Corneal collagen cross-linking as an additional step in laser in-situ keratomileusis surgery for preventing post-laser in-situ keratomileusis regression

2018 ◽  
Vol 19 (3) ◽  
pp. 174
Author(s):  
NermeenM Badawi ◽  
AhmedA Alhagaa
2020 ◽  
pp. 112067212092892 ◽  
Author(s):  
Ahmed Elmassry ◽  
Osama Ibrahim Said Ahmed ◽  
Moones F Abdalla ◽  
Karim Gaballah

Purpose To study the effect of corneal collagen cross-linking (CXL) using riboflavin and ultraviolet rays on cases of corneal ectasia in keratoconus cases, post-laser–assisted in situ keratomileusis ectasia, and pellucid marginal degeneration and to present its long-term results over many years. Methods This study was conducted throughout 10 “years” experience in corneal collagen CXL, including 6120 cases. The study consists of two parts: a retrospective and a prospective part. All patients in the retrospective part were operated by epi-off, while in the prospective part, the epi-on procedure was used. Also, other machines were used as Peschke Vario, Peschke Phoenix, and different types of riboflavin. The results were analyzed using SPSS. Results The study showed stabilization ectasia in 95% of cases using our standard protocol, and this was proved by topography, pachymetry, refraction, and visual acuity. The effect of CXL was continued in 20% of cases, over a period of 3–5 years, some cases needed to repeat CXL due to the progression of corneal ectasia after cross-linking, in six eyes, that were rubbing their eyes and/or hormonal disturbance. Conclusion Corneal collagen cross-linking CXL is an effective method to prevent the progression of corneal ectasia, whether primary or post-laser–assisted in situ keratomileusis, and the effect was stable over the years of study.


2021 ◽  
pp. 112067212110183
Author(s):  
Yasin Cinar ◽  
Cagla Cilem Han ◽  
Alparslan Sahin ◽  
Zeba A Syed

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.


Cornea ◽  
2020 ◽  
Vol 39 (2) ◽  
pp. 186-191
Author(s):  
Paulo Rodolfo Tagliari Barbisan ◽  
Roberto Damian Pacheco Pinto ◽  
Camillo Carneiro Gusmão ◽  
Rosane Silvestre de Castro ◽  
Carlos Eduardo Leite Arieta

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