keyword(s):

Visual Acuity ◽

Observational Study ◽

Corneal Thickness ◽

Treatment Delay ◽

Cross Linking ◽

Corneal Surface ◽

Collagen Crosslinking ◽

Time Period ◽

Corneal Collagen Crosslinking ◽

Corneal Collagen

Purpose: Royal College of Ophthalmologist recent guidance recommended delaying cross-linking services during the COVID-19 pandemic. This study investigates the effects of such delays in the delivery of cross-linking services in patients with keratoconus progression. Methods: Retrospective observational study of 46 patients with keratoconus progression, whose cross-linking was delayed due to the COVID-19 pandemic. Demographic and clinical details were obtained from assessments on the day of listing, and subsequent review on the day of the procedure. Topographic indices included keratometry of the posterior and anterior corneal surface, maximum keratometry ( Kmax), thinnest corneal thickness, ABCD progression and progression based on standard criteria recommendations (1.5 D Kmax & 20 microns thinning). Results: A total of 46 eyes were analysed with an average time between being listed for CXL and having the procedure done was 182 ± 65 days. The delay due to COVID-19 was of 3 months. In this time period they had a significant worsening of all keratometric indices and lost almost one line of visual acuity (0.19 ± 0.19 to 0.26 ± 0.18 LogMAR, p: 0.03). Thirty two eyes (70%) demonstrated progression in accordance with the ABCD progression criteria, while 18 eyes (39%) showed either an increase in Kmax of more than 1.5D or a thinning in corneal thickness of at least 20 μm. Conclusions: The treatment delay for the keratoconus patients caused further progression and vision worsening. We recommend that corneal collagen crosslinking needs to be considered as a high priority intervention.

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Effect of Corneal Cone Location on Corneal Curvature Changes and Uncorrected Distance Visual Acuity after Corneal Collagen Cross-Linking for Progressive Keratoconus: A one-year Survey

Biosciences Biotechnology Research Asia ◽

10.13005/bbra/1990 ◽

2015 ◽

Vol 12 (3) ◽

pp. 3067-3072

Author(s):

Sattar Rajabi ◽

Seyyed Tabatabaee ◽

Mohammad Amiri ◽

Ahmad Rad ◽

Mohammad Yavari

Keyword(s):

Visual Acuity ◽

Cross Linking ◽

Corneal Curvature ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

One Year ◽

Collagen Cross Linking ◽

Corneal Collagen

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Corneal Curvature Changes and Uncorrected Distance Visual Acuity after Corneal Collagen Cross-Linking for Progressive Keratoconus: A one year follow-up survey

Biomedical & Pharmacology Journal ◽

10.13005/bpj/783 ◽

2015 ◽

Vol 8 (october Spl Edition) ◽

pp. 783-788

Author(s):

Sattar Rajabi ◽

Mohammad Amiri ◽

Seyyedmehdi Tabatabaee ◽

Ahmad Salamatrad ◽

Mohammad Yavari

Keyword(s):

Visual Acuity ◽

Cross Linking ◽

Corneal Curvature ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

One Year ◽

Collagen Cross Linking ◽

Corneal Collagen

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Transepithelial accelerated versus conventional corneal collagen crosslinking in patients with keratoconus: a comparative study

Clinical Ophthalmology ◽

10.2147/opth.s189183 ◽

2019 ◽

Vol Volume 13 ◽

pp. 445-452 ◽

Cited By ~ 4

Author(s):

Carolina Madeira ◽

Ana Vasques ◽

João Beato ◽

Gonçalo Godinho ◽

Luís Torrão ◽

...

Keyword(s):

Comparative Study ◽

Collagen Crosslinking ◽

Corneal Collagen Crosslinking ◽

Corneal Collagen

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Corneal Collagen Cross-Linking in Pellucid Marginal Degeneration: 2 Patients, 4 Eyes

Case Reports in Ophthalmological Medicine ◽

10.1155/2015/840687 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Serife Bayraktar ◽

Zafer Cebeci ◽

Merih Oray ◽

Nilufer Alparslan

Keyword(s):

Visual Acuity ◽

Long Term Results ◽

Cross Linking ◽

Specular Microscopy ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

Ring Segment ◽

The Right ◽

Collagen Cross Linking ◽

Corneal Collagen

Purpose. To report the long-term results of corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A irradiation in 4 eyes of 2 patients affected by pellucid marginal degeneration (PMD).Methods. This study involved the retrospective analysis of 4 eyes of 2 patients with PMD that underwent CXL treatment. Of the eyes, three had only CXL treatment and one had CXL treatment after an intrastromal corneal ring segment implantation. We have pre- and postoperatively evaluated uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCDVA), corneal topography (Pentacam), specular microscopy, and pachymetry.Results. Patient 1 was a woman, aged 35, and Patient 2 was a man, aged 33. The right eye of Patient 1 showed an improvement in her BCDVA, from 16/40 to 18/20 in 15 months, and her left eye improved from 12/20 to 18/20 in 20 months. Patient 2’s right eye showed an improvement in his BCDVA, from 18/20 to 20/20 in 43 months, and his left eye improved from 16/20 to 18/20 in 22 months. No complications were recorded during or after the treatment.Conclusion. CXL is a safe tool for the management of PMD, and it can help to stop the progression of this disease.

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

European Journal of Ophthalmology ◽

10.1177/1120672118760149 ◽

2018 ◽

Vol 28 (4) ◽

pp. 415-418 ◽

Cited By ~ 10

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.

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