scholarly journals Epithelial Remodelling After Epithelium-off Continuous Accelerated Corneal Collagen Cross-linking in Progressive Keratoconus

2021 ◽  
Author(s):  
Junjie Piao ◽  
Ying Li ◽  
Meng Wang ◽  
Sun Joo Kim ◽  
Choun-Ki Joo ◽  
...  
Keyword(s):  
Corneal Thickness ◽  
Anterior Segment ◽  
Cross Linking ◽  
Ultraviolet A ◽  
Corneal Epithelial ◽  
Postoperative Changes ◽  
Uncorrected Distance Visual Acuity ◽  
Minimum Angle ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Abstract Background: To analyse regional corneal epithelial and stromal remodelling after epithelium-off (epi-off) continuous accelerated corneal collagen cross-linking (CXL) for keratoconus (KC).Methods: In this retrospective study, 20 patients (33 eyes) who were treated with epi-off continuous accelerated CXL (KXL system; Avedro, Inc., Waltham, MA, USA). All treatments were performed with ultraviolet-A (UVA) (energy, 7.2 J/cm2; irradiance, 30 mW/cm2), using continuous (4 min) illumination. The postoperative changes in corneal biometric and visual outcomes were compared. The corneal thickness changes were evaluated using anterior segment optical coherence tomography (Optovue). All patients were followed up for 12 months postoperatively.Results: Uncorrected distance visual acuity significantly improved from 1.06 ± 0.49 logarithm of the minimum angle resolution (logMAR) to 0.71 ± 0.37 logMAR at 3 months after epi-off continuous accelerated CXL (p<0.001). The corneal epithelial thickness changes were significant in the inner nasal at -1.48 ± 3.65 µm (p=0.024), -1.76 ± 4.21 µm in the inner superior-nasal (p=0.024), -1.52 ± 4.02 µm in the inner superior (p=0.046), -1.97 ± 4.57 µm in the inner superior-temporal (p=0.018), -2.12 ± 4.46 µm in the outer inferior (p=0.014), -2.15 ± 4.82 µm in the outer inferior-nasal (p=0.022), -1.73 ± 4.45 µm in the outer temporal (p=0.019) at 6 months after epi-off continuous accelerated CXL.Conclusions: Significant regional epithelial remodelling occurs after epi-off continuous accelerated CXL; a more regular corneal thickness profile and keratometric variations were observed after treatment.

Protection of corneal epithelial stem cells prevents ultraviolet A damage during corneal collagen cross-linking treatment for keratoconus

2013 ◽  
Vol 98 (2) ◽  
pp. 270-274 ◽  
Author(s):  
Jonathan E Moore ◽  
Sarah D Atkinson ◽  
Dimitri T Azar ◽  
Jenny Worthington ◽  
C Stephen Downes ◽  
...  
Keyword(s):  
Stem Cells ◽  
Cross Linking ◽  
Ultraviolet A ◽  
Epithelial Stem Cells ◽  
Corneal Epithelial ◽  
Collagen Cross Linking ◽  
Corneal Collagen

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 Accelerated corneal collagen cross-linking in clinical management of infectious keratitis

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092641
Author(s):  
Miao Li ◽  
Tao Yu ◽  
Xin Gao ◽  
Xin-Yi Wu
Keyword(s):  
Visual Acuity ◽  
Clinical Efficacy ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Cross Linking ◽  
Infectious Keratitis ◽  
Biomechanical Parameters ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Objective To evaluate the clinical efficacy of corneal collagen cross-linking (CXL) in the treatment of infectious corneal diseases. Methods This study retrospectively analyzed the clinical efficacy of CXL in 65 eyes with infectious keratitis in Jinan Second People’s Hospital from December 2016 to June 2018. During 6 months of follow-up after CXL treatment, the results of confocal microscopy and anterior segment optical coherence tomography, as well as visual acuity and corneal biomechanical parameters, were recorded in detail. Results In general, the overall cure rate was 93.85%; no corneal endothelial dysfunction was encountered in any patients. After 6 months of follow-up, the visual acuity of cured patients was significantly enhanced, while corneal thickness was significantly reduced. Hyphae growth of patients with fungal keratitis was completely inhibited at 1 month postoperatively. Furthermore, corneal biomechanical parameters (i.e., central corneal thickness, deformation amplitude, and pachymetry intraocular pressure) were significantly improved after surgery, compared with baseline measurements. Conclusion Accelerated CXL may be an effective adjuvant treatment for infectious keratitis.

Long term results of accelerated corneal collagen cross-linking in pediatric keratoconus

2021 ◽  
pp. 112067212110183
Author(s):  
Yasin Cinar ◽  
Cagla Cilem Han ◽  
Alparslan Sahin ◽  
Zeba A Syed
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
University Hospital ◽  
Long Term Results ◽  
Cross Linking ◽  
Distance Visual Acuity ◽  
The Mean ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose: To evaluate the long term visual, refractive, and corneal tomographic outcomes of epithelium-off accelerated corneal collagen cross-linking (ACXL) in the management of pediatric keratoconus (KC). Methods: This retrospective study included patients under 18 years old with progressive KC who underwent ACXL between 2012 and 2019 at Dicle University Hospital. Complete ophthalmic examination was performed including uncorrected distance visual acuity (UDVA), best spectacle-corrected distance visual acuity (CDVA), manifest refraction, and corneal tomography. Evaluations were performed preoperatively and at 6 months intervals postoperatively. Results: Forty-nine eyes of 49 patients were included in the study. The mean age of patients at the time of ACXL was 14.2 ± 1.8 (range: 9.5–17.3) years. Mean follow up was 4.61 ± 1.90 (range: 2.0–8.1) years. The mean LogMAR UDVA improved from 0.94 ± 0.41 to 0.81 ± 0.43, 0.69 ± 0.41, and 0.67 ± 0.33 after 1, 3, and 5 years respectively ( p = 0.001). The mean LogMAR CDVA improved from 0.58 ± 0.36 to 0.46 ± 0.31, 0.34 ± 0.23, and 0.39 ± 0.27 after 1, 3, and 5 years respectively ( p = 0.015). The mean refractive cylinder improved significantly from 6.01 ± 2.07 diopters (D) to 5.46 ± 1.87, 5.38 ± 2.18, and 5.02 ± 2.31 D after 1, 3, and 5 years respectively ( p = 0.005). As compared to preoperative values, steep keratometry and maximum keratometry were not significantly different ( p = 0.805 and 0.448, respectively) following ACXL, while flat keratometry significantly improved after ACXL ( p = 0.012). Although central corneal thicknesses decreased significantly ( p = 0.029), the decrease in thinnest corneal thickness was not statistically significant ( p = 0.205). Conclusion: Epithelium-off ACXL seems to be effective for halting KC progression with long term clinical benefits in pediatric patients.

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.

Polymicrobial keratitis after accelerated corneal collagen cross-linking in keratoconus: Case reports and literature review

2021 ◽  
pp. 112067212110519
Author(s):  
Ying Lu ◽  
Yewei Yin ◽  
Tu Hu ◽  
Kaixuan Du ◽  
Yanyan Fu ◽  
...  
Keyword(s):  
Literature Review ◽  
Case Reports ◽  
Cross Linking ◽  
Retrospective Case ◽  
Corneal Epithelial ◽  
Corneal Scarring ◽  
Corneal Ulcers ◽  
First Case ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose To report two cases of polymicrobial keratitis following corneal collagen cross-linking for keratoconus and to review the literature. Methods Retrospective case note and literature review. Results The first case involved a 27-year-old male who presented with amebic corneal ulcers 3 days after the collagen cross-linking procedure. Some gram-negative (gram-ve) cocci were found upon staining, and cysts were observed by confocal microscopy at 7 days after surgery. Acanthamoeba infection mixed with gram-ve organisms was diagnosed. In the second case, a 14-year male developed Staphylococcus aureus corneal infection with anterior chamber empyema 3 days after the collagen cross-linking procedure for keratoconus. Occasional gram-positive (gram + ve) cocci and gram-ve bacilli were observed under a microscope. The mixed keratitis in the two patients resolved after systemic and topical antibiotic therapy, but the infection ultimately resulted in corneal scarring. Follow-up keratoplasty was needed to improve vision acuity in both patients. Conclusion Although ultraviolet irradiation and the reactive oxygen released by riboflavin during collagen cross-linking have bactericidal effects, a lack of a corneal epithelial barrier, bandage contact lens usage, perioperative hygiene, and an abnormal immune state are risk factors for infectious keratitis after collagen cross-linking. Perioperative management of collagen cross-linking is important to prevent infection.

scholarly journals Corneal thickness changes during corneal collagen cross-linking with UV-A irradiation and hypo-osmolar riboflavin in thin corneas

2013 ◽  
Vol 76 (3) ◽  
pp. 155-158 ◽  
Author(s):  
Belquiz Amaral Nassaralla ◽  
Diogo Mafia Vieira ◽  
Márcia Leite Machado ◽  
Marisa Novaes Faleiro Chaves de Figueiredo ◽  
João Jorge Nassaralla Jr
Keyword(s):  
Corneal Thickness ◽  
Cross Linking ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Comparison between OrbscanIIz, Pentacam, Ultrasound Pachymetry (Tomey SP-100) at Different Stages of Keratoconus

2020 ◽  
pp. 7-33
Author(s):  
E. Pateras ◽  
Ch. Koufala
Keyword(s):  
Correlation Coefficient ◽  
Study Design ◽  
Refractive Surgery ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Moderate Correlation ◽  
Measurement Systems ◽  
Ultrasound Pachymetry ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Aims: To compare results of OrbscanIIz and Pentacam and Ultrasound pachymetry at different stages of keratoconus on corneal thickness. Sample and Study Design: 94 keratoconic patients participated in the study, of which 52 were men and 42 women. Keratoconus patients were measured with OrbscanIIz, Pentacam and Ultrasound pachymetry in pre-operation examinations for corneal collagen cross-linking. The patients belong to different keratoconus stages. Place and Duration of Study: University of West Attica Dept Biomedical Sciensce Course Optics & Optometry in collaboration with Athens “Ophthalmologico” Clinic during the period between October 2017 to January 2019. Methodology: Corneal Pachymetry maps correlation of three types of corneal pachymeters OrbscanIIz, Pentacam and Ultrasound pachymetry (Tomey SP-100 Pachymeter). The measurements of the thinnest point of the cornea from each patient were collected at different stages of keratoconus and compared. Results: A sample of 188 eyes were measured at different stages of keratoconus and compared for the thinnest corneal thickness with three different measurement systems, OrbscanIIz ,Pentacam and Ultrasound pachymetry. At sublinical stage Orbscan-Pentacam had Correlation coefficient r=0,7971, Orbscan-Ultrasound r=0,7483 and Pentacam-Ultrasound r=0,9442. At 1st stage Orbscan-Pentacam had Correlation coefficient r=0,8913, Orbscan-Ultrasound r=0,8151 and Pentacam-Ultrasound r=0,8151. At 2nd stage Orbscan-Pentacam had Correlation coefficient r=0,9339, Orbscan-Ultrasound r=0,8819 and Pentacam-Ultrasound r=0,9633. For 3rd stage Orbscan-Pentacam had Correlation coefficient r=0,8317, Orbscan-Ultrasound r=0,8457 and Pentacam-Ultrasound r=0,9633. For 4th stage Orbscan-Pentacam had Correlation coefficient r=-0,4655, Orbscan-Ultrasound r=0,3089 and Pentacam-Ultrasound r=0,9633. In Iatrogenic keratoectasiaafter refractive surgery Orbscan-Pentacam had Correlation coefficient r=0,9327, Orbscan-Ultrasound r=0,3089 and Pentacam-Ultrasound r=0,9859. Conclusion: Statistical differences between OrbscanIIz, Pentacam and Ultrasound pachymetry were found for corneal thickness in all stages of keratoconus for the thinnest point measured. Orbscan-Pentacam have statistical significant differences but weak to moderate correlation. Orbscan-Ultasound have also statistical significant differences their correlation is very weak, while Pentacam-Ultrasound have statistical significant differences smaller as the previous but their correlation is very strong at all stages of keratoconus.

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