Efficacy of pulsed-light accelerated crosslinking in the treatment of progressive keratoconus: Two-year results

2019 ◽  
Vol 30 (6) ◽  
pp. 1256-1260 ◽  
Author(s):  
Selman Belviranli ◽  
Refik Oltulu
Keyword(s):  
Visual Acuity ◽  
Total Dose ◽  
First Year ◽  
Ultraviolet A ◽  
Pulsed Light ◽  
Collagen Crosslinking ◽  
Corrected Visual Acuity ◽  
Corneal Collagen Crosslinking ◽  
Second Year ◽  
Corneal Collagen

Purpose: The aim of this study was to evaluate the 2-year results of epithelium-off pulsed-light accelerated corneal collagen crosslinking treatment in progressive keratoconus using 30 mW/cm2 ultraviolet A light for 6 min with a total dose of 5.4 J/cm2. Methods: A total of 30 eyes of 22 patients with documented progressive keratoconus and treated with epithelium-off pulsed-light accelerated corneal collagen crosslinking using the KXL® crosslinking device (Avedro Inc, Waltham, MA, USA) were included in this retrospective study. Corneal tomographic measurements and best spectacle-corrected visual acuity were compared using analysis of variance with repeated measurements between the baseline visit (before the corneal collagen crosslinking treatment), and the sixth month, first, and second year visits. Results: Flat keratometry (K1), steep keratometry (K2), and mean keratometry (Km) decreased significantly at sixth month, first, and second years ( p < 0.001, p = 0.001, and p < 0.001, respectively). Maximum keratometry (Kmax) decreased from 55.40 ± 4.90 D at baseline to 54.82 ± 4.68 D, 54.80 ± 5.12 D, and 54.65 ± 5.36 D at sixth month, first year, and second year, respectively ( p = 0.007). The best spectacle-corrected visual acuity improved from 0.34 ± 0.24 logMAR at baseline to 0.25 ± 0.16 logMAR, 0.22 ± 0.15 logMAR, and 0.17 ± 0.13 logMAR at sixth month, first year, and second year, respectively ( p < 0.001). At the second year visit, best spectacle-corrected visual acuity remained stable (no lines lost) with respect to the baseline in 8 eyes and increased 1 or more lines in 22 eyes. Conclusion: Pulsed-light accelerated corneal collagen crosslinking using 30 mW/cm2 ultraviolet A light for 6 min with a total dose of 5.4 J/cm2 is an effective treatment modality in cases with progressive keratoconus—it stops progression at 2 years also regresses some of the cases.

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 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.

Influence of Corneal Collagen Crosslinking with Riboflavin and Ultraviolet-A Irradiation on Excimer Laser Surgery

2010 ◽  
Vol 51 (8) ◽  
pp. 3929 ◽  
Author(s):  
Daniel Kampik ◽  
Bernhard Ralla ◽  
Sabine Keller ◽  
Markus Hirschberg ◽  
Peter Friedl ◽  
...  
Keyword(s):  
Excimer Laser ◽  
Laser Surgery ◽  
Ultraviolet A ◽  
Collagen Crosslinking ◽  
Corneal Collagen Crosslinking ◽  
Corneal Collagen

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

2016 ◽  
Vol 42 (7) ◽  
pp. 1046-1052 ◽  
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

scholarly journals High Order Aberration Outcomes of Corneal Collagen Crosslinking in Eyes with Keratoconus and Post-LASIK Ectasia

2014 ◽  
Vol 3 (3) ◽  
pp. 107-112
Author(s):  
Adam Muzychuk ◽  
Victor Penner ◽  
Guillermo Rocha
Keyword(s):  
Visual Acuity ◽  
Spherical Aberration ◽  
Retrospective Chart Review ◽  
High Order ◽  
Collagen Crosslinking ◽  
Distance Visual Acuity ◽  
High Order Aberration ◽  
Manifest Refraction ◽  
Corneal Collagen Crosslinking ◽  
Corneal Collagen

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.

scholarly journals EFFICACY OF CORNEAL COLLAGEN CROSSLINKING WITH RIBOFLAVIN AND ULTRAVIOLET-A IN PROGRESSIVE KERATOCONUS.

2020 ◽  
pp. 1-3
Author(s):  
Priyanka Raut ◽  
Nikhilesh * Wairagade ◽  
Praneeta Sakarkar
Keyword(s):  
P Value ◽  
Spherical Equivalent ◽  
Ultraviolet A ◽  
Collagen Crosslinking ◽  
Institutional Ethics ◽  
Uncorrected Visual Acuity ◽  
Corneal Collagen Crosslinking ◽  
The Mean ◽  
A Prospective Study ◽  
Corneal Collagen

PURPOSE-To evaluate outcomes of collagen crosslinking in patients having progressive keratoconus. METHODS- A prospective study was done in eyes that underwent corneal collagen crosslinking for treatment of progressive keratoconus. This study was performed after approval from Institutional Ethics Committee and informed consent was obtained from all the patients. Data was analysed with the help of JASP0.8.3.1 and MS-Excel 2013. RESULT-The mean age was 20.94 ± 2.04 years. 21 (63.63%) were males, 12 (36.36 %) were females. The mean uncorrected visual acuity (UCVA) pre-operative and post-operative at 6 months were 0.64 ± 0.37 and 0.53 ± 0.31 (logMAR) respectively (p value 0.03). Mean spherical equivalent pre-operatively and post-operatively at 6 months were -2.85 ± 2.14 and -2.38 ± 1.70 respectively (p < 0.001). Mean keratometry (Mean K) preoperative and post-operative were 49.85 ± 4.10 Dioptres (D) and 49.22 ± 4.09 D respectively (p = 0.0007). CONCLUSION- Corneal collagen crosslinking with UV-A and riboavin is a safe and effective method for halting the deterioration of progressive keratoconus.

scholarly journals Keratoconus in Children. Мodern Treatment Options

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

Intraocular pressure measurements after corneal collagen crosslinking with riboflavin and ultraviolet A in eyes with keratoconus

2010 ◽  
Vol 36 (10) ◽  
pp. 1724-1727 ◽  
Author(s):  
George D. Kymionis ◽  
Michael A. Grentzelos ◽  
George A. Kounis ◽  
Dimitra M. Portaliou ◽  
Efstathios T. Detorakis ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Pressure Measurements ◽  
Ultraviolet A ◽  
Collagen Crosslinking ◽  
Corneal Collagen Crosslinking ◽  
Corneal Collagen
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