scholarly journals Long-Term Outcomes of Corneal Collagen Cross-Linking: Results of 6-Years Follow-Up

2020 ◽  
Author(s):  
Anita Csorba ◽  
Huba Kiss ◽  
Kinga Kránitz ◽  
Zoltán Zsolt Nagy
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Spherical Equivalent ◽  
Long Term Effects ◽  
Long Term Outcomes ◽  
Corrected Distance Visual Acuity ◽  
Long Term Follow Up

Abstract Background: Our aim was to evaluate the long-term effects of conventional epithelium-off corneal cross-linking performed on patients with progressive keratoconus. Methods: A retrospective analysis was performed on 34 eyes of 34 patients with progressive keratoconus underwent conventional cross-linking using Pentacam HR Scheimpflug camera. Visual acuity, spherical equivalent, keratometry, pachymetry and corneal topographic indices were analysed preoperatively and at 1, 3, and 6 years after the surgery. Results: Statistically significant decrease was detected at 1 year in spherical equivalent (p = 0.022), with no significant changes afterward (p =0.616). Uncorrected and best corrected distance visual acuity improved significantly in the first postoperative year (p =0.017 and p= 0.003, respectively), and remained stable with no significant changes at further visits (p = 0.203 and p = 0.336, respectively). Significant decrease of central corneal thickness and thinnest corneal thickness was observed at 1 year (both p <0.001), with additional thinning of thinnest corneal pachymetry up to 3 years (p = 0.01). Maximum keratometry and mean keratometry showed significant, continuous improvement between all consecutive visits over the whole follow-up period (all p-values <0.05). Significant improvement was found in the following 5 topographic indices at 1 year: ISV (p = 0.001), IVA (p = 0.028), KI (p = 0.002), CKI (p <0.001 and Rmin (p <0.001), with further improvement up to 3 years in ISV (p = 0.007), in CKI (p = 0.019) and in Rmin (p = 0.015). Rmin showed more improvement up to the end of follow-up (p <0.001).Conclusions: Conventional epithelium-off corneal cross-linking is effective in halting the progression of keratoconus and in regularization of the anterior corneal surface over a long-term follow-up period up to 6 years.

Long-term visual, anterior and posterior corneal changes after crosslinking for progressive keratoconus

2021 ◽  
pp. 112067212110528
Author(s):  
Abdelrahman Salman ◽  
Ali Ali ◽  
Shaaban Rafea ◽  
Rana Omran ◽  
Buraa Kubaisi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Statistical Significance ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Long Term Outcomes ◽  
Corrected Distance Visual Acuity ◽  
Hyperopic Shift ◽  
The Mean

Aim To evaluate the long-term outcomes of corneal cross-linking (CXL) in patients with progressive keratoconus. Method In this retrospective non-comparative study, forty-five eyes of 31 patients with progressive keratoconus were treated with 30 min “epi-off” corneal cross-linking. The visual, refractive, topographic and tomographic outcomes were evaluated preoperatively and at least 10 years after cross-linking. Results Ten years post-corneal cross-linking, the mean anterior maximum keratometry decreased (−2.10 ± 3.25 D, P = 0.0001). Conversely, the posterior maximum keratometry increased (6.38 ± 9.79 D, P = 0.065). Both uncorrected and corrected distance visual acuity improved (LogMAR −0.08 ± 0.30) and (LogMAR −0.05 ± 0.21), respectively (P > 0.05, both). A statistically significant hyperopic shift was observed postoperatively (0.70 ± 1.31 D, P = 0.0009). The anterior topographic cylinder values revealed no change (−0.17 ± 1.31 D, P = 0.3), whereas the mean posterior cylinder values decreased (absolute value increased) significantly compared to baseline from −1.31 ± 0.97 D to −1.82 ± 1.78 D, (P < 0.05). The minimum corneal thickness values decreased significantly (−35.11 ± 48.63 µm, P = 0.0001). Four eyes (8.8%) showed more than 1 D increase in the anterior maximum keratometry. Conclusion This protocol and duration of Epi-off corneal cross-linking was found to be effective in halting keratoconus progression over the follow up period (10 years). Anterior corneal flattening and a hyperopic shift were observed. A statistically significant increase in the posterior corneal cylinder was observed. Although, not reaching statistical significance, the logMAR uncorrected and corrected visual acuity were improved.

scholarly journals Three-year follow-up of accelerated transepithelial corneal cross-linking for progressive paediatric keratoconus

2020 ◽  
pp. bjophthalmol-2019-315260 ◽  
Author(s):  
Mi Tian ◽  
Weijun Jian ◽  
Xiaoyu Zhang ◽  
Ling Sun ◽  
Xingtao Zhou
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Safety And Efficacy ◽  
Manifest Refraction ◽  
Corrected Distance Visual Acuity ◽  
Minimum Angle

PurposeTo investigate the long-term safety and efficacy of accelerated transepithelial corneal cross-linking (ATE-CXL) in children with progressive keratoconus.MethodsFifty-three eyes of 41 paediatric patients (34 boys, 7 girls; mean age 14.81±1.96 years) undergoing ATE-CXL were enrolled in the study. Corrected distance visual acuity (CDVA) and manifest refraction were assessed preoperatively and 36 months postoperatively. Corneal keratometry, corneal thickness and posterior elevation were measured using Pentacam preoperatively and 1, 6, 12 and 36 months postoperatively. Pachymetry and epithelial thicknesses were measured using optical coherence tomography preoperatively and 6, 12, and 36 months postoperatively.ResultsThirty-six months postoperatively, CDVA improved from 0.32±0.28 to 0.26±0.25 in logarithm of the minimum angle resolution (p=0.025). Maximum keratometry was 58.73±9.70 D preoperatively and 59.20±10.24, 58.28±9.33, 57.88±9.99 and 58.98±10.79 D at 1, 6, 12 and 36 months postoperatively throughout the 36-month follow-up period (p>0.05). Similarly, corneal central thickness, which was 492.42±33.83 µm postoperatively, also remained stable during the 36-month follow-up (p>0.05). Both posterior central elevation and posterior highest elevation were stable at 12 months after ATE-CXL (p>0.05), but increased at 36 months postprocedure (p<0.05). Corneal pachymetry and epithelial thicknesses remained stable throughout the follow-up period (p>0.05).ConclusionsATE-CXL is a safe and effective treatment in paediatric progressive keratoconus patients, leading to stable keratometry and corneal thickness throughout the 36-month follow-up.

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 Corneal Cross-linking in Patients Younger than 18 Years: Long-term Follow-up in Three Israeli Medical Centers

2014 ◽  
Vol 3 (2) ◽  
pp. 84-87
Author(s):  
David Zadok ◽  
Isaac Avni ◽  
Erez Bakshi ◽  
Irina S Barequet ◽  
Isaac Aizenman ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pediatric Population ◽  
Cross Linking ◽  
Safe Procedure ◽  
Medical Centers ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
Long Term Follow Up

ABSTRACT Purpose To report refractive, topographic and safety outcomes of corneal cross-linking (CXL) in patients younger than 18 years of age with progressive keratoconus. Materials and methods In this retrospective study, we enrolled 31 eyes of 21 children aged 11 to 17 years that underwent corneal riboflavin-ultraviolet A induced CXL due to progressive keratoconus at three different ophthalmology departments in Israel. They were followed for 3 to 48 months (average 23 ± 13.6 months). Evaluated parameters were uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), manifest refraction, pachymetry, slit- lamp examination and corneal topography at baseline and at 1,3,6,12,24 and 48 months. Results We found a nonsignificant improvement in UCVA and BSCVA with a small reduction of manifest cylinder and no significant change in spherical equivalent or K-values. Following CXL, stability of UCVA and BSCVA at the last follow-up examination was found in 71 and 77% of treated eyes, respectively. No permanent adverse events have been recorded throughout the study period. Conclusion In our series, CXL was a safe procedure in the pediatric population. Stabilization of progressive keratoconus was achieved in visual acuity, refractive and topography parameters with no improvement in corneal indices in contrary to adult CXL treatment. How to cite this article Bakshi E, Barequet IS, Aizenman I, Levinger S, Avni I, Zadok D. Corneal Corss-linking in Patients Younger than 18 Years: Long-term Follow-up in Three Israeli Medical Centers. Int J Kerat Ect Cor Dis 2014;3(2):84-87.

Evolution of corneal flattening after repeated corneal cross-linking during a 6-year follow-up

2020 ◽  
pp. 112067212094566
Author(s):  
Michael A Grentzelos ◽  
Nafsika Voulgari ◽  
Clarice Giacuzzo ◽  
Konstantinos Droutsas ◽  
George D Kymionis
Keyword(s):  
Endothelial Cells ◽  
Visual Acuity ◽  
Case Report ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Distance Visual Acuity ◽  
Corneal Opacification ◽  
Corrected Distance Visual Acuity ◽  
Corneal Flattening

Purpose: To report the evolution of corneal flattening after repeated corneal cross-linking (CXL) in a patient with progressive keratoconus during a 6-year follow-up. Methods: Case report. Results: A 27-year-old female underwent CXL for progressive keratoconus. Postoperatively, corneal topography revealed keratoconus progression with an increase of 1.20 diopters (D) in maximum keratometry (Kmax) and CXL was repeated. After the second treatment, a continuing significant corneal flattening (up to 16.00 D in Kmax) was observed during the first 5 years followed by stabilization during the last sixth year of follow-up. Both uncorrected and corrected distance visual acuity were improved while corneal thickness was decreased. There were no complications such as corneal opacification or endothelial cells decrease during the follow-up period. Conclusion: Repeated CXL can induce an excessive corneal flattening more pronounced during the first years of follow-up followed by stabilization thereafter.

scholarly journals Two-Year Accelerated Corneal Cross-Linking Outcome in Patients with Progressive Keratoconus

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Arleta Waszczykowska ◽  
Piotr Jurowski
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Long Term Results ◽  
Cross Linking ◽  
Mean Values ◽  
Significant Difference ◽  
Uncorrected Visual Acuity ◽  
The Mean

Purpose. To evaluate the long-term results of accelerated corneal cross-linking (CXL) in patients with progressive keratoconus.Methods. Sixteen patients underwent accelerated CXL at 6 mW/cm2for 15 minutes in one eye. The follow-up visits were scheduled on 7 days, 14 days, and 3, 12, and 24 months after the treatment.Results. There were no significant differences (P>0.05) between preoperative and 2-year postoperative mean values, respectively, in terms of uncorrected visual acuity, best spectacle-corrected visual acuity, maximum keratometryKmax⁡, minimum keratometryKmin⁡, corneal astigmatism, and corneal eccentricity index. We noted a significant flattening of the cornea in 18.7% of patients with a higher preoperativeKmax⁡value (>50 D) and its steepening in patients with a lowerKmax⁡value (<50 D) (6.25%). There was no significant difference in the central corneal thickness and the apical corneal thickness preoperatively and 2 years postoperatively. The mean demarcation line depth was282±11 μm. Persistent corneal haze was noted in 25% of patients.Conclusions. Accelerated CXL appears to be a relatively effective procedure for the treatment of keratoconus in 2-year follow-up.

scholarly journals Prophylactic Corneal Cross-Linking in Myopic Femtosecond Laser-Assisted In Situ Keratomileusis: Long-Term Visual and Refractive Outcomes

Optics ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 55-62
Author(s):  
Federico Alonso-Aliste ◽  
Jonatan Amián-Cordero ◽  
Rahul Rachwani-Anil ◽  
Concepción De-Hita-Cantalejo ◽  
Davide Borroni ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Excimer Laser ◽  
Cross Linking ◽  
Spherical Equivalent ◽  
Refractive Outcomes ◽  
Safety Effectiveness

The purpose of our study was to evaluate the safety, effectiveness, predictability, and stability of myopic and astigmatic laser-assisted in situ keratomileusis (LASIK) with simultaneous prophylactic corneal cross-linking (CXL) in thin corneas. In total, 100 eyes from 50 patients who were subjected to myopic and astigmatism femtosecond LASIK with simultaneous prophylactic CXL were included. The design of the study was retrospective, longitudinal, and observational. All patients had a 48-month follow-up. The MEL 80 excimer laser was utilized with the Aberration Smart Ablation platform. CXL treatment was applied when the predicted stromal thickness was less than 330 µm. Patients’ mean age was 30.22 ± 5.97 years. Previous mean spherical equivalent was −5.50 ± 1.65 (−9.50 to −1.13) diopters (D). Postoperative mean spherical equivalent was −0.24 ± 0.29 (−0.85 to +0.50) D. Visual acuity (VA) of 20/20 or better was observed in 87% of the eyes and no eyes experienced VA loss. Spherical equivalent within ±0.50 D was observed in 93% of eyes, and 4% of eyes varied by 0.50 D or more between 3 and 48 months. Prophylactic corneal cross-linking with simultaneous femtosecond laser-assisted in situ keratomileusis in thin corneas proved to be effective, safe, and predictable. The results remained stable after 48 months of follow-up.

scholarly journals Long-term follow-up of school-age children on the effectiveness of myopia correction with contact lenses

2021 ◽  
Vol 11 (3) ◽  
pp. 266-282
Author(s):  
Nataliia Aleieva ◽  
Sergiy Rykov ◽  
Iryna Shargorodska ◽  
Mykola Petrovsky
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Corneal Thickness ◽  
School Age Children ◽  
School Age ◽  
Corrected Visual Acuity ◽  
Long Term Follow Up ◽  
Myopic Astigmatism

Introduction and purpose. Early use of contact correction for congenital myopia and astigmatism in children and adolescents contributes to their social rehabilitation. The myopia correction with contact lenses provides sustainability of correction and absence of periods of blurred retinal images, which are experienced with the use of glasses. The purpose of the study was to determine, through long-term follow-up, the extent to which contact lens correction improves uncorrected and maximally corrected visual acuity in school-age children with myopia and myopic astigmatism. Material and methods. We followed up for three years 84 children (168 eyes) aged 6–16 years with myopic manifest refraction and astigmatism, who used soft silicone hydrogel aspherical contact lenses to correct ametropia. In the early and late follow-up, these patients were examined for visual acuity, objective and subjective clinical refraction, axial eye length, corneal thickness and diameter, keratometry, and phorometric data (accommodation, vergence, disparate areas, and oculomotor apparatus and their interaction). Results.In course of long-term monitoring of myopia and myopic astigmatism correction with contact lenses in school-age children, the statistically significant results were recorded after three years of observation, namely: an increase in uncorrected visual acuity by 47% (t=5.2; p<0.01), corrected acuity vision by 8% (t=9.3; p<0.01), the spheroequivalent by 17% (t=3.7; p<0.01), anteroposterior segment of the eye by 4% (t=7,1; p<0.01), amplitude of accommodation by 27% (t=14.6; p<0.01), negative part of relative accommodation by 17% (t=7.3; p<0.01), positive part of relative accommodation by 32% (t=7.1; p<0.01), flexibility of accommodation by 35% (t=14.2; p<0.01), the ratio of accommodation convergence to accommodation by 19% (t=3.4, p<0.01), stereovision acuity by 56% (t=4.1; p<0.01), as well as a decrease in keratometry index in the strong meridian by 2% (t=5.2; p<0.01), delays in accommodative responses by 33% (t=14.2; p <0.01), distance phoria by 16% (t=10.1; p<0.01), near phoria by 16% (t=11.3, p<0.01). Conclusions. The study has shown that the use of contact lenses by school-aged children with myopia and myopic astigmatism can increase uncorrected and maximum corrected visual acuity. The increase of the spheroequivalent and anteroposterior axis (APA) of the eye indicates progression of myopia, but the use of soft contact lenses (SCL) leads to changes of the anterior corneal surface: an increase of the thickness in the central zone, and its flattening. Improvement of accommodation, vergence, disparate parts of the oculomotor apparatus, and their interaction was also observed. The results obtained indicate deceleration of myopia progression.

scholarly journals Corneal Cross-Linking (with a Partial Deepithelization) in Keratoconus with Five Years of Follow-Up

2016 ◽  
Vol 8 ◽  
pp. OED.S38364 ◽  
Author(s):  
Virgilio Galvis ◽  
Alejandro Tello ◽  
Néstor I. Carreño ◽  
Alvaro I. Ortiz ◽  
Rodrigo Barrera ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Case Series ◽  
Cross Linking ◽  
Spherical Equivalent ◽  
Corneal Endothelial Cells ◽  
Corneal Resistance Factor ◽  
Endothelial Cell Count ◽  
Corrected Visual Acuity

We performed a retrospective interventional case series including 80 eyes of 48 patients with keratoconus (KC) who were treated with modified corneal cross-linking (CXL) for KC (with a partial deepithelization in a pattern of stripes). The average follow-up was 5.8 years (with a minimum of 5 years). At the last follow-up visit, compared with preoperative values, there were no significant changes in spherical equivalent, average keratometry, corneal thickness, corneal hysteresis, or corneal resistance factor. The distance-corrected visual acuity was 20/39 preoperatively and 20/36 postoperatively ( P = 0.3). The endothelial cell count decreased by 4.7% ( P < 0.005). These findings suggest that this modified corneal CXL technique is a safe and effective alternative to halt the progression of KC up to five years after the procedure. However, some concerns remain as to whether this technique can affect in some degree the corneal endothelial cells.

scholarly journals 10-Year Results of Standard Cross-Linking in Patients with Progressive Keratoconus in Romania

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Cristina Nicula ◽  
Radu Pop ◽  
Anca Rednik ◽  
Dorin Nicula
Keyword(s):  
Visual Acuity ◽  
Clinical Signs ◽  
Functional Results ◽  
Mean Value ◽  
Favorable Effect ◽  
Cross Linking ◽  
Spherical Equivalent ◽  
Uncorrected Visual Acuity

Purpose. The purpose of the current study was to evaluate the long-term functional results based on keratometric measurements, spherical and cylinder equivalent in patients with progressive keratoconus treated with conventional “epi-off” corneal collagen cross-linking (CXL). Methods. We conducted a retrospective study in which 113 eyes from 90 keratoconus-treated patients with CXL between 2006 and 2008 in Oculens Eye Clinic from Cluj-Napoca, Romania, were included. The diagnosis of keratoconus was based on corneal topography and its clinical signs. All patients were evaluated preoperatively, and a follow-up was performed at 1, 3, and 6 months and every year from 1 to 10 years after conventional CXL. Results. All keratometry measurements improved significantly during the follow-up. Compared to preoperative values, the improvement of Kmax become statistically significant at 1 year after CXL (mean change compared to baseline −0.9 D, p<0.001) and remained statistically significant thereafter up to 10 years (mean change compared to baseline −2.3 D, p<0.001). As compared to preoperative values, mean spherical equivalent and mean cylinder improved during the follow-up, from a mean of −6.22 D before CXL to a mean value of −5.0 at 10 years, following CXL for spherical equivalent and from −4.4 D at baseline to −3.4 D at 10 years for cylinder (p<0.05 for both). Uncorrected visual acuity increased, remaining statistically significant, by 0.104 logMAR at 10 years after CXL (p=0.0015), and best-corrected visual acuity increased by 0.135 logMAR at 10 years after CXL (p=0.015). We did not observe any case of severe complication. Conclusion. Our results show that CXL has a favorable effect on the progression of KC. The reduced K values, cylinder and spherical equivalent, and increased visual acuity remained the same 10 years after the procedure.

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