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https://www.readbyqxmd.com/read/29666915/corneal-crosslinking-cxl-with-18-mw-cm-2-irradiance-and-5-4-j-cm-2-radiant-exposure-early-postoperative-safety
#1
Isaak Fischinger, Theo G Seiler, Karthiga Santhirasegaram, Moritz Pettenkofer, Chris P Lohmann, Daniel Zapp
PURPOSE: To investigate safety of accelerated corneal crosslinking during the first postoperative month. METHODS: In this retrospective study, 76 eyes of 60 patients with verified progressive keratectasia were enrolled in this study and followed for 1 month after accelerated CXL (18 mW/cm2 for 5 min, radiant exposure 5.4 J/cm2 ) (A-CXL(5*18)). Preoperatively, objective refraction, slit lamp inspection, and corneal tomography were performed. Early postoperative slit lamp examinations were performed on days 1 and 4...
April 17, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29657977/expert-practice-patterns-and-opinions-on-corneal-cross-linking-for-infectious-keratitis
#2
Yen C Hsia, Caitlin A Moe, Thomas M Lietman, Jeremy D Keenan, Jennifer Rose-Nussbaumer
Objective: To assess the current opinion and practice patterns from cornea experts regarding the benefit of corneal cross-linking (CXL) for infectious keratitis (IK). Methods and analysis: An international survey was distributed to corneal specialists via an internet survey. The survey data collected were analysed with descriptive statistics. Results: A survey was sent to 190 recipients, and 29 (15%) respondents completed the survey with an average of 7 years' experience using CXL...
2018: BMJ open ophthalmology
https://www.readbyqxmd.com/read/29623463/current-perspectives-on-corneal-collagen-crosslinking-cxl
#3
Sandeepani K Subasinghe, Kelechi C Ogbuehi, George J Dias
Corneal collagen crosslinking has revolutionized the treatment of keratoconus and post-refractive corneal ectasia in the past decade. Corneal crosslinking with riboflavin and ultraviolet A is proposed to halt the progression of keratectasia. In the original "Conventional Dresden Protocol" (C-CXL), the epithelium is removed prior to the crosslinking process to facilitate better absorption of riboflavin into the corneal stroma. Studies analyzing its short- and long-term outcomes revealed that although there are inconsistencies as to the effectiveness of this technique, the advantages prevail over the disadvantages...
April 6, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29621306/conventional-and-transepithelial-corneal-cross-linking-for-patients-with-keratoconus
#4
Xiaoyu Zhang, Jing Zhao, Meiyan Li, Mi Tian, Yang Shen, Xingtao Zhou
Previous studies investigating the effectiveness of conventional corneal collagen cross-linking (CXL) and transepithelial CXL in keratoconus treatment have reported conflicting outcomes. Therefore, we conducted a meta-analysis to compare the effectiveness of these treatments. We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials for prospective randomized controlled trials (RCTs) with no restrictions. We included visual acuity (corrected distance visual acuity, uncorrected distance visual acuity) and corneal keratometry (K) as primary outcome parameters, and spherical equivalent, central corneal thickness (CCT), and endothelial cell density, as secondary parameters...
2018: PloS One
https://www.readbyqxmd.com/read/29610222/two-year-follow-up-of-corneal-cross-linking-and-refractive-surface-ablation-in-patients-with-asymmetric-corneal-topography
#5
João Baptista N S Malta, H Kaz Soong, Bernardo Kaplan Moscovici, Mauro Campos
AIMS: To evaluate the safety and efficacy of corneal cross-linking (CXL) followed by photorefractive keratectomy (PRK) for refractive correction in patients with bilateral asymmetric topography. METHODS: Forty-four patients (88 eyes) were enrolled in this prospective randomised clinical trial. CXL with subsequent PRK after 6 months was performed in one eye (study group), and PRK alone was performed in contralateral eyes (control group). Patients were followed for 24 months after PRK...
April 2, 2018: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29610026/epithelial-remodeling-after-corneal-crosslinking-using-higher-fluence-and-accelerated-treatment-time
#6
Ilyse D Haberman, Paul Z Lang, Alvaro Fidalgo Broncano, Sang Woo Kim, Farhad Hafezi, J Bradley Randleman
PURPOSE: To evaluate changes in regional corneal epithelial thickness after corneal crosslinking (CXL) using higher fluence (7.2 J/cm2 ) and accelerated treatment time (4 minutes) in eyes with progressive keratoconus using spectral-domain optical coherence tomography (SD-OCT) and to correlate focal epithelial and focal anterior curvature changes. SETTING: Academic medical center in the United States. DESIGN: Prospective case series. METHODS: Patients had anterior segment SD-OCT (RTVue-100) with focal stromal and epithelial measurements and Scheimpflug imaging before and 1, 3, 6, and 12 months after accelerated CXL...
March 30, 2018: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29605283/patient-satisfaction-with-epithelium-off-corneal-crosslinking
#7
Marianne O Price, Matthew T Feng, Francis W Price
PURPOSE: To assess patient satisfaction with corneal crosslinking (CXL). SETTING: Price Vision Group, Indianapolis, Indiana, USA. DESIGN: Prospective case series. METHODS: Patients treated with the Dresden protocol or accelerated epithelium-off CXL during an 8-year period were invited to participate in an electronic survey. RESULTS: Of the 552 patients who were invited to participate, 448 (80% response rate) completed the electronic survey...
March 28, 2018: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29594793/sterile-keratitis-after-uneventful-corneal-collagen-cross-linking-in-a-patient-with-axenfeld-rieger-syndrome
#8
Betul Seher Uysal, Derya Yaman, Ozge Sarac, Emine Akcay, Nurullah Cagil
PURPOSE: To report on a keratoconus (KC) patient with Axenfeld-Rieger syndrome (ARS) who developed sterile keratitis after accelerated corneal collagen cross-linking (CXL). METHODS: An 18-year-old patient with ARS and KC who had previously undergone intrastromal ring segment implantation underwent accelerated CXL (9 mW/cm2  UVA intensity for 10 min). RESULTS: After uneventful surgery, the patient presented with severe photophobia, redness of the eye, and decreased vision 72 h following the procedure...
March 28, 2018: International Ophthalmology
https://www.readbyqxmd.com/read/29582259/corneal-densitometry-after-accelerated-corneal-collagen-cross-linking-in-progressive-keratoconus
#9
Myriam Böhm, Mehdi Shajari, Matthias Remy, Thomas Kohnen
PURPOSE: To analyze changes in corneal densitometry 3 months after accelerated corneal collagen cross-linking (CXL) measured with Scheimpflug tomography. METHODS: In this study we reviewed charts and anterior segment data of patients who had undergone accelerated pulsed epithelium-off CXL (30 mW/cm2 for 4 min, 8 min total radiation time) for treatment of progressive keratoconus in the Department of Ophthalmology, Goethe University, Frankfurt, Germany. Visual, topographic, pachymetric and densitometric data were extracted before surgery and at the 3-month follow-up...
March 26, 2018: International Ophthalmology
https://www.readbyqxmd.com/read/29576880/three-year-outcomes-of-cross-linking-plus-combined-cross-linking-with-femtosecond-laser-intracorneal-ring-segments-implantation-for-management-of-keratoconus
#10
Mohammed Iqbal Hafez Saleem, Hosam A Ibrahim Elzembely, Mortada Ahmed AboZaid, Mohammed Elagouz, Ahmed Mohamed Saeed, Osama Ali Mohammed, Ahmed Gad Kamel
Purpose: To analyze the results of three-year outcomes of combined epithelium-on cross-linking with femtosecond laser ICRS (cross-linking PLUS) for keratoconus management. Design: A retrospective multicenter clinical study. Methods: 43 eyes of 38 patients were subjected to preoperative and postoperative UCVA, BCVA, refraction, Pentacam pachymetry, and keratometry examinations at 3-, 6-, 12-, 24-, and 36-month follow-up period. Results: The preoperative and postoperative mean UCVA was 1...
2018: Journal of Ophthalmology
https://www.readbyqxmd.com/read/29576618/effects-of-collagen-cross-linking-on-the-keratoconus-metabolic-network
#11
Rabab Sharif, Henrik Sejersen, Garrett Frank, Jesper Hjortdal, Dimitrios Karamichos
PURPOSE: Keratoconus (KC) is a multifactorial, ectatic corneal disease. Metabolic changes in the corneal stroma with alterations in collagen fibril stability, oxidative stress, and urea cycle, have previously been reported as key players in KC pathobiology. Recently, corneal collagen cross-linking (CXL) has been introduced as a treatment that can address the progressive nature of KC. While the treatment has been successful in the early days, it is not without clinical ramifications. In this study, we investigated the alterations in KC metabolic profiles due to CXL...
March 26, 2018: Eye
https://www.readbyqxmd.com/read/29564806/prospective-randomized-contralateral-eye-study-of-accelerated-and-conventional-corneal-cross-linking-in-pediatric-keratoconus
#12
Sherif A Eissa, Amr Yassin
PURPOSE: To compare the outcomes of two different cross-linking (CXL) protocols, in pediatric keratoconus eyes. MATERIALS AND METHODS: In this prospective randomized contralateral eye interventional study, 68 eyes of 34 patients, 9-16 years old, underwent CXL and enrolled between October 2011 and October 2013. Group A represents conventional riboflavin-ultraviolet A (UVA)-induced CXL with 30 min of exposure to UVA irradiation of 3 mW/cm2 . Group B represents accelerated cross-linking with 5 min of continuous UVA irradiation of 18 mW/cm2 ...
March 21, 2018: International Ophthalmology
https://www.readbyqxmd.com/read/29561496/effects-of-thickness-on-corneal-biomechanical-properties-using-optical-coherence-elastography
#13
Srilatha Vantipalli, Jiasong Li, Manmohan Singh, Salavat R Aglyamov, Kirill V Larin, Michael D Twa
SIGNIFICANCE: Measured corneal biomechanical properties are driven by intraocular pressure, tissue thickness, and inherent material properties. We demonstrate tissue thickness as an important factor in the measurement of corneal biomechanics that can confound short-term effects due to UV riboflavin cross-linking (CXL) treatment. PURPOSE: We isolate the effects of tissue thickness on the measured corneal biomechanical properties using optical coherence elastography by experimentally altering the tissue hydration state and stiffness...
March 21, 2018: Optometry and Vision Science: Official Publication of the American Academy of Optometry
https://www.readbyqxmd.com/read/29526339/quantitative-analysis-of-corneal-stromal-riboflavin-concentration-without-epithelial-removal
#14
Roy S Rubinfeld, R Doyle Stulting, Glenwood G Gum, Jonathan H Talamo
PURPOSE: To compare the corneal stromal riboflavin concentration and distribution using 2 transepithelial corneal crosslinking (CXL) systems. SETTING: Absorption Systems, San Diego, California, USA. DESIGN: Experimental study. METHODS: The stromal riboflavin concentration of 2 transepithelial CXL systems was compared in rabbit eyes in vivo. The systems were the CXLO (Group 1) and Paracel/Vibex Xtra, containing TRIS and ethylenediaminetetraacetic acid and an isotonic solution of riboflavin 0...
March 8, 2018: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29525838/long-term-database-analysis-of-conventional-and-accelerated-crosslinked-keratoconic-mid-european-eyes
#15
Efstathios Vounotrypidis, Alexis Athanasiou, Karsten Kortüm, Daniel Kook, Mehdi Shajari, Siegfried Priglinger, Wolfgang J Mayer
PURPOSE: To investigate the long-term efficacy of accelerated corneal collagen cross-linking (CXL) in a large mid-European cohort with progressive keratoconus. METHODS: Four hundred thirteen eyes of 316 patients with progressive keratoconus were enrolled and treated with conventional (group A) or accelerated (group B) CXL. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), slit lamp, and Pentacam® examinations were performed before and 12, 24, and 36 months after surgery...
March 10, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29523106/one-year-follow-up-of-accelerated-transepithelial-corneal-collagen-cross-linking-for-progressive-pediatric-keratoconus
#16
Mi Tian, Weijun Jian, Ling Sun, Yang Shen, Xiaoyu Zhang, Xingtao Zhou
BACKGROUND: Keratoconus typically presents in the teenage years and is more advanced in younger patients when compared with adults. In the present study, we aimed to assess the safety and efficacy of accelerated transepithelial corneal collagen cross-linking (ATE-CXL) in children with progressive keratoconus. METHODS: In this retrospective consecutive study, 18 eyes were enrolled from 17 pediatric patients (15 boys and 2 girls) with a mean age of 14.44 ± 1...
March 9, 2018: BMC Ophthalmology
https://www.readbyqxmd.com/read/29522228/the-7-year-outcomes-of-epithelium-off-corneal-cross-linking-in-progressive-keratoconus
#17
Mohamed Shafik Shaheen, Mohamed M Lolah, David P Piñero
PURPOSE: To evaluate the clinical results of epitheliumoff corneal cross-linking (CXL) during a 7-year follow-up. METHODS: This retrospective, non-randomized, single-center interventional study enrolled 34 consecutive eyes of 24 patients with progressive keratoconus undergoing CXL surgery with epithelium removal. Visual, refractive, corneal topographic, pachymetric, and anterior segment changes were evaluated at 1, 3, and 7 years after surgery. RESULTS: Significant reduction of refraction was observed at 1 year postoperatively (P ≤ ...
March 1, 2018: Journal of Refractive Surgery
https://www.readbyqxmd.com/read/29522227/progression-of-keratoconus-in-patients-while-awaiting-corneal-cross-linking-a-prospective-clinical-study
#18
Vito Romano, Riccardo Vinciguerra, Esmaeil M Arbabi, Nick Hicks, Pietro Rosetta, Paolo Vinciguerra, Stephen B Kaye
PURPOSE: To assess topographical changes in patients with keratoconus while awaiting corneal cross-linking (CXL) treatment. METHODS: In this prospective, double-center, observational clinical study, patients with keratoconus were enrolled. Progression was defined as a change in the curvature within the cone area of at least 1.00 diopter (D) on tangential map and a thinning of 20 μm at the thinnest point after measurements taken at least 3 months apart. Morphological parameters were assessed at baseline (day of listing for CXL) and on the day of CXL treatment, including slit-lamp biomicroscopy, keratometry (maximum, minimum, and mean), and thinnest corneal thickness using corneal tomography (Pentacam; Oculus Optikgeräte GmbH, Wetzlar, Germany)...
March 1, 2018: Journal of Refractive Surgery
https://www.readbyqxmd.com/read/29499665/antimicrobial-efficacy-of-corneal-cross-linking-in-vitro-and-in-vivo-for-fusarium-solani-a-potential-new-treatment-for-fungal-keratitis
#19
Ziqian Zhu, Hongmin Zhang, Juan Yue, Susu Liu, Zhijie Li, Liya Wang
BACKGROUND: Fungal keratitis is one of the major causes of visual impairment worldwide. However, the effectiveness of corneal collagen cross-linking (CXL) for fungal keratitis remains controversial. In this study, we developed an in vitro and an in vivo models to assess the efficacy of CXL for Fusarium keratitis. METHODS: The effect of in vitro CXL fungicidal was evaluated on the cultures of Fusarium solani which were exposed to irradiation for different durations...
March 2, 2018: BMC Ophthalmology
https://www.readbyqxmd.com/read/29490342/an-investigation-of-the-effects-of-riboflavin-concentration-on-the-efficacy-of-corneal-cross-linking-using-an-enzymatic-resistance-model-in-porcine-corneas
#20
Naomi A L O'Brart, David P S O'Brart, Nada H Aldahlawi, Sally Hayes, Keith M Meek
Purpose: To investigate riboflavin concentration on enzymatic resistance following corneal cross-linking (CXL). Methods: Ninety-six porcine eyes were divided into five groups in two treatment runs. Group 1 remained untreated. Group 2 received riboflavin 0.05%, group 3 riboflavin 0.1%, group 4 riboflavin 0.2%, and group 5 riboflavin 0.3%. Treated eyes underwent CXL with ultraviolet A at 9 mW/cm2 for 10 minutes. Eight-millimeter discs from each cornea were submerged in pepsin digest solution...
February 1, 2018: Investigative Ophthalmology & Visual Science
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