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Corneal cross-linking

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https://www.readbyqxmd.com/read/28230557/comparison-of-the-conventional-dresden-protocol-and-accelerated-protocol-with-higher-ultraviolet-intensity-in-corneal-collagen-cross-linking-for-keratoconus
#1
Moonjung Choi, Jiwon Kim, Eung Kweon Kim, Kyoung Yul Seo, Tae-Im Kim
PURPOSE: To compare the accelerated corneal cross-linking (CXL) protocol and the conventional Dresden protocol in patients with keratoconus in terms of visual acuity, keratometric values, and topographic parameters. METHODS: Twenty-eight eyes of 25 patients with primary keratoconus were divided into 2 groups; 15 eyes in group 1 received CXL under the standard Dresden protocol (3 mW/cm for 30 min, dose 5.4 J/cm) and 13 eyes in group 2 were treated with the accelerated protocol (30 mW/cm for 3 min 40 s, dose 6...
February 22, 2017: Cornea
https://www.readbyqxmd.com/read/28226245/subconjunctival-injectable-dendrimer-dexamethasone-gel-for-the-treatment-of-corneal-inflammation
#2
Uri Soiberman, Siva P Kambhampati, Tony Wu, Manoj K Mishra, Yumin Oh, Rishi Sharma, Jiangxia Wang, Abdul Elah Al Towerki, Samuel Yiu, Walter J Stark, Rangaramanujam M Kannan
Corneal inflammation is often encountered as a key pathological event in many corneal diseases. Current treatments involve topical corticosteroids which require frequent instillations due to rapid tear turnover, causing side-effects such as corneal toxicity and elevated intraocular pressure (IOP). Hence, new interventions that can reduce side effects, dosing frequency, and increase patient compliance can be highly beneficial. In this study, we explore a subconjunctival injectable gel based on G4-PAMAM dendrimer and hyaluronic acid, cross-linked using thiol-ene click chemistry, incorporated with dendrimer dexamethasone (D-Dex) conjugates as a potential strategy for sustained delivery and enhanced bioavailability of corticosteroids...
February 16, 2017: Biomaterials
https://www.readbyqxmd.com/read/28215504/a-case-of-in-vivo-iontophoresis-assisted-corneal-collagen-cross-linking-for-keratoconus-an-immunohistochemical-study
#3
Mirko Manetti, Eleonora Favuzza, Eleonora Sgambati, Rita Mencucci, Mirca Marini
The standard corneal collagen cross-linking (CXL), that includes the removal of corneal epithelium to permit adequate penetration of riboflavin in the stroma, is an established procedure to halting keratoconus progression. However, as epithelial removal may cause postoperative pain and an increased risk of corneal infection, new therapeutic approaches have been proposed. Iontophoresis is a recently developed non-invasive technique which provides the use of electrical current during CXL to enhance transepithelial penetration of riboflavin into the corneal stroma...
February 15, 2017: Acta Histochemica
https://www.readbyqxmd.com/read/28197339/refractive-topographic-and-aberrometric-results-at-2-year-follow-up-for-accelerated-corneal-cross-link-for-progressive-keratoconus
#4
Ercüment Bozkurt, Engin Bilge Ozgurhan, Betul Ilkay Sezgin Akcay, Tugba Kurt, Yusuf Yildirim, Zehra Karaagaç Günaydin, Ahmet Demirok
Purpose. To report the visual, refractive, and corneal topography and wavefront aberration results of accelerated corneal cross-linking (CXL) during a 24-month follow-up. Methods. Forty-seven eyes underwent riboflavin-ultraviolet A-induced accelerated CXL treatment (30 mW/cm(2) with a total dose of 7.2 joules/cm(2)). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical and cylindrical values, keratometry (K) measurements (Ksteep, Kflat, Kavg, and Kapex), central corneal thickness, and anterior corneal aberrometric analyses including total wavefront error (WFE), total high order aberration (HOA), astigmatism, trefoil, coma, quadrafoil, secondary astigmatism, and spherical aberration were evaluated...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28192592/an-algorithm-to-predict-the-biomechanical-stiffening-effect-in-corneal-cross-linking
#5
Sabine Kling, Farhad Hafezi
PURPOSE: To develop an algorithm to predict the stiffening effect of CXL and to verify the accuracy with results obtained from experimental measurements. METHODS: The algorithm considers different variables: the reaction kinetics of riboflavin diffusion and riboflavin photodegradation to determine the effective riboflavin concentration in different stromal layers; the oxygen diffusion and ultraviolet (UV) absorption to determine the amount of reactive oxygen species as a function of time and stromal depth...
February 1, 2017: Journal of Refractive Surgery
https://www.readbyqxmd.com/read/28187472/-epi-bowman-keratectomy-clinical-evaluation-of-a-new-method-of-surface-ablation
#6
S Taneri, S Kießler, A Rost, T Schultz, M Elling, B Dick
Purpose A new device for epithelial abrasion before excimer laser surface ablation or corneal cross-linking (CXL) has recently been introduced (Epi-Clear™, Orca Surgical, Kiryat-Shmona, Israel). We have reviewed the literature on the clinical results, potential benefits and drawbacks of this instrument, compared to other methods of epithelial removal. Method Literature search for "Epi-Bowman Keratectomy", "Epi-clear", and "Epikeratome" yielded 1 peer-review publication, 1 non-peer-review publication, 18 posters and presentations at international conferences (European Society of Cataract and Refractive Surgeons [ESCRS] and American Society of Cataract and Refractive Surgery [ASCRS]) on the use of the Epi-Clear™ device before surface ablation, 2 posters on the use of Epi-Clear before corneal crosslinking and 1 presentation on the experimental use of Epi-Clear for removal of a pterygium...
February 10, 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28160249/evaluation-of-iontophoretic-collagen-cross-linking-for-early-stage-of-progressive-keratoconus-compared-to-standard-cross-linking-a-non-inferiority-study
#7
Alina Cantemir, Anisia I Alexa, Nicoleta Anton, Roxana E Ciuntu, Ciprian Danielescu, Dorin Chiselita, Danut Costin
INTRODUCTION: The purpose of this study was to evaluate the efficacy and safety of iontophoretic collagen cross-linking (I-CXL) compared to epithelium-off standard collagen cross-linking (CXL) in treating the early stages of progressive keratoconus. METHODS: This retrospective cohort study at Oftaprof Clinic, Iasi, Romania included 40 eyes of 40 patients with progressive keratoconus stage I according to the Amsler classification who underwent I-CXL and the results were compared with a matched group of 40 eyes from 40 patients who received standard CXL...
February 3, 2017: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/28149672/corneal-cross-linking-with-riboflavin-and-uv-a-in-the-mouse-cornea-in-vivo-morphological-biochemical-and-physiological-analysis
#8
Sabine Kling, Arthur Hammer, Alain Conti, Farhad Hafezi
PURPOSE: To morphologically, biochemically, and physiologically characterize corneal cross-linking with riboflavin and UV-A light (CXL) in a newly established in vivo murine model. METHODS: C57BL/6 wild-type mice (N = 67) were treated with various CXL protocols, with modification of the following parameters: total energy (fluence) used, duration of UV-A irradiation, continuous versus pulsed irradiation, and CXL under hypoxic conditions (contact lens). Corneas were evaluated biomicroscopically, histologically, and using optical coherence tomography...
January 2017: Translational Vision Science & Technology
https://www.readbyqxmd.com/read/28144144/thermosensitive-hydrogel-based-on-chitosan-and-its-derivatives-containing-medicated-nanoparticles-for-transcorneal-administration-of-5-fluorouracil
#9
Angela Fabiano, Ranieri Bizzarri, Ylenia Zambito
A thermosensitive ophthalmic hydrogel (TSOH) - fluid at 4°C (instillation temperature), semisolid at 35°C (eye temperature), which coupled the dosing accuracy and administration ease of eyedrops with the increased ocular bioavailability of a hydrogel - was prepared by gelling a chitosan hydrochloride (ChHCl) solution (27.8 mg/mL) medicated with 1.25 mg/mL 5-fluorouracil (5-FU) with β-glycerophosphate 0.8 mg/mL. Polymer mixtures, where Ch was partially (10%, 15%, or 20%) replaced by quaternary ammonium-chitosan conjugates (QA-Ch) or thiolated derivatives thereof, were also used to modulate 5-FU-release properties of TSOH...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28129292/persistent-epithelial-defects-and-corneal-opacity-after-collagen-cross-linking-with-substitution-of-dextran-t-500-with-dextran-sulfate-in-compounded-topical-riboflavin
#10
Roland Höllhumer, Stephanie Watson, Peter Beckingsale
PURPOSE: Collagen cross-linking (CXL) is a commonly performed procedure to prevent the progression of keratoconus. Riboflavin is an essential part of the procedure, which facilitates both the cross-linking process and protection of intraocular structures. Dextran can be added to riboflavin to create an isotonic solution. This case report highlights the importance of compounding riboflavin with the correct dextran solution. METHODS: A retrospective case series. RESULTS: Six eyes of 4 male patients with keratoconus aged from 20 to 38 years underwent CXL with substitution of 20% dextran (T-500) with 20% dextran sulfate in a compounded riboflavin 0...
March 2017: Cornea
https://www.readbyqxmd.com/read/28114577/biomechanical-strengthening-of-the-human-cornea-induced-by-nanoplatform-based-transepithelial-riboflavin-uv-a-corneal-cross-linking
#11
Cristina Labate, Marco Lombardo, Giuseppe Lombardo, Maria Penelope De Santo
Purpose: The purpose of this study was to investigate the biomechanical stiffening effect induced by nanoplatform-based transepithelial riboflavin/UV-A cross-linking protocol using atomic force microscopy (AFM). Methods: Twelve eye bank donor human sclerocorneal tissues were investigated using a commercial atomic force microscope operated in force spectroscopy mode. Four specimens underwent transepithelial corneal cross-linking using a hypotonic solution of 0.1% riboflavin with biodegradable polymeric nanoparticles of 2-hydroxypropyl-β-cyclodextrin plus enhancers (trometamol and ethylenediaminetetraacetic acid) and UV-A irradiation with a 10 mW/cm2 device for 9 minutes...
January 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28068449/repeated-cross-linking-after-a-short-time-does-not-provide-any-additional-biomechanical-stiffness-in-the-mouse-cornea-in-vivo
#12
David Tabibian, Sabine Kling, Arthur Hammer, Olivier Richoz, Farhad Hafezi
PURPOSE: To study whether repeated collagen cross-linking (CXL) performed in vivo in mice shows an additive effect on mechanical corneal stiffness. METHODS: In this experimental study, epithelium-off CXL was performed in a total of 18 eyes from male C57BL/6 mice, with 0.27%-riboflavin solution applied for 20 minutes, followed by ultraviolet-A (UVA) irradiation (365 nm, 9mW/cm(2)) for 2:50 minutes (fluence 1.53 J/cm(2)). CXL was performed as either a single (1×CXL) or a repeated (2×CXL) treatment...
January 1, 2017: Journal of Refractive Surgery
https://www.readbyqxmd.com/read/28068447/corneal-ectasia-after-lasik-combined-with-prophylactic-corneal-cross-linking
#13
Suphi Taneri, Saskia Kiessler, Anika Rost, H Burkhard Dick
PURPOSE: To report a case of unilateral corneal ectasia following LASIK surgery combined with prophylactic corneal cross-linking (CXL) in a young patient. METHODS: Case report. RESULTS: Preoperative topography was unremarkable in both eyes with a minimum corneal thickness of 554 μm in the right eye and 546 μm in the left eye. Preoperative corrected distance visual acuity (CDVA) was 1.0 (20/20 Snellen) in both eyes with a refraction of +1...
January 1, 2017: Journal of Refractive Surgery
https://www.readbyqxmd.com/read/28060061/conventional-and-iontophoresis-corneal-cross-linking-for-keratoconus-efficacy-and-assessment-by-optical-coherence-tomography-and-confocal-microscopy
#14
Léa Jouve, Vincent Borderie, Otman Sandali, Cyrille Temstet, Elena Basli, Laurent Laroche, Nacim Bouheraoua
PURPOSE: To compare the efficacy, safety, and microstructural corneal changes during 2 years after conventional corneal collagen cross-linking (C-CXL) and transepithelial corneal CXL by iontophoresis (I-CXL) for keratoconus. METHODS: Eighty eyes of 80 patients with progressive keratoconus were treated by C-CXL (n = 40) or I-CXL (n = 40). Patients were investigated before surgery and 1, 3, 6, 12, and 24 months after treatment. We measured central corneal thickness and maximal simulated keratometry values (Kmax) and performed specular microscopy and in vivo confocal microscopy at each time point...
February 2017: Cornea
https://www.readbyqxmd.com/read/28060060/ocular-surface-disease-parameters-after-collagen-cross-linking-for-keratoconus
#15
José I Recalde, Arantxa Acera, Iñaki Rodríguez-Agirretxe, Miguel A Sánchez-Tena, Juan San-Cristóbal, Juan A Durán
PURPOSE: To analyze the variations in tear quantity and quality after corneal collagen cross-linking (CXL) in patients with keratoconus. METHODS: This is a prospective observational study of 24 eyes with keratoconus that underwent epithelium-off CXL. The variables studied were tear film osmolarity, subjective symptoms (Ocular Surface Disease Index), tear breakup time, Schirmer test (SCH) score, tear clearance, fluorescein staining, and lissamine green staining. Variables were determined preoperatively and 3, 6, and 12 months after CXL...
February 2017: Cornea
https://www.readbyqxmd.com/read/28060059/efficacy-of-intrastromal-corneal-ring-segments-combined-with-flash-collagen-cross-linking-in-keratoconus
#16
Carlos H Gordillo, Juan C Grandin, Roger Zaldivar, Roberto Zaldivar, Adriana C Lotfi
PURPOSE: To evaluate outcomes, efficacy, and safety of intrastromal corneal ring segment implantation for treatment of keratoconus combined with collagen cross-linking (CXL) with 1-year follow-up. METHODS: One hundred nineteen eyes of 82 patients with keratoconus (37 females) underwent femtosecond (Intralase FS; Abbott Medical Optics, Inc) laser-assisted intrastromal corneal ring segment implantation (INTRASEG; Gamma Vision) with flash CXL (18 mW/cm for 5 minutes)...
February 2017: Cornea
https://www.readbyqxmd.com/read/28060058/corneal-collagen-cross-linking-for-keratoconus-in-pediatric-patients-long-term-results
#17
Prema Padmanabhan, Sudhir Rachapalle Reddi, Rama Rajagopal, Radhika Natarajan, Geetha Iyer, Bhaskar Srinivasan, Niveditha Narayanan, Meena Lakshmipathy, Shweta Agarwal
PURPOSE: To report the long-term outcome of corneal collagen cross-linking (CXL) for progressive keratoconus in pediatric patients. METHODS: "Epithelium-off" CXL was performed in pediatric eyes with progressive keratoconus. Spectacle-corrected distance visual acuity (CDVA), retinoscopy, topography, and tomography were documented preoperatively and postoperatively at 3 months, 6 months, 1 year, and annually thereafter. RESULTS: A total of 377 eyes of 336 pediatric patients aged 8 to 18 years with progressive keratoconus underwent CXL...
February 2017: Cornea
https://www.readbyqxmd.com/read/28057642/accelerated-transepithelial-corneal-cross-linking-for-progressive-keratoconus-a-prospective-study-of-12%C3%A2-months
#18
Wei Aixinjueluo, Tomohiko Usui, Takashi Miyai, Tetsuya Toyono, Toshihiro Sakisaka, Satoru Yamagami
BACKGROUND/AIMS: To evaluate the clinical results of accelerated transepithelial corneal cross-linking (CXL) in Japanese patients with progressive keratoconus (KCN). METHODS: Thirty eyes of 19 patients (16 male, 3 female patients) with progressive KCN were included. The mean age was 24.9±7.0 (range 16-38) years. All patients received ultraviolet A radiation for 3 min at an irradiance of 30 mW/cm(2). Patients were followed up on the first day, at 1 week and 2 weeks, and at 1 month, 3 months, 6 months and 12 months postoperatively...
January 5, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28035498/accelerated-versus-conventional-corneal-collagen-cross-linking-in-patients-with-keratoconus-an-intrapatient-comparative-study
#19
Mohammad Mehdi Sadoughi, Bahram Einollahi, Alireza Baradaran-Rafii, Danial Roshandel, Hamidreza Hasani, Mehrdad Nazeri
PURPOSE: To compare the outcomes of the conventional and accelerated corneal collagen cross-linking (CXL) in patients with bilateral progressive keratoconus (KC). METHODS: Fifteen consecutive patients with bilateral progressive KC were enrolled. In each patient, the fellow eyes were randomly assigned to the conventional CXL (3 mW/cm(2) for 30 min) or accelerated CXL (ACXL) (9 mW/cm(2) for 10 min) groups. Manifest refraction; uncorrected and corrected distant visual acuity; maximum and mean keratometry; corneal hysteresis and corneal resistance factor; endothelial cell density and morphology; central corneal thickness; and wavefront aberrations were measured before and 12 months after the CXL...
December 29, 2016: International Ophthalmology
https://www.readbyqxmd.com/read/28031696/under-flap-stromal-bed-cxl-for-early-post-lasik-ectasia-a-novel-treatment-technique
#20
Avi Wallerstein, Eser Adiguzel, Mathieu Gauvin, Nima Mohammad-Shahi, Mark Cohen
PURPOSE: Collagen cross-linking (CXL) for post-laser-assisted in situ keratomileusis (LASIK) ectasia (PLE) is traditionally performed either epi-on or epi-off on the corneal surface. This study describes a novel technique in treating early PLE with under-flap CXL (ufCXL) to the stromal bed and reports on 6-month outcomes. PATIENTS AND METHODS: Case series of seven patients (eight eyes) with topography-diagnosed early PLE treated with ufCXL. Inclusion criteria were early, mild PLE defined as new-onset postoperative manifest refraction cylinder ≤1...
2017: Clinical Ophthalmology
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