Corneal collagen crosslinking in a child with keratoconus

2021 ◽  
pp. 33-38
Author(s):  
E.Y. Markova ◽  
◽  
G.V. Avakyants ◽  
Keyword(s):  
Visual Acuity ◽  
Clinical Case ◽  
Progressive Decrease ◽  
Collagen Crosslinking ◽  
Modern Methods ◽  
History Of ◽  
Corneal Collagen Crosslinking ◽  
Decrease In Visual Acuity ◽  
Corneal Collagen ◽  
Spectacle Correction

This clinical case describes medical history of the patient who came to the clinic with complaints of progressive decrease in visual acuity and intolerance of spectacle correction. In the following article all methods of diagnostic are fully described. We are also mentioning and discuss aspects of modern methods of diagnostic and treatment of keratoconus in children such as corneal collagen crosslinking. Key words: keratoconus, keratoconus in children, corneal collagen crosslinking.

scholarly journals Rate of Corneal Collagen Crosslinking Redo in Private Practice: Risk Factors and Safety

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Joelle Antoun ◽  
Elise Slim ◽  
Rami el Hachem ◽  
Elias Chelala ◽  
Elyse Jabbour ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Private Practice ◽  
Allergic Conjunctivitis ◽  
Collagen Crosslinking ◽  
Factors Associated ◽  
Rate Of Progression ◽  
History Of ◽  
Corneal Collagen Crosslinking ◽  
Corneal Collagen

Objective. To report the rate of progression of keratectasia after primary crosslinking (CXL) and evaluate the safety and efficiency of CXL redo.Materials and Methods. We conducted a retrospective analysis of the patients who underwent CXL between 2010 and 2013 at the Beirut Eye Specialist Hospital, Lebanon. Progression of keratectasia was based on the presence of an increase in maximum keratometry of 1.00 D, a change in the map difference between two consecutive topographies of 1.00 D, a deterioration of visual acuity, or any change in the refraction. Primary and redo CXL were done using the same protocol.Results. Among the 221 eyes of 130 patients who underwent CXL, 7 eyes (3.17%) of five patients met the criteria of progression. All patients reported a history of allergic conjunctivitis and eye rubbing and progressed within 9 to 48 months. No complications were noted and all patients were stable 1 year after CXL redo.Conclusion. Allergic conjunctivitis and eye rubbing were the only risk factors associated with keratoconus progression after CXL. A close followup is thus mandatory, even years after the procedure. CXL redo seems to be a safe and efficient technique to halt the progression after a primary CXL.

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 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

scholarly journals Impact of COVID-19 on keratoconus patients waiting for corneal cross linking

2021 ◽  
pp. 112067212110013
Author(s):  
Haider Shah ◽  
Luca Pagano ◽  
Anuj Vakharia ◽  
Giulia Coco ◽  
Kunal A Gadhvi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Observational Study ◽  
Corneal Thickness ◽  
Treatment Delay ◽  
Cross Linking ◽  
Corneal Surface ◽  
Collagen Crosslinking ◽  
Time Period ◽  
Corneal Collagen Crosslinking ◽  
Corneal Collagen

Purpose: Royal College of Ophthalmologist recent guidance recommended delaying cross-linking services during the COVID-19 pandemic. This study investigates the effects of such delays in the delivery of cross-linking services in patients with keratoconus progression. Methods: Retrospective observational study of 46 patients with keratoconus progression, whose cross-linking was delayed due to the COVID-19 pandemic. Demographic and clinical details were obtained from assessments on the day of listing, and subsequent review on the day of the procedure. Topographic indices included keratometry of the posterior and anterior corneal surface, maximum keratometry ( Kmax), thinnest corneal thickness, ABCD progression and progression based on standard criteria recommendations (1.5 D Kmax & 20 microns thinning). Results: A total of 46 eyes were analysed with an average time between being listed for CXL and having the procedure done was 182 ± 65 days. The delay due to COVID-19 was of 3 months. In this time period they had a significant worsening of all keratometric indices and lost almost one line of visual acuity (0.19 ± 0.19 to 0.26 ± 0.18 LogMAR, p: 0.03). Thirty two eyes (70%) demonstrated progression in accordance with the ABCD progression criteria, while 18 eyes (39%) showed either an increase in Kmax of more than 1.5D or a thinning in corneal thickness of at least 20 μm. Conclusions: The treatment delay for the keratoconus patients caused further progression and vision worsening. We recommend that corneal collagen crosslinking needs to be considered as a high priority intervention.

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 Thinner Corneas Appear to Have More Striking Effects of Corneal Collagen Crosslinking in Patients with Progressive Keratoconus

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Yunfei Han ◽  
Yanyun Xu ◽  
Wei Zhu ◽  
Yuling Liu ◽  
Zhen Liu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Collagen Crosslinking ◽  
Group 4 ◽  
Negative Linear Correlation ◽  
Corneal Collagen Crosslinking ◽  
Group 3 ◽  
Group 2 ◽  
Corneal Collagen ◽  
Group 1

Purpose.To analyze the outcomes and difference after UVA/riboflavin corneal collagen crosslinking (CXL) in four different corneal thickness groups of patients with progressive keratoconus.Methods.Retrospective study. Eyes with progressive keratoconus after CXL were divided into 4 subgroups as follows: group 1, thinnest corneal thickness (TCT) ≤ 400 µm; group 2, 400 µm < TCT ≤ 450 µm; group 3, 450 µm < TCT ≤ 500 µm; group 4, TCT ≥ 500 µm. Baseline, 6-month, and 12-month visual acuity, corneal topography, TCT, and endothelial cell density were evaluated.Results.The analysis included 123 eyes of 101 patients. At 6 and 12 months after CXL, there was a mean improvement about visual acuity and keratometry values in all patients. There was a reduction in the change of maximum keratometry (Kmax) with the increase of TCT. After 1 year of treatment, it was 3.04 ± 0.75 D in group 1, 2.38 ± 0.51 D in group 2, 1.57 ± 0.35 D in group 3, and 0.31 ± 0.20 D in group 4.Conclusion.CXL is successful in halting the progression of keratoconus and there was a negative linear correlation between TCT andKmax. Advanced cases of progressive keratoconus seemed to obtain more benefits from the flatting effects of CXL.

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.

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