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Hany S Elsaftawy, Mansour Hassan Ahmed, Mohamed Yasser Sayed Saif, Rasha Mousa
PURPOSE: To assess the clinical outcomes after sequential surgical implantation of intracorneal ring segments and transepithelial corneal collagen cross-linking (TE-CXL) in keratoconic eyes. METHODS: In this consecutive randomized study, 40 eyes of 29 patients with progressive mild to moderate keratoconus were included and were randomly divided into two groups. Group 1 included 20 eyes that underwent Keraring implantation, and group 2 included 20 eyes that underwent Keraring insertion followed by TE-CXL 1 month later...
November 2015: Cornea
Daniel M Gore, David O'Brart, Paul French, Chris Dunsby, Bruce D Allan
PURPOSE: To measure depth-specific riboflavin concentrations in corneal stroma using two-photon fluorescence microscopy and compare commercially available transepithelial corneal collagen cross-linking (CXL) protocols. METHODS: Transepithelial CXL riboflavin preparations--MedioCross TE, Ribocross TE, Paracel plus VibeX Xtra, and iontophoresis with Ricrolin+--were applied to the corneal surface of fresh postmortem rabbit eyes in accordance with manufacturers' recommendations for clinical use...
July 2015: Investigative Ophthalmology & Visual Science
Mengmeng Wang, Fengju Zhang, Xu Zhao, Yanzheng Song, Miao Zhang
PURPOSE: The aim of this study was to evaluate riboflavin in rabbit corneas before and after corneal collagen cross-linking (CXL) using confocal laser scanning microscopy. DESIGN: A randomized controlled experimental study. METHODS: The study was divided into 3 parts. In part 1 of this study, 30 eyes from 15 rabbits were used to evaluate riboflavin in de-epithelialized corneas before standard CXL. In part 2, 12 eyes from 6 rabbits were used to compare the differences of riboflavin concentration between standard CXL and transepithelial CXL (TE-CXL)...
November 2014: Asia-Pacific Journal of Ophthalmology
Igor Knezović, Mirna Belovari Višnjić, Hrvoje Raguž
Aim. To report a case of 40-year-old male with progressive bilateral keratoconus who had undergone transepithelial phototherapeutic keratectomy (TE-PTK) and corneal collagen cross-linking (CXL) using hypoosmolar riboflavin solution in a same day procedure. Methods. Eye examination showed that UCDVA on both eyes was 0,01 according to Snellen charts, and slit lamp biomicroscopy showed paracentral diffuse intrastromal corneal haze. Anterior OCT marked stromal hyperreflective zones and localized paracentral thinning of the cornea...
2015: Case Reports in Ophthalmological Medicine
S Rossi, A Orrico, C Santamaria, V Romano, L De Rosa, F Simonelli, G De Rosa
PURPOSE: Evaluating the clinical results of trans-epithelial collagen cross-linking (CXL) and standard CXL in patients with progressive keratoconus. METHODS: This prospective study comprised 20 eyes of 20 patients with progressive keratoconus. Ten eyes were treated by standard CXL and ten by trans-epithelial cross-linking (TE-CXL, epithelium on) with 1 year of follow-up. All patients underwent complete ophthalmologic testing that included pre- and postoperative uncorrected visual acuity, corrected visual acuity, spherical error, spherical equivalent, corneal astigmatism, simulated maximum, minimum, and average keratometry, coma and spherical aberration, optical pachymetry, and endothelial cell density...
2015: Clinical Ophthalmology
Nienke Soeters, Robert P L Wisse, Daniël A Godefrooij, Saskia M Imhof, Nayyirih G Tahzib
PURPOSE: To compare the clinical effects and safety of transepithelial corneal cross-linking (CXL) to epithelium-off (epi-off) CXL in progressive keratoconus. DESIGN: Randomized clinical trial (noninferiority). METHODS: Patients received either transepithelial CXL with Ricrolin TE (n = 35) or epi-off CXL with isotonic riboflavin (n = 26) in 1 academic treatment center, using a simple unrestricted randomization procedure. The main outcome measure was clinical stabilization of keratoconus after 1 year, defined as a maximal keratometry (Kmax) increase <1 diopter (D)...
May 2015: American Journal of Ophthalmology
Z Shalchi, X Wang, M A Nanavaty
This review aims to assess the efficacy and safety of epithelial removal (ER) and transepithelial (TE) corneal collagen crosslinking (CXL) for the treatment of keratoconus. We used MEDLINE to identify all ER and TE CXL studies on keratoconic eyes (n≥20, follow-up ≥12 months). Ex vivo and studies for non-keratoconus indications or in conjunction with other procedures were excluded. Data on uncorrected (UDVA) and corrected (CDVA) distance visual acuity, refractive cylinder, maximum keratometry (Kmax), and adverse events were collected at the latest follow-up and 1 year...
January 2015: Eye
Paolo Vinciguerra, Rita Mencucci, Vito Romano, Eberhard Spoerl, Fabrizio I Camesasca, Eleonora Favuzza, Claudio Azzolini, Rodolfo Mastropasqua, Riccardo Vinciguerra
PURPOSE: To compare biomechanical effect, riboflavin penetration and distribution in transepithelial corneal collagen cross-linking with iontophoresis (I-CXL), with standard cross linking (S-CXL) and current transepithelial protocol (TE-CXL). MATERIALS AND METHODS: The study was divided into two different sections, considering, respectively, rabbit and human cadaver corneas. In both sections corneas were divided according to imbibition protocols and irradiation power...
2014: BioMed Research International
Maddalena De Bernardo, Luigi Capasso, Antonia Tortori, Michele Lanza, Luisa Caliendo, Nicola Rosa
PURPOSE: To evaluate keratoconus biomechanical changes after transepithelial corneal collagen cross linking (TE CXL) using riboflavin and ultraviolet A (UVA). SETTING: Second University of Naples, Naples, Italy. DESIGN: Prospective non comparative case series study. METHODS: Patients with progressive keratoconus were examined, before and during a 6 months follow up after TE CXL, with a Pentacam, an Ocular Response Analyzer and an IOLMaster...
December 2014: Contact Lens & Anterior Eye: the Journal of the British Contact Lens Association
I Kocak, A Aydin, F Kaya, H Koc
PURPOSE: To evaluate the safety and efficacy of transepithelial corneal collagen crosslinking (TE-CXL) as compared to epithelium-off crosslinking (epi-off CXL) in progressive keratoconus. METHODS: Records of keratoconus patients treated with TE-CXL or epi-off CXL were reviewed retrospectively. Patients were included if they had at least 12months follow-up. Pre- and postoperative measurements of visual acuity, refractive errors, keratometry, corneal topography and pachymetry were assessed and compared...
May 2014: Journal Français D'ophtalmologie
Aldo Caporossi, Cosimo Mazzotta, Anna Lucia Paradiso, Stefano Baiocchi, Davide Marigliani, Tomaso Caporossi
PURPOSE: To assess the clinical results of transepithelial collagen crosslinking (CXL) in patients 26 years and younger with progressive keratoconus suitable for epithelium-off (epi-off) CXL. SETTING: Department of Ophthalmology, Siena University Hospital, Siena, Italy. DESIGN: Prospective case series. METHODS: The study included 26 eyes (26 patients) treated by transepithelial (epithelium-on) CXL. The mean age was 22 years (range 11 to 26 years) (10 younger than 18 years; 16 between 19 years and 26 years)...
August 2013: Journal of Cataract and Refractive Surgery
Adriano Magli, Raimondo Forte, Achille Tortori, Luigi Capasso, Giovanni Marsico, Elena Piozzi
PURPOSE: To compare efficiency and safety of epithelium-off corneal cross-linking (CXL) and transepithelial cross-linking (TE-CXL) in pediatric patients with progressive keratoconus. METHODS: Uncorrected and corrected visual acuity, corneal topography and pachymetry (Pentacam; Oculus Pentacam), and in vivo confocal microscopy (HRT II, Rostock Cornea Module, Heidelberg Engineering, Heidelberg, Germany) were evaluated at baseline and at 3, 6, and 12 months. RESULTS: In the epithelium-off CXL group (19 patients, 23 eyes; mean age, 14...
May 2013: Cornea
Massimo Filippello, Edoardo Stagni, Donato Buccoliero, Vincenza Bonfiglio, Teresio Avitabile
PURPOSE: To analyze the modifications of the corneal layers after transepithelial (TE) corneal cross-linking (CXL). METHODS: Twenty eyes of 20 patients with progressive keratoconus were treated with TE-CXL (without epithelium debridement), and their corneas analyzed at different times, up to 18 months, by confocal microscopy using a Nidek Confoscan 4. RESULTS: The epithelial layer, after an initial disorganization due to the TE technique, returned to a normal state after 2 weeks...
October 2012: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Aldo Caporossi, Cosimo Mazzotta, Stefano Baiocchi, Tomaso Caporossi, Anna Lucia Paradiso
PURPOSE: This was a qualitative investigation of corneal microstructural modifications in keratoconic patients undergoing experimental transepithelial crosslinking (TE CXL). METHODS: Ten patients with keratoconus intolerant to gas-permeable rigid contact lenses were enrolled. Corneal thickness was in the range 350-390 µm at the thinnest point measured by Visante AC optical coherence tomography system (Zeiss, Jena, Germany). All patients underwent TE CXL with 0...
2012: European Journal of Ophthalmology
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