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 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 Long-term Stability of Ectasia in a Young Patient with Asymmetric Keratoconus

2015 ◽  
Vol 4 (2) ◽  
pp. 66-68
Author(s):  
Rosane de Oliveira Corrêa ◽  
Ana Laura Caiado Canedo ◽  
Rozalia Beildeck ◽  
Marcella Quaresma Salomão ◽  
Penelope Burle de Politis
Keyword(s):  
Visual Acuity ◽  
Young Patient ◽  
Distance Visual Acuity ◽  
Long Term Stability ◽  
Uncorrected Distance Visual Acuity ◽  
Manifest Refraction ◽  
Corrected Distance Visual Acuity ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
The Right

ABSTRACT Purpose To report the clinical course of a typical young patient presenting with asymmetric keratoconus (KC), that demonstrates that stabilization of the ectatic process is possible without cross-linking (CXL) procedure. Methods Case report and review of the literature. Results A 17-year-old male patient was referred due to the diagnosis of keratoconus. Patient complained of loss of vision in the left eye (OS). Uncorrected distance visual acuity (UDVA) was 20/25+ in the right eye (OD) and 20/80 in the left eye; wavefront-assisted manifest refraction gave best corrected distance visual acuity (CDVA) of 20/20 in OD and 20/40 in OS. The diagnosis of keratoconus was confirmed with Placido disk-based topography (Oculus Keratograph 4), and Pentacam HR corneal tomography (Oculus Optikgeräte GmbH, Wetzlar, Germany). Femtosecond laser-assisted intracorneal ring segment (ICRS) implantation was performed in the left eye and treatment for allergy was prescribed for both eyes, along with patient education and advice not to rub the eyes. After 3 months, significant improvement was observed on UDVA (20/30) and CDVA (20/20) in the left eye. Topometric and tomographic stability of ectasia was observed in the right eye in a 4-year follow-up. Conclusion Intracorneal ring segment caused significant regularization of the corneal shape and improvement on visual acuity. Ectasia stability was achieved with no need for CXL, despite the patient's young age. This case raises the point that the indication of CXL for every keratoconic patient should be reconsidered. How to cite this article de Oliveira Corrêa R, Canedo ALC, Beildeck R, Salomão MQ, de Politis PB, Ambrósio R Jr. Longterm Stability of Ectasia in a Young Patient with Asymmetric Keratoconus. Int J Kerat Ect Cor Dis 2015;4(2):66-68.

scholarly journals Accelerated Corneal Collagen Cross-Linking in Pediatric Patients: Two-Year Follow-Up Results

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Rohit Shetty ◽  
Harsha Nagaraja ◽  
Chaitra Jayadev ◽  
Natasha Kishore Pahuja ◽  
Mathew Kurian Kummelil ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pediatric Patients ◽  
Vernal Keratoconjunctivitis ◽  
Cross Linking ◽  
Specular Microscopy ◽  
Safe Procedure ◽  
Distant Visual Acuity ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose.To evaluate the effectiveness and safety of accelerated corneal collagen cross-linking (ACXL) in patients below 14 years of age with progressive keratoconus.Materials and Methods. Thirty eyes of 18 patients with established progressive keratoconus underwent preoperative and postoperative visual acuity assessment, topography, and specular microscopy prior to ACXL and were followed up for 24 months.Results.Mean age of the patients was 12.7 years with ten males and eight females. There was an improvement in the mean postoperative uncorrected distant visual acuity (from0.76±0.26to0.61±0.25;P=0.005), mean corrected distant visual acuity (from0.24±0.19to0.12±0.12;P<0.001), mean spherical refraction (from-3.04 DS±3.60to-2.38 DS±3.37;P=0.28), mean cylinder (from-3.63 DC±1.82to-2.80 DC±1.48;P=0.008), and spherical equivalent (from-4.70 D±3.86to-3.75 D±3.49;P=0.15). Three eyes of two patients with vernal keratoconjunctivitis (VKC) showed progression. There were no intra- or postoperative complications.Conclusion.In pediatric patients ACXL is an effective and safe procedure for the management of keratoconus. Optimal management of VKC is important to arrest the progression of keratoconus.

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 Corneal Collagen Cross-Linking with and without Epithelial Removal: A Contralateral Study with 0.5% Hypotonic Riboflavin Solution

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Aleksandar Stojanovic ◽  
Wen Zhou ◽  
Tor Paaske Utheim
Keyword(s):  
Visual Acuity ◽  
Postoperative Pain ◽  
Patient Questionnaire ◽  
Cross Linking ◽  
Specular Microscopy ◽  
Group 2 ◽  
Collagen Cross Linking ◽  
Corneal Collagen ◽  
Group 1

Purpose. Our main purpose was to compare safety and efficacy in the treatment of progressive keratoconus with “epithelium-on” and “epithelium-off” corneal collagen cross-linking (CXL). Our secondary purpose was to evaluate efficacy of CXL when hypotonic 0.5% riboflavin is used as photosensitizer.Methods. One eye of 20 patients with bilateral progressive keratoconus was randomly treated for “epithelium-on” CXL (group 1) while the fellow eye underwent “epithelium-off” CXL (group 2). Hypotonic 0.5% riboflavin was used in both groups. Visual acuity, refraction, corneal topography, and wavefront aberrometry were evaluated at baseline and after 1, 6, and 12 months. Specular microscopy was performed on 10 patients preoperatively and after 12 months. Postoperative pain was evaluated using a patient questionnaire.Results. Uncorrected and corrected distance visual acuity improved significantly in both groups. Refraction, topography, and aberrometry showed nonsignificant changes from the preoperative status throughout the 12-month follow-up in both groups. Moreover, the outcomes between the groups were comparable at all follow-up points. Endothelial cell-count was stable. Postoperative pain length was shorter in group 1P<0.001.Conclusion. “Epithelium-on” and “epithelium-off” CXL using hypotonic 0.5% riboflavin were equally safe and effective in stabilization of keratoconus. Topography and aberrometry outcomes in both groups failed to show any significant improvements. This study is registered at ClinicalTrials.gov:NCT01181219.

scholarly journals Corneal Cross-Linking as Treatment in Pediatric Keratoconus: Comparison of Two Protocols

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Shira Hed ◽  
Ran Matlov Kormas ◽  
Sagi Shashar ◽  
Boris E. Malyugin ◽  
Matthew Boyko ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Treatment Time ◽  
Pediatric Population ◽  
Long Term Results ◽  
Cross Linking ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Intergroup Comparison ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity

Introduction. Keratoconus is a progressive corneal disease commonly treated by collagen cross-linking (CXL). Accelerated protocols have recently become common. This study sought to compare the outcomes of accelerated and standard CXL in terms of visual acuity, keratometry, and tomographic parameters in pediatric population. Methods. We retrospectively reviewed the files of pediatric patients who underwent standard and accelerated CXL for keratoconus in our hospital, between October 2014 and March 2018. Changes in uncorrected distance visual acuity (UCDVA), best corrected distance visual acuity (BCDVA), tomographic keratometry parameters (Kmax, Ksteep, Kflat, Kmean), and endothelial density count (EDC) were assessed before and at 6 and 12 months following treatment. The analysis included intergroup and intragroup comparisons. Results. This study included 53 eyes (44 patients). Fourteen eyes were treated with standard CXL (S-CXL, 3 mW/cm2, 30 min), while 39 underwent accelerated CXL (A-CXL, 9 mW/cm2, 10 min). Intergroup comparison found insignificant differences between groups, with the exception of better results for UCDVA in the S-CXL group after 12 months ( P  = 0.03). In this study, there was no significant difference between the two protocols postoperatively in BCDVA, Kmax, Kmean, pachymetry, or corneal astigmatism. Conclusion. A-CXL is as safe and effective as S-CXL for stabilizing progressive keratoconus in pediatric population. Larger-sample-size studies with a longer follow-up time are required. Considering the long-term results of 9 mW A-CXL and its safety and efficacy profile, it should be preferred to S-CXL for reducing treatment time and improving patients’ comfort.

Sign in / Sign up

Export Citation Format

Share Document