scholarly journals Efficacy and Safety of LASIK Combined with Accelerated Corneal Collagen Cross-Linking for Myopia: Six-Month Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ying Wu ◽  
Lei Tian ◽  
Li-qiang Wang ◽  
Yi-fei Huang
Keyword(s):  
Clinical Trial ◽  
Cross Linking ◽  
Controlled Clinical Trial ◽  
Morphologic Change ◽  
Efficacy And Safety ◽  
Collagen Cross Linking ◽  
Keratocyte Density ◽  
Corneal Collagen

This was a prospective controlled clinical trial. 48 myopia patients (96 eyes) were included in this study. After LASIK, accelerated corneal collagen cross-linking (ACXL) was used for myopia treatment. During 6-month follow-up, the results of LASIK-ACXL treatment were studied and compared to the LASIK-only procedure. The results showed that no statistically significant differences in UDVA, CDVA, MRSE,Kmean, pachymetry, or ECD were found between the two groups at the visit after 6 months of follow-up (allP>0.05). At 6 months postoperatively, 2 eyes lost one or more lines of visual acuity in the LASIK-ACXL group, whereas all LASIK-only treated eyes had a stable CDVA.In vivoconfocal microscopy showed a decrease of keratocyte density and appearance of honeycomb-like structures in the anterior residual stroma bed; the changes were similar but more pronounced following LASIK-only. None of the cases in both groups developed signs of significant keratitis, regression, or ectasia during the 6-month follow-up. LASIK-ACXL can effectively correct refractive error in patients with myopia, with no significant complications during 6-month follow-up, indicating stability and morphologic change similar to those with LASIK-only treatment.

scholarly journals Five Years Follow-up of Riboflavin/Ultraviolet A (370 nm) Corneal Collagen Cross-linking to Halt the Progression of Keratoconus

2014 ◽  
Vol 3 (2) ◽  
pp. 63-68
Author(s):  
PS David O’Brart ◽  
Parul Patel ◽  
Naomi A O’Brart
Keyword(s):  
Cross Linking ◽  
Spherical Equivalent ◽  
Efficacy And Safety ◽  
Ultraviolet A ◽  
Cone Apex ◽  
Collagen Cross Linking ◽  
Corneal Collagen ◽  
Fellow Eyes

ABSTRACT Aims To determine the long-term efficacy and safety of riboflavin/ultraviolet a corneal cross-linking (CXL) to halt the progression of keratoconus. Materials and methods Thirty-five patients (35 eyes) who had undergone CXL with epithelial removal 5 or more years previously were examined. Results At 5 years, mean spherical equivalent (SEQ) increased by 0.78 diopters (D) (p < 0.001), mean simulated K (Sim K) reduced by 0.86D (p < 0.00001), cone apex power (CAP) reduced by 1.1D (p < 0.0002) and root mean square (RMS) (p < 0.0001), coma (p < 0.0001), and secondary astigmatism (p < 0.001) decreased compared to preoperative values. Compared to values at 1 year, mean refractive cylinder reduced by 0.26D (p < 0.05), mean Sim K reduced by 0.46D (p < 0.0005), CAP reduced by 0.81D (p < 0.01), RMS (p < 0.001), coma (p < 0.002) and secondary astigmatism (p < 0.02) reduced and central pachymetry increased (p < 0.05) at 5 years. No treated eyes showed evidence of progression at 5 years. None lost >1 line of CDVA. Eight untreated fellow eyes progressed during the follow-up period and underwent CXL. Conclusions Corneal cross-linking is an effective treatment to halt the progression of keratoconus at 5 years, with no sight-threatening complications. Improvements in topographic and wave-front indices present at 1 year continue to improve at 5 years. How to cite this article O’Brart PSD, Patel P, O’Brart NA. Five Years Follow-up of Riboflavin/Ultraviolet A (370 nm) Corneal Collagen Cross-linking to Halt the Progression of Keratoconus. Int J Kerat Ect Cor Dis 2014;3(2):63-68.

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.

scholarly journals Response to “Comment on: Effectiveness and safety of accelerated (9 mW/cm2) corneal collagen cross-linking for progressive keratoconus: a 24-month follow-up”

Eye ◽  
2019 ◽  
Vol 33 (7) ◽  
pp. 1185-1186
Author(s):  
Darren Shu Jeng Ting ◽  
Jean-Pierre Danjoux ◽  
Stephen J. Morgan ◽  
Saurabh Ghosh ◽  
Oliver Baylis
Keyword(s):  
Cross Linking ◽  
Collagen Cross Linking ◽  
Corneal Collagen

scholarly journals Iontophoresis-Assisted Corneal Collagen Cross-Linking with Epithelial Debridement: Preliminary Results

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Paolo Vinciguerra ◽  
Vito Romano ◽  
Pietro Rosetta ◽  
Emanuela F. Legrottaglie ◽  
Magdalena Kubrak-Kisza ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Anterior Segment ◽  
Cross Linking ◽  
Prospective Clinical Study ◽  
Positive Trend ◽  
Cell Counts ◽  
Early Results ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose. To report the early outcomes of iontophoresis-assisted corneal collagen cross-linking procedure with epithelial debridement (I-SCXL).Methods. Twenty eyes of twenty patients with progressive keratoconus were included in this prospective clinical study. Best spectacle corrected visual acuity (BSCVA), sphere and cylinder refraction, corneal topography, Scheimpflug tomography, aberrometry, anterior segment optical coherence tomography (AS-OCT), and endothelial cell count were assessed at baseline and at 1, 3, and 6 months of follow-up. The parameters considered to establish keratoconus progression were always proven with differential maps as change in curvature in the cone area of at least 1 diopter obtained with an instantaneous map.Results. Functional parameters showed a significant improvement (p<0.05) of BSCVA after 3 and 6 months of follow-up. Morphological parameters indicated stabilization of the corneal ectasia during the follow-up; however, a positive trend was noted with a mean flattening of 1.73 D. Minimum pachymetry values showed thinning that remained constant after the treatment. The demarcation line was clearly visible in all patients, reaching a depth of308.2±37.74 μm. None of the patients had continuous progression of keratoconus or had to repeat cross-linking procedures. Endothelial cell counts did not change significantly (p>0.05).Conclusion. The early results indicate that the I-SCXL may be able to reduce the treatment time and improve the riboflavin diffusion.

Supersonic Shear Wave Elastography for the In Vivo Evaluation of Transepithelial Corneal Collagen Cross-Linking

2014 ◽  
Vol 55 (3) ◽  
pp. 1976 ◽  
Author(s):  
David Touboul ◽  
Jean-Luc Gennisson ◽  
Thu-Mai Nguyen ◽  
Antoine Robinet ◽  
Cynthia J. Roberts ◽  
...  
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Cross Linking ◽  
In Vivo Evaluation ◽  
Collagen Cross Linking ◽  
Corneal Collagen

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

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
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.

scholarly journals Analysis of long-term results of collagen corneal cross-linking in patients with ectatic forms of corneal dystrophy

2018 ◽  
Vol 11 (2) ◽  
pp. 6-12 ◽  
Author(s):  
Oleg A. Frolov ◽  
Sergey Yu. Astakhov ◽  
Pavel A. Danilov ◽  
Sergey A. Novikov
Keyword(s):  
Corneal Dystrophy ◽  
Asymmetry Index ◽  
Long Term Results ◽  
Cross Linking ◽  
Periodical Literature ◽  
Intermediate Data ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Corneal collagen cross-linking became a permanent part of complex treatment for patients with different forms of corneal ectasia. In periodical literature, there are anecdotal reports concerning long-term results of this corneal disease therapy method, which is an isolated variant of photodynamic therapy. Purpose. To carry out a retrospective study of corneal collagen cross-linking long-term results in various ectatic corneal diseases. Materials and methods. Results of corneal collagen cross-linking in patients with ectatic forms of corneal dystrophy 6 years after surgery were analyzed. The nosological structure of the study included a group of patients with primary keratoconus, pellucid marginal corneal degeneration, secondary ectasias. The group with primary keratoconus includes 30 patients (31 eyes), that with pellucid marginal degeneration 10 patients (10 eyes), that with secondary ectasias – 10 patients (10 eyes). Data of the diagnostic examination before surgery, intermediate data of the dynamic follow-up during 6 years of observation were used for the analysis. Corneal collagen cross-linking was performed in the first or second year of follow-up, followed by monitoring of changes in the state of the cornea after corneal collagen cross-linking for 4-5 years. Results. A statistically significant increase in visual acuity was observed after the corneal collagen cross-linking in patients with primary and secondary ectasias. In patients diagnosed with pellucid marginal degeneration, there was no statistically significant increase of visual function. A decrease in the corneal asymmetry index was revealed in all groups and confirmed by statistical analysis.

scholarly journals Epi-off-lenticule-on corneal collagen cross-linking in thin keratoconic corneas

2020 ◽  
Vol 40 (12) ◽  
pp. 3403-3412
Author(s):  
Carlo Cagini ◽  
F. Riccitelli ◽  
M. Messina ◽  
F. Piccinelli ◽  
G. Torroni ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Cell Density ◽  
Corneal Thickness ◽  
Endothelial Cell Density ◽  
Cross Linking ◽  
Corneal Transplant ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Abstract Purpose To evaluate the safety and efficacy of corneal collagen cross-linking (CXL) performed on overlaying a corneal lenticule to thin recipient corneas of progressive keratoconus (KC) patients. Methods In this study were enrolled eyes of patients affected by progressive KC with a minimum corneal thickness less than 400 µm, after overlaying a lenticule of human corneal stroma prepared with the femtosecond laser. The lenticules used were 100 µm thick and of 8.5 mm diameter in all the cases. Both the host cornea and the lenticules were subjected to epithelial debridement. CXL was carried out according to the standard protocol. Visual acuity, refraction, slit-lamp examination, endothelial cell density, pachymetry and keratometry, anterior segment tomography (AS-OCT) and confocal microscopy were evaluated preoperatively and at 1, 3, 6 and 12 months postoperatively. Results CXL was performed in 10 eyes of 8 patients (main age 23), corneal thickness range 379–414 µm, mean 387.6 µm. One patient was lost at follow-up. In all other cases, visual acuity and the endothelial cell density remained stable over a 12-month follow-up. Preoperative mean K1 and mean K2 were 46.91 ± 1.9 and 50.75 ± 2.93, respectively, and at 12 months mean K1 was 47.36 ± 2.66 and mean K2 50.53 ± 3.35. The AS-OCT clearly showed a demarcation line in all patients at 1, 3 (mean depth 283 µm and 267 µm, respectively) and in some cases at 6 months. Reduced keratocyte density and stromal oedema were observed immediately up to 1 month after treatment, while a slight subepithelial haze was present at 1-month and completely disappeared by 6 months. Conclusion This new technique seems to offer a therapeutic opportunity for young patients suffering from progressive KC with very thin corneas, in which the standard treatment is not indicate, and delay or avoid the need for a corneal transplant.

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