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Corneal cross-linking

Ahmad R Dhaini, Maamoun Abdul Fattah, Sara Maria El-Oud, Shady T Awwad
PURPOSE: To evaluate a proposed technology for offering objective grading and mapping of corneal haze as detected by corneal spectral domain optical coherence tomography after corneal cross-linking. METHODS: This was a retrospective study to evaluate corneal optical coherence tomography images performed on 44 eyes of 44 patients who underwent corneal cross-linking between January 2014 and May 2015, at the American University of Beirut Medical Center. RESULTS: Overall average brightness of the cornea was markedly increased from 43...
March 13, 2018: Cornea
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
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
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
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
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
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
Juan Wang, Geoffrey S Williamson, Michael G Lancina, Hu Yang
In this work, we developed a mildly cross-linked dendrimer hydrogel (mcDH) via aza -Michael addition of polyamidoamine (PAMAM) dendrimer G5 and polyethylene glycol diacrylate (PEG-DA, Mn =575 g/mol). We chose the antiglaucoma drug brimonidine tartrate as a model drug and developed a new antiglaucoma drug formulation on the basis of mcDH. Cytotoxicity of the mcDH formulation to NIH3T3 fibroblasts, in vitro drug release kinetics and ex vivo drug permeability across the rabbit cornea were examined. We also studied interactions between PAMAM dendrimer and the drug using1 H NMR spectroscopy for a mechanistic understanding of brimonidine release from the mcDH...
December 2017: Journal of Biomedical Nanotechnology
Niklas Pircher, Jan Lammer, Stephan Holzer, Andreas Gschließer, Ruth Donner, Stefan Pieh, Gerald Schmidinger
PURPOSE: A stromal demarcation line (DL) after corneal cross-linking (CXL) has lately been suggested as a surrogate parameter for the success of CXL. The aim of this study was to investigate the correlation between depth of the central DL 1 month and the change in K values 12 months after CXL. METHODS: Treatment-naive subjects with keratoconus were treated using an accelerated CXL protocol [A-CXL(9*10)]. Depth of the DL/relative depth of the DL (DL%) was measured using Visante OCT imaging 1 month postoperatively (OP)...
February 23, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
M Alnawaiseh, N Eter
BACKGROUND: Corneal densitometry, based on the Scheimpflug principle, is a useful noninvasive tool for quantitative evaluation of the optical quality of the cornea. It enables us to evaluate corneal transparency in the different corneal layers and different annuli. In this article, we discuss the basis of application of corneal densitometry measurements and summarize findings in patients with keratoconus. METHODS: This article is based on a selective literature review and analysis of own data...
February 21, 2018: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Elif Erdem, Ibrahim Inan Harbiyeli, Hazal Boral, Macit Ilkit, Meltem Yagmur, Reha Ersoz
PURPOSE: To evaluate the efficiency of corneal collagen cross-linking (CXL) in addition to topical voriconazole in cases with mycotic keratitis. DESIGN: Retrospective case series in a tertiary university hospital. PARTICIPANTS: CXL was performed on 13 patients with mycotic keratitis who presented poor or no response to topical voriconazole treatment. METHODS: The clinical features, symptoms, treatment results and complications were recorded retrospectively...
February 16, 2018: Mycopathologia
Giuseppe Lombardo, Valentina Villari, Norberto Liborio Micali, Nancy Leone, Cristina Labate, Maria Penelope De Santo, Marco Lombardo
Keratoconus is the primary cause of corneal transplantation in young adults worldwide. Riboflavin/UV-A corneal cross-linking may effectively halt the progression of keratoconus if an adequate amount of riboflavin enriches the corneal stroma and is photo-oxidated by UV-A light for generating additional cross-linking bonds between stromal proteins and strengthening the biomechanics of the weakened cornea. Here we reported a UV-A theranostic prototype device for performing corneal cross-linking with the ability to assess corneal intrastromal concentration of riboflavin and to estimate treatment efficacy in real time...
February 16, 2018: Journal of Biophotonics
Frans Eberth Costa Andrade, Joyce Luciana Covre, Lisandra Ramos, Rossen Mihaylov Hazarbassanov, Myrna Serapião Dos Santos, Mauro Campos, José Álvaro Pereira Gomes, Cristiane Damas Gil
AIMS: To evaluate the expression of β-galactoside-binding proteins galectin (Gal)-1 and Gal-3 in patients with keratoconus (KC) and postcorneal collagen cross-linking (CXL) treatment in vitro. METHODS: Tear fluid, cornea samples and conjunctival impression cytology specimens from control and KC patients were used to evaluate Gal-1 and Gal-3 expressions. Primary keratocytes were isolated by collagenase digestion from surgically removed corneas of five normal or KC human corneal buttons and cultured in Dulbecco's modified eagle medium/Ham's F12 medium supplemented with 2% fetal bovine serum...
February 8, 2018: British Journal of Ophthalmology
Orhan Ayar, Orkun Muftuoglu, Mehmet Orcun Akdemir, Mehmet Cuneyt Ozmen
PURPOSE: To evaluate the topographic, refractive, and pachymetric changes after ethanol-assisted transepithelial corneal cross-linking (CXL) to stabilize progression of keratoconus (KC). PATIENTS AND METHODS: This study retrospectively evaluated the long-term topographic, refractive, and pachymetric changes in patients diagnosed with KC who underwent corneal cross-linking and/or intrastromal corneal ring segment (ICRS) implantation. The subjects were divided into three groups, corresponding to eyes treated with CXL alone (group 1), CXL and ICRS at the same time (group 2), and CXL after ICRS implantation (group 3)...
February 10, 2018: International Ophthalmology
Javier Adrián Calles, Maria Julia Mora, Renée Onnainty, Luis Ignacio Tartara, Gladys Ester Granero, Marcela Raquel Longhi, Yolanda Diebold, Enrique Marcelo Vallés, Santiago Daniel Palma
AIM: This work aimed to design and characterize cross-linked hyaluronic acid-itaconic acid films loaded with acetazolamide-hydroxypropyl β cyclodextrin-triethanolamine complexes. MATERIALS & METHODS: Films were cross-linked with itaconic acid and poly(ethyleneglycol)-diglycidylether. Biopharmaceutical properties were assessed by evaluating in vitro drug release rate, biocompatibility in a human corneal epithelial cell line, bioadhesiveness with pig gastric mucin, in vivo bioadhesion and efficacy...
February 1, 2018: Therapeutic Delivery
Mohamed Hosny, Moustafa Nour, Sarah Azzam, Mohsen Salem, Esraa El-Mayah
Purpose: The purpose of this study is to compare the efficacy of intratunnel cross-linking combined with intrastromal corneal ring segment (ICRS) implantation versus combined epithelium-off (epi-off) cross-linking and ICRS implantation for the management of keratoconus. Methods: Our study included 20 eyes of 12 patients with moderate-to-severe keratoconus. Group A included 10 eyes that underwent simultaneous ICRS implantation with intratunnel cross-linking. Group B included 10 eyes that underwent simultaneous ICRS implantation with epi-off cross-linking...
2018: Clinical Ophthalmology
Abdulrahman Mohammed Al-Amri
AIM: To evaluate the visual outcomes of simultaneous non-topography guided photorefractive keratectomy (PRK) and corneal collagen cross-linking (CXL) in eyes with keratoconus 5y after the procedure. METHODS: Prospective, interventional, non-randomized, and non-controlled case series design was used. Sixty eyes of 30 patients (16 males and 14 females; age: 21-41y) with mild, non-progressive (stages 1-2) keratoconus were enrolled. Refraction, uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), flat and steep keratometry readings, and adverse events were evaluated preoperatively and postoperatively...
2018: International Journal of Ophthalmology
Mariya Zyablitskaya, E Laura Munteanu, Takayuki Nagasaki, David C Paik
Methods to strengthen tissue by introducing chemical bonds (non-enzymatic cross-linking) into structural proteins (fibrillar collagens) for therapy include photochemical cross-linking and tissue cross-linking (TXL) methods. Such methods for inducing mechanical tissue property changes are being employed to the cornea in corneal thinning (mechanically weakened) disorders such as keratoconus as well as the sclera in progressive myopia, where thinning and weakening of the posterior sclera occurs and likely contributes to axial elongation...
January 6, 2018: Journal of Visualized Experiments: JoVE
Alireza Hedayatfar, Hassan Hashemi, Gholamhossein Aghaei, Nahid Ashraf, Soheila Asgari
PURPOSE: To compare the subclinical inflammatory response (as measured by anterior chamber flare) induced after standard (3 mW/cm2, 30 min) and accelerated (18 mW/cm2, 5 min) corneal cross-linking (CXL). METHODS: In this comparative, non-randomized study, patients with progressive keratoconus who underwent standard or accelerated CXL were studied. Laser flare photometery (FM-600; Kowa, Tokyo, Japan) was used to measure anterior chamber flare preoperatively and at 1 week, 1 month, 3 months, and 6 months after the procedure...
January 15, 2018: Ocular Immunology and Inflammation
Jingjing You, Susan M Corley, Li Wen, Chris Hodge, Roland Höllhumer, Michele C Madigan, Marc R Wilkins, Gerard Sutton
Keratoconus is a common degenerative corneal disease that can lead to significant visual morbidity, and both genetic and environmental factors have been implicated in its pathogenesis. We compared the transcriptome of keratoconus and control epithelium using RNA-Seq. Epithelial tissues were obtained prior to surgery from keratoconus and myopia control patients, undergoing collagen cross-linking and photorefractive keratectomy, respectively. We identified major differences in keratoconus linked to cell-cell communication, cell signalling and cellular metabolism...
January 10, 2018: Scientific Reports
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