scholarly journals Simultaneous Noncentered Photoactivated Chromophore for Keratitis-Corneal Collagen Cross-Linking and Penetrating Keratoplasty for Treatment of Severe Marginal Fusarium spp. Keratitis: A Description of a New Surgical Technique

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Kepa Balparda ◽  
Juan Carlos Mejia-Turizo ◽  
Tatiana Herrera-Chalarca
Keyword(s):  
Penetrating Keratoplasty ◽  
Cross Linking ◽  
Corneal Tissue ◽  
Corneal Perforation ◽  
Fusarium Spp ◽  
Retrospective Case ◽  
Clinical Control ◽  
Collagen Cross Linking ◽  
New Surgical Technique ◽  
Corneal Collagen

The purpose of this article is to describe the use of simultaneous noncentered photoactivated chromophore for keratitis-corneal collagen cross-linking (PACK-CXL) combined with penetrating keratoplasty in the treatment of a severe marginal Fusarium spp. keratitis case with imminent corneal perforation. It is a retrospective case report study; it was performed by collecting clinical data, images, video, and postoperative evaluations. The clinical control of the infection was accomplished, despite difficulties in obtaining antifungal medications due to the patient’s extremely poor socioeconomic status and essentially nonexistent health insurance. We can conclude that combining simultaneous decentered PACK-CXL with centered penetrating keratoplasty appears to be a safe and effective way of treating patients with fungal marginal keratitis with corneal perforation, in which regular penetrating keratoplasty alone would leave fungal elements in the receptor corneal tissue, which would predispose to infection of the graft.

scholarly journals Long-term Follow-up of Pachymetric and Topographic Alterations after Corneal Collagen Cross-Linking for Keratoconus

2012 ◽  
Vol 1 (1) ◽  
pp. 22-25
Author(s):  
Paraskevi G Zotta ◽  
Diamantis D Almaliotis ◽  
George D Kymionis ◽  
Vasilios F Diakonis ◽  
Kostas A Moschou ◽  
...  
Keyword(s):  
Corneal Thickness ◽  
Case Series ◽  
Cross Linking ◽  
Retrospective Case ◽  
Time Intervals ◽  
Long Term Follow Up ◽  
Collagen Cross Linking ◽  
Corneal Collagen

ABSTRACT Purpose To determine the long-term alterations of corneal thickness, along with topographic outcomes, after corneal collagen cross-linking treatment (CXL) for keratoconus. Materials and methods In this retrospective case series, 46 patients (52 eyes), 32 males and 14 females, with progressive keratoconus were included. All eyes underwent CXL in accordance with the standard protocol (Dresden) for the treatment of their ectatic corneal disorder between January 2006 and June 2007. Pachymetric and topographic outcomes were evaluated preoperatively and at 1, 3, 6, 12, 24 and 36 months postoperatively. Results Mean follow-up was 28.08 ± 8.39 months (range, from 12 to 36 months). A statistically significant decline in corneal pachymetric values (at the thinnest location) when compared with preoperative values (467.65 ± 41.08 µm) was demonstrated at 1 (437.63 ± 50.57 µm), 3 (439.08 ± 52.27 µm), 6 (449.37 ± 52.73 µm), 12 (449.63 ± 83.53 µm) and 24 (459.97 ± 47.32 µm) months after CXL (p < 0.05, for all mentioned time intervals). Return to preoperative pachymetric values (469.52 ± 40.52 µm) was revealed 36 months post-CXL (p > 0.05). With respect to topographic (flat and steep keratometric values, keratoconus index), no statistically significant differences between preoperative and all postoperative intervals were found (p > 0.05, for all values for all time intervals). Conclusion Corneal pachymetric values reduce significantly up to 24 months after CXL treatment, while a return to preoperative values was revealed 36 months after the procedure. No significant changes’ concerning topographic outcomes was demonstrated after CXL, indicating stability of these parameters. How to cite this article Zotta PG, Almaliotis DD, Kymionis GD, Diakonis VF, Moschou KA, Karampatakis VE. Long-term Follow-up of Pachymetric and Topographic Alterations after Corneal Collagen Cross-Linking for Keratoconus. Int J Keratoco Ectatic Corneal Dis 2012;1(1):22-25.

Polymicrobial keratitis after accelerated corneal collagen cross-linking in keratoconus: Case reports and literature review

2021 ◽  
pp. 112067212110519
Author(s):  
Ying Lu ◽  
Yewei Yin ◽  
Tu Hu ◽  
Kaixuan Du ◽  
Yanyan Fu ◽  
...  
Keyword(s):  
Literature Review ◽  
Case Reports ◽  
Cross Linking ◽  
Retrospective Case ◽  
Corneal Epithelial ◽  
Corneal Scarring ◽  
Corneal Ulcers ◽  
First Case ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Purpose To report two cases of polymicrobial keratitis following corneal collagen cross-linking for keratoconus and to review the literature. Methods Retrospective case note and literature review. Results The first case involved a 27-year-old male who presented with amebic corneal ulcers 3 days after the collagen cross-linking procedure. Some gram-negative (gram-ve) cocci were found upon staining, and cysts were observed by confocal microscopy at 7 days after surgery. Acanthamoeba infection mixed with gram-ve organisms was diagnosed. In the second case, a 14-year male developed Staphylococcus aureus corneal infection with anterior chamber empyema 3 days after the collagen cross-linking procedure for keratoconus. Occasional gram-positive (gram + ve) cocci and gram-ve bacilli were observed under a microscope. The mixed keratitis in the two patients resolved after systemic and topical antibiotic therapy, but the infection ultimately resulted in corneal scarring. Follow-up keratoplasty was needed to improve vision acuity in both patients. Conclusion Although ultraviolet irradiation and the reactive oxygen released by riboflavin during collagen cross-linking have bactericidal effects, a lack of a corneal epithelial barrier, bandage contact lens usage, perioperative hygiene, and an abnormal immune state are risk factors for infectious keratitis after collagen cross-linking. Perioperative management of collagen cross-linking is important to prevent infection.

Vitamin B2 in Corneal Surgery—Riboflavin and Collagen Cross-Linking

2012 ◽  
Vol 05 (02) ◽  
pp. 105
Author(s):  
Spencer Thornton ◽  
Keyword(s):  
Collagen Fibrils ◽  
New Method ◽  
Cross Linking ◽  
Corneal Tissue ◽  
Chemical Bonds ◽  
Vitamin B2 ◽  
Corneal Surgery ◽  
Collagen Cross Linking ◽  
Corneal Collagen

Cross-linking of collagen refers to the ability of collagen fibrils to form strong chemical bonds with adjacent fibrils. Corneal collagen cross-linking (CXL) with vitamin B2 activated by ultraviolet offers a new method for stabilization of unstable or weakened corneal tissue in cases of ectasia, dystrophy and irregular post-surgical healing.

scholarly journals Corneal cross-linking in a 10-year-old child with stage III keratoconus

2017 ◽  
Vol 8 (2) ◽  
pp. 174-177
Author(s):  
Marco Abbondanza ◽  
Valentina De Felice ◽  
Gabriele Abbondanza
Keyword(s):  
Penetrating Keratoplasty ◽  
Young Patients ◽  
Corneal Dystrophy ◽  
Effective Procedure ◽  
Stage Iii ◽  
Cross Linking ◽  
Rapid Progression ◽  
Collagen Cross Linking ◽  
Irregular Astigmatism ◽  
Corneal Collagen

Background: Keratoconus is a corneal dystrophy characterized by progressive thinning, conical shape of the cornea and irregular astigmatism. It is particularly insidious when it occurs in very young patients. Case: We report the case of a 10-year-old child with an aggressive stage III keratoconus, who was suggested to undergo a Penetrating Keratoplasty. We performed Corneal Collagen Cross-linking with epithelium removal instead, which was successful in arresting the rapid progression of keratoconus. Observations: Eighteen months later, Kmax had decreased by 1.3 D, astigmatism by 0.8 D, thinnest pachimetry had improved by 69 μm and CDVA was 20/32. Conclusion: This case confirms that Corneal Collagen Cross-linking is a safe and effective procedure for the treatment of keratoconus even in its aggressive forms. We encourage ophthalmic surgeons to favor conservative treatments when dealing with very young patients. 

scholarly journals Molecular processes of corneal collagen cross-linking in keratoconus therapy

2018 ◽  
Vol 4 (1) ◽  
pp. 489-492
Author(s):  
Steven Melcher ◽  
Eberhard Spörl ◽  
Edmund Koch ◽  
Gerald Steiner
Keyword(s):  
Mechanical Stability ◽  
Attenuated Total Reflection ◽  
Secondary Amines ◽  
Cross Linking ◽  
Therapeutic Effects ◽  
Corneal Tissue ◽  
In Situ Experiments ◽  
Cross Links ◽  
Collagen Cross Linking ◽  
Corneal Collagen

AbstractCorneal collagen cross-linking (CXL) with riboflavin and UVA light is a therapeutic procedure to restore the mechanical stability of corneal tissue. The treatment method applies to pathological tissue changes, such as keratoconus. It induces the photochemical formation of new collagen cross-links. Although therapeutic effects are indisputable, the exact molecular process of CXL and how cross-links are formed is still unclear. In this work, Fouriertransform infrared (FT-IR) spectroscopy is used to investigate the cross-linking process. For that purpose, in-situ experiments with porcine corneas are carried out using attenuated total reflection (ATR) spectroscopy. Furthermore, IR micro-spectroscopic imaging in transmission mode is used to investigate thin tissue sections of the cornea and initial approaches for the distinction of cross-linked and untreated tissue by IR microspectroscopic imaging were performed. Multivariate methods are applied to access changes that occur as a result of CXL. It is shown that spectral changes after cross-linking are caused predominantly by an increase of methyl- and methylene groups as well as primary and secondary amines. In addition, a decrease of carbonyl groups could be observed.

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