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Waleed Ali Abou Samra, Eman Azmy Awad, Amr Hassan El Kannishy
AIM: To evaluate the visual and topographic outcomes of a two-stage approach treatment for selected cases of progressive keratoconus (KC); corneal collagen cross-linking (CXL) followed by phacoemulsification with toric intraocular lens (IOL) implantation. METHODS: The study included 9 eyes of 6 patients diagnosed with progressive KC, aged from 35 to 47 years (41.6±11.2 years). All studied eyes underwent a two-stage approach treatment: first corneal collagen CXL followed after at least 6 months by phacoemulsification with foldable toric IOL implantation in both eyes of three patients and only one eye of the other three patients...
October 3, 2016: Eye & Contact Lens
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
Omer Karti, Mehmet Ozgur Zengin, Esat Cinar, Merve Tutuncu, Eyyup Karahan, Asl Celik, Cem Kucukerdonmez
PURPOSE: To study the effect of 1- and 6-hour-delayed corneal collagen cross-linking (CXL) on wound-healing of experimental alkali burns of the cornea. METHODS: Twenty-four albino rabbits were used. Alkali burns were created using 1 M NaOH. The animals were divided randomly into 2 groups: group 1 (control group, n = 6) and group 2 (experimental group, n = 18). The experimental group was further divided into 3 subgroups as follows: group 2A, untreated (non-CXL) subgroup; group 2B, 1-hour-delayed CXL treatment subgroup; and group 2C, 6-hour-delayed CXL treatment subgroup...
October 12, 2016: Cornea
Ozge Sarac, Mehtap Caglayan, Hasan Basri Cakmak, Nurullah Cagil
PURPOSE: To assess the preoperative patient characteristics that may predict outcomes of keratoconus 2 years after corneal collagen cross-linking (CXL) in pediatric patients with keratoconus. METHODS: This retrospective study included 72 eyes of 52 consecutive patients with keratoconus under the age of 18 with 2-year follow-up after CXL. Subgroup analysis and cutoff values were determined as per age (<14 and ≥14 years), sex, baseline uncorrected and corrected distance visual acuities (UCVA, CDVA; <0...
October 12, 2016: Cornea
Tae Gi Kim, Ki Young Kim, Jung Bin Han, Kyung Hyun Jin
PURPOSE: To evaluate the long-term clinical effectiveness and safety of corneal collagen cross-linking (CXL) in progressive keratoconus compared with untreated contralateral eyes. METHODS: In this retrospective study, nine eyes of nine patients with progressive keratoconus who received CXL (treatment group) and nine untreated contralateral eyes with keratoconus (control group) were included. All patients were followed for at least 5 years and assessed with best-corrected visual acuity, maximum keratometry, mean keratometry, corneal astigmatism, and corneal thickness...
October 2016: Korean Journal of Ophthalmology: KJO
Vasilios F Diakonis, Nikita Y Likht, Nilufer Yesilirmak, Desiree Delgado, Andreas E Karatapanis, Yener Yesilirmak, Christopher Fraker, Sonia H Yoo, Noël M Ziebarth
The purpose of this study was to assess anterior and mid corneal stromal elasticity after high intensity (HI) corneal cross linking (CXL), with and without oxygen (O2) enrichment, and compare these results to conventional CXL. Experiments were performed on 25 pairs of human cadaver eyes, divided into four different groups. Group 1 included corneas that did not receive treatment and served as controls; Group 2 included corneas that received conventional CXL treatment (Dresden Protocol: corneal epithelial debridement, 30 min of riboflavin pretreatment followed by 30 min of exposure to 3 mW/cm2 of ultraviolet light); Group 3 included corneas that received HI CXL treatment (corneal epithelial debridement, 30 min of riboflavin pretreatment followed by 3 min of exposure to 30mW/cm2 of ultraviolet light); and Group 4 included corneas that received the same treatment as Group 3, except that they were enriched with oxygen (4 liter per minute pure O2 gas stream) during ultraviolet irradiation...
October 7, 2016: Experimental Eye Research
Ronald N Gaster, J Ben Margines, David N Gaster, Xiaohui Li, Yaron S Rabinowitz
PURPOSE: To compare the visual, refractive, keratometric, topographic, and pachymetric outcomes of corneal collagen cross-linking (CXL) for progressive keratoconus following epithelial removal by transepithelial phototherapeutic keratectomy (PTK) or manual debridement. METHODS: In this analysis, 339 eyes (78% male, 22% female) that had undergone CXL following manual epithelial debridement (n = 180) or ablation via PTK (n = 159) were evaluated preoperatively and at 6, 12, and 24 months postoperatively for uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), maximum corneal keratometry, pachymetry, and spherical equivalent...
October 1, 2016: Journal of Refractive Surgery
Paolo Vinciguerra, Vito Romano, Pietro Rosetta, Emanuela F Legrottaglie, Raffaele Piscopo, Claudia Fabiani, Claudio Azzolini, Riccardo Vinciguerra
PURPOSE: To compare 1-year transepithelial corneal collagen cross-linking with iontophoresis (I-CXL) outcomes with standard CXL (S-CXL) epithelium-off for progressive keratoconus. METHODS: Forty eyes of 40 patients with progressive keratoconus were included in this comparative, prospective clinical study. Corrected distance visual acuity (CDVA), spherical equivalent, cylinder refraction, corneal topography, Scheimpflug tomography, aberrometry, and endothelial cell count were assessed at baseline and at 1, 3, 6, and 12 months of follow-up...
October 1, 2016: Journal of Refractive Surgery
Leopoldo Spadea, Emanuele Tonti, Enzo Maria Vingolo
Collagen cross-linking (CXL) is a relatively new conservative approach for progressive corneal ectasia, which is able to strengthen corneal tissue reforming new covalent bonds. Subjective and objective results following this method seem to be promising. In recent years, newer CXL protocols have been developed to perform more effective and less invasive procedures. The increasing diffusion of CXL in the corneal ectatic disease has increased the need to have actual indices regarding the efficacy of the treatment...
2016: Clinical Ophthalmology
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
Ibrahim Toprak, Volkan Yaylali, Cem Yildirim
PURPOSE: To evaluate the effects of pediatric corneal collagen cross-linking (CXL) on corrected distance visual acuity (CDVA), maximum keratometry (Kmax), and other Scheimpflug imaging system parameters during 2 years of follow-up. METHODS: The records of 29 eyes of 29 pediatric patients who underwent unilateral CXL treatment for progressive keratoconus were reviewed. Changes in CDVA, Kmax, anterior chamber depth, anterior chamber volume, anterior chamber angle, pupil-center pachymetry, apical pachymetry, thinnest pachymetry, corneal volume, and topographic indices (index of surface variance [ISV], index of vertical asymmetry [IVA], index of height asymmetry [IHA], keratoconus index [KI], center keratoconus index [CKI], index of height decentration [IHD], and minimum radius of curvature [Rmin]) were analyzed among baseline and 1 and 2 years after the CXL treatment...
September 26, 2016: Journal of Pediatric Ophthalmology and Strabismus
Muhammad Saim Khan, Imran Basit, Mazhar Ishaq, Tariq Shakoor, Amer Yaqub, Rana Intisar
OBJECTIVE: To determine mean change in visual acuity, central corneal thickness and symptoms in patients with pseudophakic bullous keratopathy after treatment with corneal collagen crosslinking. METHODS: This quasi experimental study was conducted at Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan from April 2015 to Nov 2015. A total of 24 eyes of 24 patients were included in the study. Visual symptoms were graded in five grades (Grade 1-5), Grade-1 being very mild with decreased vision only while patients with all five symptoms (decreased vision, foreign body sensations, pain, watering and photophobia) were graded as Grade-5...
July 2016: Pakistan Journal of Medical Sciences Quarterly
Patrícia A Bersanetti, Tatiane L N Bueno, Andreia de A Morandim-Giannetti, Regina F Nogueira, Jivaldo R Matos, Paulo Schor
PURPOSE: In this study, we characterized rabbit corneas subjected to corneal cross-linking (CXL) with açaí extract compared with a riboflavin photo-stimulated procedure. MATERIALS AND METHODS: The corneas of the slaughterhouse rabbits were divided into three groups: control, consisting of untreated corneal samples; riboflavin/UVA, where corneas were treated with 0.1% riboflavin photo-stimulated at 365 nm as the standard protocol; and açaí, where the samples were subjected to 4% açaí extract for 0...
September 9, 2016: Current Eye Research
Xiao Zhang, Xiang-Chen Tao, Zhi-Wei Li, Wei-Yan Zhou, Ping Ma, Chun-Xiao Zhang, Yu-Meng Wang, Guo-Ying Mu
The present study reports the use of a phakic toric Implantable Collamer Lens (ICL) that improved the refraction correction of high myopia and astigmatism in a case of keratectasia following corneal cross-linking. A 31-year-old male was diagnosed with keratectasia 12 years after laser-assisted in situ keratomileusis (LASIK). Following LASIK, the manifest refraction was -3.50-2.25×90 [0.1 logarithmic expression (LogMAR) best corrected visual acuity (BVCA)] in the right eye and -8.00-3.50×175 (0.3 LogMAR BCVA) in the left eye, with a LogMAR uncorrected distance visual acuity (UDVA) of 0...
September 2016: Experimental and Therapeutic Medicine
Xiangjun Chen, Aleksandar Stojanovic, Xiaorui Wang, Jing Liang, Di Hu, Tor Paaske Utheim
PURPOSE: To evaluate corneal epithelial remodeling after topography-guided transepithelial photorefractive keratectomy (PRK) combined with corneal collagen cross-linking (CXL) in the treatment of keratoconus. METHODS: Retrospective analysis of the epithelial thickness distribution changes in 53 keratoconic eyes of 44 patients. Manifest refraction, maximum (Kmax) and minimum (Kmin) keratometry obtained by Placido topography, corneal irregularity index (IRI) measured by Scheimpflug topography, and the epithelial thickness profile over the central 5-mm zone obtained by anterior-segment spectral domain optical coherence tomography (SD-OCT) were evaluated preoperatively and at 1 to 3, 3 to 6, and more than 6 months postoperatively...
August 1, 2016: Journal of Refractive Surgery
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
Yong Zhang, Kuan-Chen Wang, Chao-Kai Chang, Jui-Teng Lin
AIM: To analyze the efficacy of ultraviolet (UV) light initiating corneal cross-linking (CXL). METHODS: The time-dependent absorption of UV light due to the depletion of the initiator (riboflavin) was calculated. The effective dose of CXL with corneal surface covered by a thin layer of riboflavin was derived analytically. The cross linking time was calculated by the depletion level of the riboflavin concentration. A comprehensive method was used to derive analytic formulas...
2016: International Journal of Ophthalmology
Ahmed M Bata, Katarzyna J Witkowska, Piotr A Wozniak, Klemens Fondi, Gerald Schmidinger, Niklas Pircher, Stephan Szegedi, Valentin Aranha Dos Santos, Anca Pantalon, René M Werkmeister, Gerhard Garhofer, Leopold Schmetterer, Doreen Schmidl
Importance: Corneal abrasions are frequent after standard (epithelium-off [epi-off]) corneal collagen cross-linking (CXL) in patients with progressive keratoconus. A new matrix therapy agent (ReGeneraTing Agent [RGTA]) has been developed to promote corneal wound healing. Objective: To assess the effect of the new type of matrix therapy agent on corneal wound healing after epi-off CXL in patients with keratoconus. Design, Setting, and Participants: This double-masked randomized clinical trial enrolled 40 patients with keratoconus undergoing epi-off CXL from July 18, 2014, to October 21, 2015, when the last follow-up was completed...
October 1, 2016: JAMA Ophthalmology
Manmohan Singh, Jiasong Li, Srilatha Vantipalli, Shang Wang, Zhaolong Han, Achuth Nair, Salavat R Aglyamov, Michael D Twa, Kirill V Larin
The mechanical properties of tissues can provide valuable information about tissue integrity and health and can assist in detecting and monitoring the progression of diseases such as keratoconus. Optical coherence elastography (OCE) is a rapidly emerging technique, which can assess localized mechanical contrast in tissues with micrometer spatial resolution. In this work we present a noncontact method of optical coherence elastography to evaluate the changes in the mechanical properties of the cornea after UV-induced collagen cross-linking...
May 2016: IEEE Journal of Selected Topics in Quantum Electronics
S H Chen, J Zhang, Y N Li, P Ding, Q M Wang
OBJECTIVE: To evaluate the effect of transepithelial corneal collagen cross-linking (CXL) in the treatment of keratoconus. METHODS: Prospective study. Sixteen eyes of 16 patients with keratoconus underwent transepithelial CXL, and the fellow eyes were considered as the controls. The mean age was (22.4±6.5) years old. In the CXL group, topical anesthesia (0.1% tetracaine) was given for 15 minutes, and 0.5% riboflavin was applied until saturated in the anterior chamber...
July 2016: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
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