scholarly journals Safety and Efficacy of Epithelium-On Corneal Collagen Cross-Linking Using a Multifactorial Approach to Achieve Proper Stromal Riboflavin Saturation

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Aleksandar Stojanovic ◽  
Xiangjun Chen ◽  
Nan Jin ◽  
Ting Zhang ◽  
Filip Stojanovic ◽  
...  
Keyword(s):  
Cross Linking ◽  
Slight Reduction ◽  
Irregularity Index ◽  
Uva Irradiation ◽  
Odd Order ◽  
Corrected Distance Visual Acuity ◽  
Superficial Epithelium ◽  
Multifactorial Approach ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose. To evaluate the efficacy and safety of epithelium-on corneal collagen cross-linking (CXL) using a multifactorial approach to achieve proper stromal riboflavin saturation.Methods. This non-randomized retrospective study comprised 61 eyes with progressive keratoconus treated with epithelium-on CXL. Chemical epithelial penetration enhancement (benzalkonium chloride-containing local medication and hypotonic riboflavin solution), mechanical disruption of the superficial epithelium, and prolongation of the riboflavin-induction time until verification of stromal saturation were used before the UVA irradiation. Uncorrected and corrected distance visual acuity (UDVA, CDVA), refraction, corneal topography, and aberrometry were evaluated at baseline and at 1, 3, 6, and 12 months postoperative.Results. At 12-month, UDVA and CDVA improved significantly. None of the eyes lost lines of CDVA, while 27.4% of the eyes gained 2 or more lines. Mean spherical equivalent decreased by 0.74 D, and mean cylindrical reduction was 1.15 D. Irregularity index and asymmetry from Scheimpflug-based topography and Max-Kat the location of cone from Placido-based topography showed a significant decrease. Higher-order-aberration data demonstrated a slight reduction in odd-order aberrationsS3, 5,7 (). Postoperative pain without other complications was recorded.Conclusion. Epithelium-on CXL with our novel protocol appeared to be safe and effective in the treatment of progressive keratoconus.

scholarly journals Corneal Collagen Cross-Linking with Hypoosmolar Riboflavin Solution in Keratoconic Corneas

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Shaofeng Gu ◽  
Zhaoshan Fan ◽  
Lihua Wang ◽  
Xiangchen Tao ◽  
Yong Zhang ◽  
...  
Keyword(s):  
Corneal Thickness ◽  
Cross Linking ◽  
Ultraviolet A ◽  
Uva Irradiation ◽  
Manifest Refraction ◽  
Corrected Distance Visual Acuity ◽  
The Mean ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose. To report the 12-month outcomes of corneal collagen cross-linking (CXL) with a hypoosmolar riboflavin and ultraviolet-A (UVA) irradiation in thin corneas.Methods. Eight eyes underwent CXL using a hypoosmolar riboflavin solution after epithelial removal. The corrected distance visual acuity (CDVA), manifest refraction, the mean thinnest corneal thickness (MTCT), and the endothelial cell density (ECD) were evaluated before and 6 and 12 months after CXL.Results. The MTCT was 413.9 ± 12.4 μm before treatment and reduced to 381.1 ± 7.3 μm after the removal of the epithelium. After CXL, the thickness decreased to 410.3 ± 14.5 μm at the last follow-up. Before treatment, the meanK-value of the apex of the keratoconus corneas was 58.7 ± 3.5 diopters and slightly decreased (57.7 ± 4.9 diopters) at 12 months. The mean CDVA was 0.54 ± 0.23 logarithm of the minimal angle of resolution before treatment and increased to 0.51 ± 0.21 logarithm at the last follow-up. The ECD was 2731.4 ± 191.8 cells/mm2before treatment and was 2733.4 ± 222.6 cells/mm2at 12 months after treatment.Conclusions. CXL with a hypoosmolar riboflavin in thin corneas seems to be a promising method for keratoconic eyes with the mean thinnest corneal thickness less than 400 μm without epithelium.

scholarly journals Transepithelial versus Epithelium off Crosslinking for Treating Keratoconus among Jordanians

2019 ◽  
Vol 13 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Khalid Al Zubi ◽  
Yaser Albakar ◽  
Rana Nasser
Keyword(s):  
Corneal Thickness ◽  
Tertiary Care ◽  
Cross Linking ◽  
Corrected Distance Visual Acuity ◽  
Corneal Collagen Crosslinking ◽  
The Mean ◽  
Group 2 ◽  
Collagen Cross Linking ◽  
Corneal Collagen ◽  
Group 1

Background: The progression of keratoconus is stabilized with the help of corneal collagen cross-linking (CXL) supported through photosynthesized riboflavin. Objective: This study aims to compare the effectiveness of the transepithelial procedure and epithelium off procedure of corneal collagen crosslinking among keratoconus patients in Jordan. Methods: The study recruited 80 patients suffering from progressive keratoconus, from a tertiary care setting in Jordan. These participants were randomly divided into two groups; group 1 with 40 participants subjected to transepithelial (Corneal collagen cross-linking) CXL; and 40 participants in group 2 received conventional epithelium off CXL. Results: Improvement was observed in the mean contact lens, which corrected distance visual acuity (CDVA) from logMAR 0.332 ± 0.09 (group 1), 0.35 ± 0.09 (group 2) to 0.241 ± 0.07 (group 1), 0.21 ± 0.07 (group 2), respectively at the end of follow-up (12 months). The mean pachymetry improved from 429.81 ± 18.96 μm (group 1), 430.08 ± 17.05 μm (group 2) to 436.5 ± 15.49 μm (group 1), 436.44 ± 12.53 μm (group 2), respectively, after twelve months. Additionally, the mean Sim K astigmatism declined from 7.0 ± 2.0 (group 1), 6.73 ± 1.98 (group 2) to 5.97 ± 1.88 (group 1), 5.53 ± 0.08 (group 2) respectively at twelve months post-treatment. Majority of the patients in group 2 experienced more pain as compared to group 1 participants. Conclusion: The effectiveness of a cross-linking procedure related to keratometry readings and corneal thickness showed that conventional (epithelium off) CXL method is more effective than transepithelial CXL.

scholarly journals Transepithelial Phototherapeutic Keratectomy Using a 213-nm Solid-State Laser System Followed by Corneal Collagen Cross-Linking with Riboflavin and UVA Irradiation

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
George D. Kymionis ◽  
Michael A. Grentzelos ◽  
Alexandra E. Karavitaki ◽  
George A. Kounis ◽  
Georgios A. Kontadakis ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Solid State ◽  
Laser System ◽  
Solid State Laser ◽  
Cross Linking ◽  
State Laser ◽  
Phototherapeutic Keratectomy ◽  
Uva Irradiation ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose. To present a case of a keratoconic patient who underwent epithelial removal with transepithelial phototherapeutic keratectomy (t-PTK) using a 213-nm solid-state laser system followed by corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A (UVA) irradiation.Methods. Case report.Results. A twenty-four-year-old male with keratoconus underwent CXL treatment after epithelial removal with t-PTK using a solid-state laser system. No intra- or early postoperative complications were found. One month postoperatively, uncorrected visual acuity (UCVA) improved from 20/63 to 20/32 while best spectacle- corrected visual acuity (BSCVA) improved from 20/40 to 20/25. Corneal topography revealed a significant improvement which remained stable during the six-month followup period.Conclusions. Epithelial removal with t-PTK before CXL could improve patient's visual outcome.

scholarly journals EVALUATION OF CHANGES IN VISUAL ACUITY AND CONTRAST SENSITIVITY IN PATIENTS WITH KERATOCONUS AFTER CORNEAL COLLAGEN CROSS-LINKING

2021 ◽  
Vol 71 (5) ◽  
pp. 1705-08
Author(s):  
Hassaan Javaid ◽  
Omar Zafar ◽  
Seemal Akram ◽  
Asfandyar Khan ◽  
Sana Abbas ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Armed Forces ◽  
Cross Linking ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Quasi Experimental ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Objective: To evaluate changes in visual acuity and contrast sensitivity in patients with keratoconus after corneal collagen cross-linking. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan, from May 2019 to Apr 2020. Methodology: A total of 48 eyes of 30 patients with progressive keratoconus were included in this study. Baseline uncorrected distance visual acuity, corrected distance visual acuity and contrast sensitivity were recorded, following which transepithelial corneal collagen cross-linking with topical riboflavin and ultraviolet A light was performed. Uncorrected distance visual acuity, corrected distance visual acuity and contrast sensitivity measurements were repeated and recorded 6-months postoperatively. Results: Mean preoperative uncorrected distance visual acuity was 0.56 ± 0.27 logarithm of the minimum angle of resolution which improved to 0.51 ± 0.26 at 6 months after the procedure (p=0.002). Mean corrected distance visual acuity was 0.30 ± 0.19 preoperatively, improving to 0.24 ± 0.18 (p=0.001) at 6 months after corneal collagen cross-linking, thereby depicting a statistically significant improvement. Treated eyes also showed a significant improvement in contrast sensitivity (p=0.001) of 0.05 ± 0.08 logarithmic units of contrast sensitivity, from a mean preoperative contrast sensitivity of 1.72 ± 0.10 to 1.77 ± 0.09 when evaluated 6 months after corneal collagen cross-linking. Conclusion: Corneal collagen cross-linking is a promising advancement in the treatment of keratoconus. It was found effective in significantly improving visual acuity as well as contrast sensitivity, thus enhancing visual outcomes in keratoconus.

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