scholarly journals Safety and Visual Outcome of Visian Toric ICL Implantation after Corneal Collagen Cross-Linking in Keratoconus: Up to 2 Years of Follow-Up

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Rafic Antonios ◽  
Ali Dirani ◽  
Ali Fadlallah ◽  
Elias Chelala ◽  
Adib Hamade ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Visual Outcome ◽  
Cross Linking ◽  
Implantable Collamer Lens ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Effective Option ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose. To evaluate the long-term safety and clinical outcome of phakic Visian toric implantable collamer lens (ICL) insertion after corneal collagen cross-linking (CXL) in progressive keratoconus.Methods. This was a retrospective study of 30 eyes (19 patients), with progressive keratoconus, who underwent sequential CXL followed by Visian toric ICL implantation after 6 months.Results. At baseline, 6 eyes had stage I, 14 eyes stage II, and 10 eyes stage III keratoconus graded by Amsler-Krumeich classification. At 6 months after CXL, onlyK(steep) andK(max) decreased significantly from baseline, with no change in visual acuity or refraction. Flattening in keratometric readings was stable thereafter. There was significant improvement in mean uncorrected distance visual acuity (1.57 ± 0.56 to 0.17 ± 0.06 logMAR,P<0.001) and mean corrected distance visual acuity (0.17 ± 0.08 to 0.11 ± 0.05 logMAR,P<0.001) at 12 months after ICL implantation that was maintained at the 2-year follow-up. Mean cylinder power and mean spherical equivalent (SE) also decreased significantly after ICL implantation. A small hyperopic shift in SE (+0.25 D) was observed at 2 years that did not alter visual outcomes.Conclusions. Visian toric ICL implantation following CXL is an effective option for improving visual acuity in patients with keratoconus up to 2 years.

scholarly journals EVALUATION OF CHANGES IN VISUAL ACUITY AND CONTRAST SENSITIVITY IN PATIENTS WITH KERATOCONUS AFTER CORNEAL COLLAGEN CROSS-LINKING

2021 ◽  
Vol 71 (5) ◽  
pp. 1705-08
Author(s):  
Hassaan Javaid ◽  
Omar Zafar ◽  
Seemal Akram ◽  
Asfandyar Khan ◽  
Sana Abbas ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Armed Forces ◽  
Cross Linking ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Quasi Experimental ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Objective: To evaluate changes in visual acuity and contrast sensitivity in patients with keratoconus after corneal collagen cross-linking. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan, from May 2019 to Apr 2020. Methodology: A total of 48 eyes of 30 patients with progressive keratoconus were included in this study. Baseline uncorrected distance visual acuity, corrected distance visual acuity and contrast sensitivity were recorded, following which transepithelial corneal collagen cross-linking with topical riboflavin and ultraviolet A light was performed. Uncorrected distance visual acuity, corrected distance visual acuity and contrast sensitivity measurements were repeated and recorded 6-months postoperatively. Results: Mean preoperative uncorrected distance visual acuity was 0.56 ± 0.27 logarithm of the minimum angle of resolution which improved to 0.51 ± 0.26 at 6 months after the procedure (p=0.002). Mean corrected distance visual acuity was 0.30 ± 0.19 preoperatively, improving to 0.24 ± 0.18 (p=0.001) at 6 months after corneal collagen cross-linking, thereby depicting a statistically significant improvement. Treated eyes also showed a significant improvement in contrast sensitivity (p=0.001) of 0.05 ± 0.08 logarithmic units of contrast sensitivity, from a mean preoperative contrast sensitivity of 1.72 ± 0.10 to 1.77 ± 0.09 when evaluated 6 months after corneal collagen cross-linking. Conclusion: Corneal collagen cross-linking is a promising advancement in the treatment of keratoconus. It was found effective in significantly improving visual acuity as well as contrast sensitivity, thus enhancing visual outcomes in keratoconus.

scholarly journals Corneal Collagen Cross-Linking in Pellucid Marginal Degeneration: 2 Patients, 4 Eyes

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Serife Bayraktar ◽  
Zafer Cebeci ◽  
Merih Oray ◽  
Nilufer Alparslan
Keyword(s):  
Visual Acuity ◽  
Long Term Results ◽  
Cross Linking ◽  
Specular Microscopy ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Ring Segment ◽  
The Right ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose. To report the long-term results of corneal collagen cross-linking (CXL) with riboflavin and ultraviolet-A irradiation in 4 eyes of 2 patients affected by pellucid marginal degeneration (PMD).Methods. This study involved the retrospective analysis of 4 eyes of 2 patients with PMD that underwent CXL treatment. Of the eyes, three had only CXL treatment and one had CXL treatment after an intrastromal corneal ring segment implantation. We have pre- and postoperatively evaluated uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCDVA), corneal topography (Pentacam), specular microscopy, and pachymetry.Results. Patient 1 was a woman, aged 35, and Patient 2 was a man, aged 33. The right eye of Patient 1 showed an improvement in her BCDVA, from 16/40 to 18/20 in 15 months, and her left eye improved from 12/20 to 18/20 in 20 months. Patient 2’s right eye showed an improvement in his BCDVA, from 18/20 to 20/20 in 43 months, and his left eye improved from 16/20 to 18/20 in 22 months. No complications were recorded during or after the treatment.Conclusion. CXL is a safe tool for the management of PMD, and it can help to stop the progression of this disease.

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 Corneal Safety and Stability in Cases of Small Incision Lenticule Extraction with Collagen Cross-Linking (SMILE Xtra)

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Ihab Mohamed Osman ◽  
Hany Ahmed Helaly ◽  
Mohsen Abou Shousha ◽  
Amir AbouSamra ◽  
Islam Ahmed
Keyword(s):  
Visual Acuity ◽  
Cross Linking ◽  
Small Incision Lenticule Extraction ◽  
Distance Visual Acuity ◽  
Small Incision ◽  
Corneal Densitometry ◽  
Lenticule Extraction ◽  
Safety And Stability ◽  
Collagen Cross Linking

Purpose. To assess the safety and stability in cases of small incision lenticule extraction with collagen cross-linking (SMILE Xtra). Methods. This study was a retrospective interventional comparative study that included 60 eyes of 30 patients divided equally into two groups: SMILE Xtra and SMILE alone. The inclusion criteria were patients >18 years of age, myopic error >6 D, thinner cornea <520 microns, and abnormal corneal topography. Outcome data were recorded including uncorrected distance visual acuity and corrected distance visual acuity (UDVA and CDVA), manifest refraction spherical equivalent (MRSE), central corneal thickness, average keratometry, endothelial cell density, corneal resistance factor (CRF), and corneal densitometry. The follow-up period was 24 months. Results. There was a significant difference between the 2 groups regarding UDVA, CDVA, and MRSE at 1 month. In the SMILE Xtra group, 90% of eyes had postoperative UDVA of 20/20 and 97% had UDVA of 20/30 at 24 months. At 24 months, 26 eyes (87%) vs. 25 eyes (84%) were within ±0.50 D of attempted correction in SMILE Xtra and SMILE groups, respectively. Regarding stability, both groups showed improvement of MRSE at 1st month postoperatively and remained stable along the 24 months of follow-up. CRF and corneal densitometry were higher in the SMILE Xtra group along the whole follow-up period (p=0.001). Conclusion. Combining corneal cross-linking with SMILE procedure (SMILE Xtra) is a promising tool to prevent ectasia in high-risk patients. It is a safe and simple procedure that can be offered to patients undergoing SMILE with risk for ectasia. Trial registration no: PACTR201810577524718.

scholarly journals Epi-off-lenticule-on corneal collagen cross-linking in thin keratoconic corneas

2020 ◽  
Vol 40 (12) ◽  
pp. 3403-3412
Author(s):  
Carlo Cagini ◽  
F. Riccitelli ◽  
M. Messina ◽  
F. Piccinelli ◽  
G. Torroni ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Cell Density ◽  
Corneal Thickness ◽  
Endothelial Cell Density ◽  
Cross Linking ◽  
Corneal Transplant ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Abstract Purpose To evaluate the safety and efficacy of corneal collagen cross-linking (CXL) performed on overlaying a corneal lenticule to thin recipient corneas of progressive keratoconus (KC) patients. Methods In this study were enrolled eyes of patients affected by progressive KC with a minimum corneal thickness less than 400 µm, after overlaying a lenticule of human corneal stroma prepared with the femtosecond laser. The lenticules used were 100 µm thick and of 8.5 mm diameter in all the cases. Both the host cornea and the lenticules were subjected to epithelial debridement. CXL was carried out according to the standard protocol. Visual acuity, refraction, slit-lamp examination, endothelial cell density, pachymetry and keratometry, anterior segment tomography (AS-OCT) and confocal microscopy were evaluated preoperatively and at 1, 3, 6 and 12 months postoperatively. Results CXL was performed in 10 eyes of 8 patients (main age 23), corneal thickness range 379–414 µm, mean 387.6 µm. One patient was lost at follow-up. In all other cases, visual acuity and the endothelial cell density remained stable over a 12-month follow-up. Preoperative mean K1 and mean K2 were 46.91 ± 1.9 and 50.75 ± 2.93, respectively, and at 12 months mean K1 was 47.36 ± 2.66 and mean K2 50.53 ± 3.35. The AS-OCT clearly showed a demarcation line in all patients at 1, 3 (mean depth 283 µm and 267 µm, respectively) and in some cases at 6 months. Reduced keratocyte density and stromal oedema were observed immediately up to 1 month after treatment, while a slight subepithelial haze was present at 1-month and completely disappeared by 6 months. Conclusion This new technique seems to offer a therapeutic opportunity for young patients suffering from progressive KC with very thin corneas, in which the standard treatment is not indicate, and delay or avoid the need for a corneal transplant.

Corneal collagen cross-linking for management of keratoconus in patients affected by Tourette syndrome

2020 ◽  
pp. 112067212094510
Author(s):  
Karl Anders Knutsson ◽  
Giorgio Paganoni ◽  
Oriella Ambrosio ◽  
Giulio Ferrari ◽  
Paolo Rama
Keyword(s):  
Visual Acuity ◽  
Tourette Syndrome ◽  
Case Series ◽  
Young Male ◽  
Cross Linking ◽  
Male Patients ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose: To present a series of two patients affected by Tourette syndrome (TS) and progressive keratoconus. Case series: Two young male patients with keratoconus and TS were referred to our center. In both patients eye rubbing was present and in one patient, an ocular tic was present determining blepharospasm. Progression of keratoconus occurred in both cases and corneal collagen cross-linking (CXL) was performed. All treated eyes showed topographic stability with stable refraction and conserved visual acuity, with a follow-up period ranging from 1.5 to 2.5 years. Conclusion: Patients with keratoconus and TS should be observed frequently to document topographical and refractive changes, and in case of progressing disease, CXL should be performed in order to prevent further progression.

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.

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