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Accelerated CXL

Eren Çerman, Deniz Özarslan Özcan, Ebru Toker
PURPOSE: To evaluate possible risk factors leading to sterile corneal infiltrates following corneal collagen cross-linking (CXL). METHODS: A total of 588 eyes of 459 patients treated with Epi-off (n = 461) or Epi-on (n = 127) CXL were retrospectively evaluated. Risk factors, including preoperative blepharitis and vernal conjunctivitis, the postoperative use of topical non-steroidal anti-inflammatory drugs (NSAIDs), as well as Kmax and pachymetry measurements, were assessed...
October 24, 2016: Acta Ophthalmologica
Amani E Badawi
PURPOSE: The purpose of this study was to evaluate the effects of accelerated cross-linking (CXL) on corneal endothelium in keratoconus and postlaser-assisted in situ keratomileusis (LASIK) ectasia. DESIGN: This study is a prospective nonrandomized controlled study. SETTING: This study was conducted in Mansoura Ophthalmic Center (Mansoura University) and Al-Mostakbal Ophthalmic Center, Mansoura, Egypt. METHODS: In total, 40 eyes with progressive keratoconus and 10 eyes with postLASIK ectasia were subjected to an accelerated CXL (10 mW/cm(2) for 9 minutes)...
2016: Clinical Ophthalmology
Ömür Ö Uçakhan, Betül Bayraktutar
PURPOSE: To evaluate the morphological features of the corneal limbus as measured by in vivo confocal microscopy (IVCM) following standard and accelerated corneal collagen cross-linking (CXL) for keratoconus. METHODS: Patients with progressive keratoconus scheduled to undergo standard CXL (group 1; 31 patients, 3 mW/cm, 370 nm, 30 minutes), or accelerated CXL (group 2; 20 patients, 9 mW/cm, 370 nm, 10 minutes) in the worse eye were included in this prospective study...
October 5, 2016: Cornea
Lisa McAnena, Frank Doyle, Michael O'Keefe
Keratoconus can behave more aggressively in pediatric than in adult patients. We systematically reviewed the literature to determine the effectiveness of corneal collagen cross-linking (CXL) in children. For this study, MEDLINE(®) and Cochrane databases were searched for all studies examining the effects of standard, trans-epithelial or accelerated CXL protocols in patients age 18 years or younger. Primary outcomes were; uncorrected visual acuity (UCVA) and maximum keratometry (Kmax) and secondary outcomes were; best-corrected visual acuity (BCVA), mean refractive spherical equivalent (MRSE), central corneal thickness (CCT) and endothelial cell density (ECD)...
September 28, 2016: Acta Ophthalmologica
Xiaoyu Zhang, Ling Sun, Yingjun Chen, Meiyan Li, Mi Tian, Xingtao Zhou
The thickness of corneal pachymetry and the epithelium after accelerated (45 mW/cm(2)) transepithelial corneal collagen cross-linking (CXL) for keratoconus were assessed in this prospective case series study. Twenty-eight patients were treated for keratoconus. The mean Kmax was 56.18 ± 7.90. The thinnest point, as assessed by optical coherence tomography (OCT), was 443.18 ± 39.75 μm. Accelerated transepithelial CXL was performed, and corrected distance visual acuity (CDVA), corneal topography, and OCT were recorded at 1 week postoperatively as well as at 1, 3, 6, and 12 months...
September 6, 2016: Scientific Reports
Hun Lee, David Sung Yong Kang, Byoung Jin Ha, Jin Young Choi, Eung Kweon Kim, Kyoung Yul Seo, Tae-Im Kim
BACKGROUND: To compare the changes in anterior and posterior corneal elevations after combined transepithelial photorefractive keratectomy (PRK) and accelerated corneal collagen cross-linking (CXL) and after PRK. METHODS: Medical records of 82 eyes of 44 patients undergoing either combined transepithelial PRK and CXL (PRK-CXL group) or transepithelial PRK (PRK group) were examined retrospectively. Changes in anterior and posterior corneal elevations were calculated by fitting an 8...
August 8, 2016: BMC Ophthalmology
Ahmet Kırgız, Kürşat Atalay, Kübra Şerefoğlu Çabuk, Havva Kaldırım, Muhittin Taşkapılı
PURPOSE: The present study aimed to report the outcomes of patients with progressive keratoconus who were treated via accelerated crosslinking (CXL) 6 months earlier and to determine the factors that promoted improved visual acuity after treatment. METHODS: This retrospective study included 35 eyes of 34 patients with progressive keratoconus who underwent CXL. Topographical measurements were obtained preoperatively and in the first, third, and sixth months postoperatively using a rotating Scheimpflug camera...
May 2016: Arquivos Brasileiros de Oftalmologia
Döndü Melek Ulusoy, Emre Göktaş, Necati Duru, Ayşe Özköse, Mustafa Ataş, İsa Yuvacı, Hasan Basri Arifoğlu, Gökmen Zararsız
PURPOSE: To evaluate the safety and efficacy of accelerated corneal crosslinking (CXL) in patients with progressive keratoconus aged 18 years or less. METHODS: A total of 28 eyes from 19 patients with progressive keratoconus aged 18 years or less were enrolled. We divided participants into 2 groups according to corneal thickness (CT). Group 1 included 13 eyes of 8 patients with CT ≥450 µm; group 2 included 15 eyes of 11 patients with CT <450 µm. Each participant underwent accelerated CXL using 10-minute ultraviolet A irradiance at 9 mW/cm2 for a total energy dose of 5...
July 20, 2016: European Journal of Ophthalmology
Yang Shen, Weijun Jian, Ling Sun, Meng Li, Tian Han, Jooyeon Son, Xingtao Zhou
PURPOSE: The objective of this study is to investigate changes in corneal densitometry after accelerated transepithelial corneal collagen cross-linking (ATE-CXL) for patients with progressive keratoconus (KC). METHODS: Seventeen progressive KC patients who underwent ATE-CXL (KC group) were examined and compared against 17 non-KC myopes (control group). For the KC group, corneal topography and densitometry were evaluated preoperatively and at 1, 6, and 12 months postoperatively...
July 13, 2016: Cornea
Muhammet Bahattin Kır, Kemal Türkyılmaz, Veysi Öner
PURPOSE: To report 2-year outcomes of transepithelial high-intensity cross-linking (CXL) procedure in the treatment of patients with progressive keratoconus. METHODS: Forty-eight eyes of 48 consecutive progressive keratoconus patients who underwent transepithelial accelerated CXL procedure were enrolled in the study. Each patient underwent pre- and postoperative comprehensive ophthalmologic examinations including determination of refractive error as spherical equivalent (SE) and corrected distant visual acuity (CDVA), slit lamp biomicroscopic examination, fundoscopy, and a detailed analysis on a Scheimplug+Placido device (Sirius, CSO, Florence, Italy)...
June 1, 2016: Current Eye Research
Manuela Lanzini, Claudia Curcio, Eberhard Spoerl, Roberta Calienno, Alessandra Mastropasqua, Martina Colasante, Rodolfo Mastropasqua, Mario Nubile, Leonardo Mastropasqua
The aim of this study is to determine modifications in stromal fluorescence intensity after different corneal cross-linking (CXL) procedures and to correlate stromal fluorescence to corneal biomechanical resistance. For confocal microscopy study, 15 human cadaver corneas were examined. Three served as control (group 1), three were just soaked with iontophoresis procedure (group 2), three were treated with standard epi-off technique (group 3), and six underwent iontophoresis imbibition. Three of later six were irradiated for 30 min with 3 mW/cm(2) UVA (group 4) and three for 9 min at 10 mW/cm(2) UVA (group 5)...
May 24, 2016: International Ophthalmology
Nilay Yuksel, Ummuhani Ozel-Turkcu, Duygu Yalinbas, Sahin Novruzlu, Ayse Bilgihan, Kamil Bilgihan
PURPOSE: Nitric oxide production can cause either apoptotic or necrotic cell death through oxidative stress. We aimed to investigate the nitrite oxide metabolites (NOx) and nitrite levels in the aqueous humor of rabbit eyes after different methods of corneal collagen cross-linking (CXL). MATERIALS AND METHODS: Twenty-four eyes of 12 adult New Zealand rabbits were used. They were assigned into four groups, each including six eyes. Group 1 (control) consisted of eyes with no treatment...
May 23, 2016: Current Eye Research
Emine Kalkan Akçay, Aydan Kilicarslan, Betul Seher Uysal, Gozde Hondur, Pinar Kosekahya, Hasan Altinkaynak, Nurullah Cagil
OBJECTIVE: To investigate the alterations in the ocular surface and tear film parameters 3 months after accelerated corneal collagen cross-linking (A-CXL) in progressive keratoconus (KC) patients. METHODS: Twenty-six patients (33 eyes total) with progressive KC were enrolled in this study. All patients were subjected to ophthalmic surface examination, such as OSDI (ocular surface disease index) scoring, the osmolarity tear test, Schirmer test, tear film breakup time (TBUT) analysis, rose bengal (RB) and fluorescein (Fl) ocular surface staining, and conjunctival impression cytology (IC) analysis, respectively...
May 11, 2016: Eye & Contact Lens
Natasha Pahuja, Nimisha Rajiv Kumar, Mathew Francis, Shaika Shanbagh, Rohit Shetty, Arkasubhra Ghosh, Abhijit Sinha Roy
PURPOSE: To assess visual, keratometry, densitometry, and corneal deformation outcomes after accelerated crosslinking (CXL) and its association with gene expression of extracellular matrix proteins. METHODS: 33 eyes underwent accelerated CXL (9 mW/cm(2) for 10 minutes) after epithelium removal. Refraction, visual acuity, keratometry, corneal densitometry, and deformation (Corvis-ST) were assessed before and 6 months after surgery. Epithelium-collected intraoperative was analyzed with qPCR to determine whether the molecular state of disease [lysyl oxidase (LOX), matrix metalloproteinase 9 (MMP 9), transforming growth factor beta (TGFβ), tumor necrosis factor-α (TNFα), interleukin 10 (IL10), interleukin (IL6), collagens (COL IA1 and COL IVA1)] had any bearing on the outcome...
May 9, 2016: Current Eye Research
Minoru Tomita
PURPOSE OF REVIEW: The purpose is to review the literature of combined laser in-situ keratomileusis (LASIK) and accelerated corneal collagen cross-linking (CXL) in context of its indications-contraindications, kerato-refractive, visual and safety outcomes, particularly with reference to preventing the development of post-LASIK ectasia. RECENT FINDINGS: LASIK + accelerated CXL has been developed with the rationale that the addition of CXL after LASIK may strengthen the LASIK compromised corneal biomechanics and minimize the complications such as post-LASIK ectasia...
July 2016: Current Opinion in Ophthalmology
Hani Sakla, Wassim Altroudi, Gonzalo Munoz, Yousef Sakla
PURPOSE: To study the evolution of visual and refractive outcomes through the first year after simultaneous topography-guided photorefractive keratectomy (t-PRK) and corneal collagen cross-linking (CXL) in keratoconus. METHODS: This retrospective case series included 85 eyes of 66 patients with a mean age of 26.3 ± 5.7 years, which underwent simultaneous t-PRK with accelerated CXL. Patients were examined for uncorrected distance visual acuity and corrected distance visual acuity (CDVA), flat and steep keratometry readings, and manifest refraction spherical equivalent at 1, 3, 6, and 12 months...
July 2016: Cornea
George D Kymionis, Konstantinos I Tsoulnaras, Dimitrios A Liakopoulos, Christina A Skatharoudi, Michael A Grentzelos, Nikolaos G Tsakalis
PURPOSE: To compare the corneal stromal demarcation line depth using anterior segment optical coherence tomography (AS-OCT) after corneal cross-linking (CXL) using two different treatment protocols: the standard Dresden protocol (30 minutes with 3 mW/cm(2)) and a modified high intensity protocol (7 minutes with 18 mW/cm(2)), corresponding to a total surface dose of 5.4 and 7.5 J/cm(2), respectively. METHODS: This prospective, comparative, interventional case series included 29 keratoconic patients (32 eyes)...
April 2016: Journal of Refractive Surgery
Arthur B Cummings, Rebecca McQuaid, Stephanie Naughton, Elizabeth Brennan, Michael Mrochen
PURPOSE: To evaluate and compare the safety and efficacy of accelerated (AXL) and standard corneal cross-linking (CXL) protocols in patients with progressive keratoconus. METHODS: Progressive keratoconus patients (14-40 years) received either standard-intensity CXL or high-intensity CXL (AXL). Corneas were exposed to ultraviolet-A 365 nm light for 30 minutes at an irradiance of 3.0 mW/cm in the standard CXL group and to ultraviolet-A 365 nm light for 10 minutes at 9...
June 2016: Cornea
Alireza Peyman, Alireza Nouralishahi, Farhad Hafezi, Sabine Kling, Mohamadreza Peyman
PURPOSE: To compare the stromal demarcation line depth in pulsed versus continuous corneal cross-linking (CXL) for keratoconus. METHODS: Seventy eyes underwent epithelium-off cross-linking, with 0.1% riboflavin applied during 10 minutes prior to ultraviolet irradiation at 30 mW/cm2. Thirty-six eyes received pulsed irradiation (1 second on, 1 second off) for 8 minutes and 34 eyes underwent continuous irradiation for 4 minutes. Total fluence was 7.2 J/cm2 for both groups...
March 2016: Journal of Refractive Surgery
Ahmed M Sherif, Nihal A El-Gheriany, Yehia M Salah El-Din, Lamiaa S Aly, Amr A Osman, Michael A Grentzelos, George D Kymionis
Purpose. To evaluate corneal thickness changes during pulsed accelerated corneal cross-linking (CXL) for keratoconus using a new isotonic riboflavin formula. Methods. In this prospective, interventional, clinical study patients with grades 1-2 keratoconus (Amsler-Krumeich classification) underwent pulsed accelerated (30 mW/cm(2)) CXL after application of an isotonic riboflavin solution (0.1%) with HPMC for 10 minutes. Central corneal thickness (CCT) measurements were taken using ultrasound pachymetry before and after epithelial removal, after riboflavin soaking, and immediately after completion of UVA treatment...
2016: Journal of Ophthalmology
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