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CXL thin cornea

Alina Cantemir, Anisia-Iuliana Alexa, Bogdan Gabriel Galan, Nicoleta Anton, Roxana Elena Ciuntu, Ciprian Danielescu, Dorin Chiselita, Danut Costin
The purpose of this retrospective study was to report the results of iontophoretic corneal collagen crosslinking (I-CXL) with riboflavin and ultraviolet A irradiation in patients affected by keratoconus, each with thinnest pachymetry values of <400 μ (with epithelium) and not treatable using standard epithelium-off technique.Fifteen eyes of 15 patients affected by progressive keratoconus and with thinnest pachymetry values <400 μ underwent I-CXL. The uncorrected (UDVA) and corrected (CDVA) distance visual acuity, maximum and minimum keratometry (K max and K min) readings, corneal thickness at the thinnest point (CTTP), endothelial cell density (ECD), and intraocular pressure (IOP) were assessed before I-CXL, at 1, 3, 6, and 12 months postoperatively...
November 2017: Medicine (Baltimore)
Bushra Akbar, Rana Intisar-Ul-Haq, Mazhar Ishaq, Ayesha Fawad, Sabahat Arzoo, Kashif Siddique
PURPOSE: The purpose of this study is to compare the safety and efficacy of transepithelial corneal crosslinking (CXL) with epithelium-off crosslinking (epithelium-off CXL) in the treatment of progressive keratoconus in adult Pakistani population. MATERIALS AND METHODS: Sixty-four eyes of 64 consecutive patients of progressive keratoconus were included in this quasi-experimental study. Thirty-two eyes received transepithelial CXL with Peschke TE (0.25% riboflavin (Vitamin B2), 1...
October 2017: Taiwan Journal of Ophthalmology
Z R Lin, H P Wu, S R Luo, Z S Liu, N Dong, X M Shang, Z W Xie, L Yan, X Fang
Objective: To evaluate the clinical results of keratoconic eyes with a thin cornea treated with accelerated transepithelial corneal collagen cross-linking (A-TE-CXL) within 1 year. Methods: Nineteen eyes of 19 patients with progressive keratoconus with a minimum corneal thickness from 380 μm to 420 μm (including the epithelium) were included in this prospective, nonrandomized clinical study and treated with A-TE-CXL. Scoring of pain and foreign body sensation, slit lamp examination, uncorrected visual acuity, best corrected distance visual acuity, corneal topography, anterior segment optical coherence tomography, in vivo corneal confocal microscopy and endothelial cell count were assessed before surgery and at 1, 3, 6 and 12 months postoperatively...
September 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
Bushra Akbar, Rana Intisar-Ul-Haq, Mazhar Ishaq, Sabahat Arzoo, Kashif Siddique
OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of transepithelial corneal collagen cross linking (TE-CXL) with modified riboflavin and accelerated UVA irradiance in thin corneas with pachymetry less than 400 microns at thinnest point, untreatable by epithelium off corneal collagen cross linking (CXL) in adult Pakistani population with progressive keratoconus. METHODS: This quasi experimental study included twenty six eyes of 26 patients with progressive keratoconus who underwent accelerated transepithelial CXL in Armed forced institute of ophthalmology with 12 months follow up...
May 2017: Pakistan Journal of Medical Sciences Quarterly
Wenjing Song, Yun Tang, Jing Qiao, Haili Li, Bei Rong, Songlin Yang, Yuan Wu, Xiaoming Yan
PURPOSE: To investigate, after 24 h, the safety of genipin or ultraviolet A (UVA)-riboflavin crosslinking of keratocytes and endothelial cells. METHODS: Fifteen New Zealand white rabbits were selected and divided into a PBS group (five rabbits), a 0.2% genipin crosslinking (GP-CXL) group (five rabbits), and a UVA-riboflavin crosslinking (UVA-CXL) group (five rabbits). In the GP-CXL and PBS groups, 0.2% genipin or PBS was applied to the corneal surface of the right eyes...
2017: Molecular Vision
Yirui Zhu, Peter S Reinach, Hanlei Zhu, Qiufan Tan, Qinxiang Zheng, Jia Qu, Wei Chen
Corneal collagen cross-linking (CXL) halts human corneal ectasias progression by increasing stromal mechanical stiffness. Although some reports describe that this procedure is effective in dealing with some infectious and immunologic corneal thinning diseases, there is a need for more animal models whose corneal thickness more closely resemble those occurring in these patients. To meet this need, we describe here high-intensity protocols that are safe and effective for obtaining CXL in rat corneas. Initially, a range of potentially effective UVA doses were evaluated based on their effectiveness in increasing tissue enzymatic resistance to dissolution...
2017: PloS One
Virgilio Galvis, Alejandro Tello, Alvaro I Ortiz, Luis C Escaf
Corneal cross-linking (CXL) is an option that in the last decade has demonstrated its efficacy and safety in halting the progression of keratoconus (KCN) and other corneal ectasias. Its indication has been extended beyond the classic definition that required evidence of KCN progression, especially in the presence of some risk factors for a possible progression (particularly the younger age). However, the results can be still somewhat variable today. There are several protocols, each with its own advantages and disadvantages...
2017: Clinical Ophthalmology
Youssef Abdelmassih, Sylvain El-Khoury, Ali Dirani, Rafic Antonios, Ali Fadlallah, Carole G Cherfan, Elias Chelala, Elias F Jarade
PURPOSE: To evaluate the safety and visual outcome of intracorneal ring segment (ICRS) implantation followed by cross-linking in pediatric keratoconus patients. DESIGN: Retrospective interventional case series. METHODS: This retrospective study included pediatric patients (aged ≤14 years) with keratoconus and poor corrected distance visual acuity (CDVA) that underwent ICRS implantation and cross-linking (CXL). ICRS were inserted under topical anesthesia after creating a corneal tunnel with a femtosecond laser...
June 2017: American Journal of Ophthalmology
Hasan Razmjoo, Alireza Peyman, Ali Rahimi, Hoda Jafari Modrek
BACKGROUND: Keratoconus is a progressive degenerative disorder of the cornea in which structural changes in the cornea cause it to become thin and conical in shape. Recently, collagen cross-linking (CXL) has been introduced as an effective intervention in management of progressive keratoconus. Accelerated CXL is a new protocol of this procedure which reduces corneal ultraviolet irradiation exposure time to 5 min. This study aimed to compare visual acuity, keratometry and topographic criteria of keratoconic eyes after conventional and accelerated CXL with a six-month follow-up...
2017: Advanced Biomedical Research
Tommy C Y Chan, Alex L K Ng, Karen K W Chan, George P M Cheng, Ian Y H Wong, Vishal Jhanji
Laser in-situ keratomileusis (LASIK) is safe and effective laser refractive procedures in treating refractive errors. However, regression of treatment and iatrogenic keratectasia remain to be a major concern, especially in treating thin cornea with high ametropia. Collagen cross-linking (CXL) is an effective method in stopping keratoconus progression through increasing the biomechanical strength of the cornea. Adjuvant cross-linking to refractive procedures can theoretically help prevent regression and reduce the risk of keratectasia development by increasing the mechanical stability of cornea...
November 2017: Acta Ophthalmologica
R P L Wisse, N Soeters, D A Godefrooij, N G de Koning-Tahzib
Keratoconus is a corneal disease with onset typically occurring during puberty or early adulthood. The cornea progressively thins and acquires a cone-like shape which negatively affects visual acuity. In the early stages, visual acuity can be corrected with glasses or contact lenses. In more advanced cases, a corneal transplant is ultimately indicated to restore visual acuity. Corneal cross-linking (CXL) is a treatment given at a relatively early stage that protects patients against deterioration of visual acuity and further corneal deformation in progressive cases of keratoconus...
2016: Nederlands Tijdschrift Voor Geneeskunde
Bia Z Kim, Charlotte A Jordan, Charles N J McGhee, Dipika V Patel
PURPOSE: To analyze corneal haze after corneal collagen crosslinking (CXL) for progressive keratoconus using Scheimpflug densitometry. SETTING: Auckland District Health Board, Auckland, New Zealand. DESIGN: Prospective randomized controlled study. METHODS: Both eyes of all patients were examined preoperatively and 1, 3, 6, and 12 months postoperatively. One eye of each patient was treated with corneal CXL, with the contralateral eye serving as the control...
July 2016: Journal of Cataract and Refractive Surgery
Karim Mohamed-Noriega, Karla Butrón-Valdez, Jeronimo Vazquez-Galvan, Jibran Mohamed-Noriega, Humberto Cavazos-Adame, Jesús Mohamed-Hamsho
PURPOSE: To report the case of a 50-year-old woman with diabetes that presented with corneal melting and perforation 6 weeks after collagen cross-linking (CxL) for keratoconus (KC) and postoperative use of nepafenac eye drops, a nonsteroidal anti-inflammatory drug (NSAID). METHODS: This is a case report of a patient with diabetes, KC and a thin cornea that had undergone left eye corneal CxL at a different hospital followed by postoperative use of nepafenac eye drops for 6 weeks...
January 2016: Case Reports in Ophthalmology
Cosimo Mazzotta, Soosan Jacob, Amar Agarwal, Dhivya Ashok Kumar
PURPOSE: To study in vivo confocal microscopy (IVCM) after contact lens-assisted corneal collagen cross-linking (CACXL) in keratoconic eyes with thin corneas. METHODS: This prospective interventional case series included patients with progressive keratoconus with minimum corneal thickness less than 400 µm after removing epithelium. CACXL was done once functional corneal thickness was confirmed to be 400 µm or greater after applying a riboflavin-soaked, ultraviolet barrier-free contact lens...
May 1, 2016: Journal of Refractive Surgery
Elan Rosenblat, Peter S Hersh
PURPOSE: To determine intraoperative changes in corneal thickness and outcomes of corneal collagen crosslinking (CXL) using 2 intraoperative regimens: riboflavin-dextran or hypotonic riboflavin. SETTING: Cornea and refractive surgery practice, Teaneck, New Jersey, USA. DESIGN: Prospective randomized case series. METHODS: Eyes with keratoconus or corneal ectasia were treated. All eyes received preloading with riboflavin 0...
April 2016: Journal of Cataract and Refractive Surgery
Nurullah Cagil, Ozge Sarac, Gamze Dereli Can, Emine Akcay, Mehmet Erol Can
The purpose of the study was to evaluate the outcomes and possible complications of CXL performed with customized epithelial debridement technique to keratoconic corneas with the thinnest pachymetry values less than 400 µm. Nineteen eyes of 19 patients were included. The uncorrected (UCVA) and best corrected visual acuity (BCVA), flattest and steepest keratometric (K) readings, central corneal thickness at the thinnest point (t-CCT), endothelial cell density (ECD) were assessed before and 12 months after CXL...
February 2017: International Ophthalmology
Mustafa Koç, Mehmet Murat Uzel, Yaran Koban, Irfan Durukan, Kemal Tekin, Pelin Ylmazbaş
PURPOSE: To evaluate the effect of accelerated corneal cross-linking (CXL) according to corneal thickness in keratoconus. METHODS: Patients undergoing corneal CXL (9 mW/cm(2)) with hypo-osmolar riboflavin solution were included in this study. The patients were divided into 2 groups. Group 1 included patients with corneal thickness below 400 μm (50 eyes from 45 patients), and group 2 included patients with corneal thickness above 400 μm (50 eyes from 47 patients)...
February 2016: Cornea
Sabine Kling, Olivier Richoz, Arthur Hammer, David Tabibian, Soosan Jacob, Amar Agarwal, Farhad Hafezi
PURPOSE: To compare the currently available ultraviolet-A (UV-A) corneal cross-linking (CXL) treatment protocols for thin corneas with respect to oxygen, UV fluence, and osmotic pressure. METHODS: Freshly enucleated murine (n = 16) and porcine (n = 16) eyes were used. The dependency on oxygen and the amount of UV absorption were evaluated using different CXL protocols, including standard CXL, contact lens-assisted CXL (caCXL), and CXL after corneal swelling. The CXL protocol was adapted from the treatment parameters of the human cornea to fit the thickness of murine and porcine corneas...
December 2015: Journal of Refractive Surgery
Nacim Bouheraoua, Lea Jouve, Vincent Borderie, Laurent Laroche
Keratoconus is a bilateral and progressive corneal ectasia. In order to slow down its progression, corneal collagen cross-linking (CXL) has recently been introduced as an efficient treatment option. In biological and chemical sciences, crosslinking refers to new chemical bonds formed between reactive molecules. Hence, the aim of corneal collagen CXL is to synthetically increase the formation of crosslinks between collagen fibrils in the corneal stroma. Despite the fact that the efficiency of the conventional CXL (C-CXL) protocol has already been shown in several clinical studies, it might benefit from improvements in duration of the procedure and removal of corneal epithelium...
November 12, 2015: Journal of Visualized Experiments: JoVE
Xiangjun Chen, Aleksandar Stojanovic, Jon Roger Eidet, Tor Paaske Utheim
Corneal collagen cross-linking (CXL) is a therapeutic procedure aiming at increasing the corneal stiffness in the keratoconus eyes by induction of cross-links within the extracellular matrix. It is achieved by ultraviolet-A (370 nm) irradiation of the cornea after saturation with the photosensitizer riboflavin. In the conventional CXL protocol, a minimum de-epithelialized corneal thickness of 400 μm is recommended to avoid potential irradiation damage to the corneal endothelium. In advanced keratoconus, however, stromal thickness is often lower than 400 μm, which limits the application of CXL in that category...
2015: Eye and Vision (London, England)
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