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corneal cross linking

Nada H Aldahlawi, Sally Hayes, David P S O'Brart, Naomi D O'Brart, Keith M Meek
The aim of this study was to investigate corneal enzymatic resistance following epithelium off and on riboflavin/UVA cross-linking (CXL). One hundred and fourteen porcine eyes were divided into four non-irradiated control groups and seven CXL groups. The latter comprised; (i) epithelium-off, 0.1% iso-osmolar riboflavin, 9 mW UVA irradiation for 10 min, (ii) disrupted epithelium, 0.1% hypo-osmolar riboflavin, 9 mW UVA for 10 min, (iii) epithelium-on, 0.25% hypo-osmolar riboflavin with 0.01% benzylalkonium chloride (BACS), 9 mW UVA for 10 min, (iv) epithelium-on, 5 min iontophoresis at 0...
October 17, 2016: Experimental Eye Research
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
Marina Hovakimyan, Oliver Stachs, Olmiere Céline, Rudolf F Guthoff
PURPOSE: Corneal collagen cross-linking (CXL) is associated with massive cellular damage, the long-term clinical consequences of which have still to be elucidated. In this study, we seek to determine whether matrix-based regenerating agent (RGTA) therapy has a positive influence on stromal regeneration after CXL. METHODS: Twelve New Zealand white rabbits were randomly divided into 2 groups of 6. CXL of the right cornea was performed in both groups, followed by topical corneal application of one drop of vehicle or one drop of RGTA...
October 14, 2016: Cornea
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
Natasha Pahuja, Nimisha R Kumar, Rushad Shroff, Rohit Shetty, Rudy M M A Nuijts, Anuprita Ghosh, Abhijit Sinha-Roy, Shyam S Chaurasia, Rajiv R Mohan, Arkasubhra Ghosh
Purpose: In this study, we elucidated the differential expression of a set of local molecular factors in ectatic cone area of the cornea to uncover a functional cause for focal corneal weakening characteristic of the keratoconus (KC) disease. Methods: All human corneal samples were collected after approval of Institutional Ethics Committee and informed consent. Keratoconus patients were classified based on clinical parameters, topographical features, and structural deformity...
October 1, 2016: Investigative Ophthalmology & Visual Science
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
Akilesh Gokul, Dipika V Patel, Grant A Watters, Charles N J McGhee
BACKGROUND/AIMS: To determine if significant progression of disease occurs in older, non-contact lens wearing, subjects with keratoconus and to identify potential predictive factors. METHODS: Clinical and computerised corneal topography records of subjects with keratoconus attending a specialist optometry practice were retrospectively analysed to identify those aged ≥30 years, with ≥2 consultations ≥12 months apart, no contact lens wear and no corneal scarring, surgery or corneal hydrops...
October 11, 2016: British Journal of Ophthalmology
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/cm(2) 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/cm(2) of ultraviolet light); and Group 4 included corneas that received the same treatment as Group 3, except that they were enriched with oxygen (4 L per minute pure O2 gas stream) during ultraviolet irradiation...
October 8, 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
Tommy C Y Chan, Marco C Y Yu, Alex L K Ng, George P M Cheng, Jiamei Zhang, Yan Wang, Vishal Jhanji
PURPOSE: To analyze the visual and refractive outcomes of LASIK with and without simultaneous cross-linking for correction of myopia. METHODS: Patients who received femtosecond laser-assisted LASIK with and without adjunctive cross-linking according to patient's preference were examined longitudinally for 6 months. Patients with myopic manifest refraction spherical equivalent of 5.00 diopters (D) or greater and estimated residual stromal thickness of greater than 250 µm were included...
October 1, 2016: Journal of Refractive Surgery
Shihui Yu, Xiaoyu Zhang, Guoxin Tan, Lei Tian, Dandan Liu, Yaxuan Liu, Xinggang Yang, Weisan Pan
In this work, a stimuli-responsive three dimensional cross-linked hydrogel system containing carboxymethyl chitosan (CMC) and poloxamer composed of a poly (ethylene oxide)/poly (propylene oxide)/poly (ethylene oxide) (PEO-PPO-PEO) block copolymer was constructed, and its aqueous solution was found to undergo a reversible sol-gel transition upon a temperature and/or pH change at a very low concentration. The hydrogels were synthesized via a cross-linking reaction using glutaraldehyde (GA) as the cross-linking agent...
January 2, 2017: Carbohydrate Polymers
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
Ying Wu, Lei Tian, Li-Qiang Wang, Yi-Fei Huang
This was a prospective controlled clinical trial. 48 myopia patients (96 eyes) were included in this study. After LASIK, accelerated corneal collagen cross-linking (ACXL) was used for myopia treatment. During 6-month follow-up, the results of LASIK-ACXL treatment were studied and compared to the LASIK-only procedure. The results showed that no statistically significant differences in UDVA, CDVA, MRSE, K mean, pachymetry, or ECD were found between the two groups at the visit after 6 months of follow-up (all P > 0...
2016: BioMed Research International
Johnny E Moore, Davide Schiroli, C B Tara Moore
Corneal cross-linking is nowadays the most used strategy for the treatment of keratoconus and recently it has been exploited for an increasing number of different corneal pathologies, from other ectatic disorders to keratitis. The safety of this technique has been widely assessed, but clinical complications still occur. The potential effects of cross-linking treatment upon the limbus are incompletely understood; it is important therefore to investigate the effect of UV exposure upon the limbal niche, particularly as UV is known to be mutagenic to cellular DNA and the limbus is where ocular surface tumors can develop...
2016: BioMed Research International
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
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