scholarly journals One-Year Outcomes of Intracorneal Ring–Segment Insertion Assisted by Femtosecond Laser Simultaneously Performed with Corneal Collagen Cross-Linking for Treatment of Keratoconus

2021 ◽  
Vol Volume 15 ◽  
pp. 4447-4453
Author(s):  
Ahmed El-Massry ◽  
Khalid Rashid ◽  
Seham Saad ◽  
Ihab Osman
Keyword(s):  
Femtosecond Laser ◽  
Cross Linking ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
One Year ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Corneal collagen cross-linking with and without simultaneous intrastromal corneal ring segment implantation: One-year pilot study

2019 ◽  
pp. 112067211988787 ◽  
Author(s):  
Indra Prasad Sharma ◽  
Ramendra Bakshi ◽  
Monica Chaudhry
Keyword(s):  
Visual Acuity ◽  
Confidence Interval ◽  
Randomized Study ◽  
Cross Linking ◽  
Intrastromal Corneal Ring ◽  
Ring Segment ◽  
One Year ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Aim: The aim of this study was to assess and compare the visual, refractive, and topographic outcomes of keratoconic eyes treated with corneal collagen cross-linking combined with and without same day intrastromal corneal ring segment over the first 12 months. Methods: This prospective randomized study analyzed 38 eyes of 30 consecutive keratoconus patients aged 26.21 ± 6.97 (range = 15–41) years. A total of 20 eyes were treated with collagen cross-linking alone, and 18 eyes underwent collagen cross-linking combined with simultaneous femtosecond laser-assisted intrastromal corneal ring segment. Visual acuity, manifest refraction, and corneal topography (using a rotating Scheimpflug topographer) were assessed and compared between the two groups at baseline, 6, and 12 months. Results: On an average follow-up duration of 12.2 ± 0.50 (range = 11–13) months, both collagen cross-linking alone and collagen cross-linking with simultaneous intrastromal corneal ring segment implantation were effective. However, collagen cross-linking plus intrastromal corneal ring segment resulted in an additional improvement of uncorrected distance visual acuity of 0.16 (95% confidence interval = 0.01 to 0.32) logarithm of the minimum angle of resolution units (p = 0.035), cylindrical power by 1.16 D (95% confidence interval = 0.25 to 2.06, p = 0.014), and spherical equivalent by 1.40 D (95% confidence interval = −2.71 to −0.08, p = 0.038) at 1 year. During the study period, no serious intraoperative or postoperative complications were noted in either group. Conclusion: One-year follow-up results suggest that collagen cross-linking with simultaneously combined intrastromal corneal ring segment implantation could yield an additive visual and refractive outcome. The combined procedure is safe and merits consideration for the treatment of progressive keratoconus to achieve better visual rehabilitation.

scholarly journals One-Year Efficacy and Safety of Combined Photorefractive Keratectomy and Accelerated Corneal Collagen Cross-Linking after Intacs SK Intracorneal Ring Segment Implantation in Moderate Keratoconus

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Il Hwan Koh ◽  
Kyoung Yul Seo ◽  
Seong Bae Park ◽  
Hun Yang ◽  
InSik Kim ◽  
...  
Keyword(s):  
Corneal Thickness ◽  
Photorefractive Keratectomy ◽  
Cross Linking ◽  
Retrospective Case ◽  
Contact Lens Wear ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
One Year ◽  
Retrospective Case Study ◽  
Collagen Cross Linking

Purpose. To report one-year outcomes of a modified version of two-stage multimodal surgical protocol for moderate keratoconus which has been suggesting promising preliminary results. Materials and Methods. 30 eyes of 25 patients with moderate keratoconus who exhibited visual complaints and/or disease progression were included for this retrospective case study. Approximately 3 months after implantation of intracorneal ring segment (Intacs SK™), a combination of corneal wavefront-guided transepithelial photorefractive keratectomy (CWG-transPRK, Schwind Amaris® 1050, and Schwind Sirius) and accelerated collagen cross-linking (accCXL, Avedro KXL™) was performed. Patients were examined for uncorrected and corrected distance visual acuity (UDVA; CDVA), keratometric power (K), corneal thickness, and corneal higher-order aberrations (HOAs) preoperatively and at postoperative 1, 3, 6, and 12 months. Results. The median UDVA and mean CDVA were enhanced from 6/38 to 6/12 and from 6/19 to 6/7.5, respectively, through 12 months after CWG-transPRK/accCXL. The 12-month CDVA of all patients was better than 6/12 Snellen, and no subject lost one or more lines of CDVA. The magnitudes of both myopia and corneal steepness were decreased in turn by Intacs SK implantation and also by CWG-transPRK/accCXL, but the reduction in HOA was largely the result of CWG-transPRK/accCXL. The magnitude of corneal thinning stabilized within 3 months after CWG-transPRK/accCXL. Conclusion. This approach may allow patients with moderate keratoconus to obtain satisfactory vision without the need for contact lens wear. This surgery appeared to be effective and safe through 1 year of follow-up.

scholarly journals One-Year Results of Simultaneous Topography-Guided Photorefractive Keratectomy and Corneal Collagen Cross-Linking in Keratoconus Utilizing a Modern Ablation Software

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
A. M. Sherif ◽  
M. A. Ammar ◽  
Y. S. Mostafa ◽  
S. A. Gamal Eldin ◽  
A. A. Osman
Keyword(s):  
Photorefractive Keratectomy ◽  
Cross Linking ◽  
Safety Index ◽  
Interventional Study ◽  
Effective Option ◽  
Efficacy Index ◽  
One Year ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose.To evaluate effectiveness of simultaneous topography-guided photorefractive keratectomy and corneal collagen cross-linking in mild and moderate keratoconus.Methods. Prospective nonrandomized interventional study including 20 eyes of 14 patients with grade 1-2 keratoconus that underwent topography-guided PRK using a Custom Ablation Transition Zone (CATz) profile with 0.02% MMC application immediately followed by standard 3 mw/cm2UVA collagen cross-linking. Maximum ablation depth did not exceed 58 μm. Follow-up period: 12 months.Results.Progressive statistically significant improvement of UCVA from0.83±0.37logMAR preoperative, reaching0.25±0.26logMAR at 12 months (P<0.001). Preoperative BCVA (0.27±0.31logMAR) showed a progressive improvement reaching0.08±0.12logMAR at 12 months (P=0.02). MeanKmax reduced from48.9±2.8to45.4±3.1 D at 12 months (P<0.001), meanKmin reduced from45.9±2.8 D to44.1±3.2 D at 12 months (P<0.003), mean keratometric asymmetry reduced from3.01±2.03 D to1.25±1.2 D at 12 months (P<0.001). The safety index was 1.39 at 12 months and efficacy index 0.97 at 12 months.Conclusion. Combined topography-guided PRK and corneal collagen cross-linking are a safe and effective option in the management of mild and moderate keratoconus.Precis. To our knowledge, this is the first published study on the use of the CATz ablation system on the Nidek Quest excimer laser platform combined with conventional cross-linking in the management of mild keratoconus.

scholarly journals Corneal collagen cross-linking in pediatric patients with keratoconus

2020 ◽  
Vol 148 (1-2) ◽  
pp. 70-75 ◽  
Author(s):  
Svetlana Stanojlovic ◽  
Vedrana Pejin ◽  
Tanja Kalezic ◽  
Jelica Pantelic ◽  
Borivoje Savic
Keyword(s):  
Visual Acuity ◽  
Pediatric Patients ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Rubbing Behavior ◽  
Distant Visual Acuity ◽  
One Year ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Introduction/Objective. The aim of this study was to report visual, refractive, and tomographic outcomes of corneal collagen cross-linking (CXL) in pediatric keratoconus. Methods. This retrospective study included 17 eyes of 12 patients with progressive keratoconus who underwent epithelium-off CXL at the age ? 18 years. Following data were analyzed at baseline and postoperatively at one, three, six, nine, 12 months for all the patients, and annually where available: uncorrected distant visual acuity (UDVA) and best spectacle-corrected distant visual acuity (CDVA), refraction and corneal tomography. Results. Mean UDVA improved significantly from 0.52 ? 0.38 at baseline to 0.24 ? 0.29 logarithm of minimum angle resolution (log MAR) at one year (p = 0.011) and remained stable at two-year follow-up (0.21 ? 0.34 log MAR). Mean CDVA was 0.15 ? 0.21 at baseline and 0.06 ? 0.13 log MAR at one year (p = 0.248). Maximum keratometry showed a significant flattening of 1.30 ? 1.99 D (p = 0.011) after a year and remained stable two years after CXL. Minimum keratometry significantly decreased with a mean change of 1.34 ? 1.37 (p = 0.001). Mean reduction of corneal thickness after CXL was 55.35 ? 64.42 ?m (P=0.003). After a year, seven (42%) eyes showed Kmax regression, nine (53%) stabilization, and one (5%) progression. Conclusion. In our study CXL effectively prevented progression of keratoconus in 95% of pediatric patients after a year, while improving UDVA and keratometry values. One patient with eye rubbing behavior showed signs of keratoconus progression after CXL treatment.

Sign in / Sign up

Export Citation Format

Share Document