Accelerated versus standard corneal collagen cross-linking in pediatric keratoconus patients: 24 months follow-up results

Saraç, Özge; Çağlayan, Mehtap; Uysal, Betül Seher; Uzel, Ayşe Güzin Taşlıpınar; Tanriverdi, Burak; Çağıl, Nurullah

doi:10.1016/j.clae.2018.06.001

Cited by 45 publications

(67 citation statements)

References 33 publications

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“…They found non-significant changes in UDVA, CDVA, keratometry, pachymetry and posterior elevation. Similar results were also published by Sarac et al 25 for up to 2 years postoperatively.…”

Section: Discussionsupporting

confidence: 90%

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Long-Term Visual, Refractive and Topographic Outcomes of “Epi-off” Corneal Collagen Cross-Linking in Pediatric Keratoconus: Standard versus Accelerated Protocol

Amer¹,

Elaskary²,

Mostafa³

et al. 2020

OPTH

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Purpose To compare the visual, refractive and topographic outcomes of standard and accelerated corneal collagen cross-linking (CXL) in pediatric keratoconus patients. Methods Prospective, comparative observational study on 68 eyes of 35 pediatric keratoconus patients (<18 years). Patients were classified into two groups, group (I) included 34 eyes and received standard “Epi-Off” CXL (3 mW/cm 2 , 30 min.) and group (II) included 34 eyes and received accelerated “Epi-Off” CXL (9 mW/cm 2 , 10 min.). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), simulated keratometry (Sim K-1, Sim K-2, K-max, K-mean), cylindrical (CYL), pachymetry and Q-value were evaluated preoperatively and for 3 years postoperatively. Results Postoperative UDVA and CDVA did not significantly change in both groups after 3 years. Postoperative SE was increased significantly in accelerated CXL (p=0.012) with no significant change in the postoperative cylinder in both procedures. Standard CXL had greater “significant” effect in decreasing Sim K-1, K-max and K-mean. The mean reduction in postoperative corneal pachymetry (at thinnest location) was significant in standard CXL (18.4 μm) (p=0.001). No significant change was noticed in postoperative Q-value. Conclusion Standard and accelerated CXL protocols are efficient in pediatric keratoconus management with better outcomes in the standard procedure.

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“…They found non-significant changes in UDVA, CDVA, keratometry, pachymetry and posterior elevation. Similar results were also published by Sarac et al 25 for up to 2 years postoperatively.…”

Section: Discussionsupporting

confidence: 90%

“…To our knowledge, few studies have compared the effectiveness of these two protocols in pediatric patients. 24 , 25 …”

Section: Discussionmentioning

confidence: 99%

Long-Term Visual, Refractive and Topographic Outcomes of “Epi-off” Corneal Collagen Cross-Linking in Pediatric Keratoconus: Standard versus Accelerated Protocol

Amer¹,

Elaskary²,

Mostafa³

et al. 2020

OPTH

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“…They also noted that the flattening effect of crosslinking was reduced with higher irradiation and shorter treatment duration [23]. Few other studies have reported a decrease in the spherical equivalent and cylinder error in both accelerated and conventional crosslinking, but with no significant difference between the 2 groups [24][25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of safety and efficacy of different protocols of collagen cross linking for keratoconus

Singh¹,

Taneja²,

Murthy³

et al. 2020

rjo

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Introduction: Collagen cross-linking is a well-established modality that could stop the keratoconus from progressing. Off late, newer protocols have been suggested for progressive keratoconus, which include the use of hypoosmolar riboflavin for thinner corneas and the use of accelerated CXL protocol to reduce the effective treatment time. Objective: To assess the safety and efficacy of different protocols of conventional CXL, hypoosmolar CXL and accelerated CXL in patients with keratoconus. Materials & methods: It was a prospective, interventional study with minimum of 12 months follow-up. Patients were divided into 3 groups; conventional CXL, CXL using hypotonic riboflavin and accelerated CXL group. Primary outcome measures - For efficacy, Sim Kmax and Sim Kmin (Progression (Kmax > +1 D), stabilization (Kmax +1 D to -1 D) and regression (Kmax > -1 D). For safety - endothelial count evaluation (decrease >10% amounted to compromise the safety of the procedure). Secondary outcome measures - BCVA and adverse events. Results: 32 eyes underwent isotonic CXL treatment. Pre-treatment and post-treatment BCVA were 0.16 +/- 0.15 and 0.10 +/- 0.11 log MAR; specular counts 2782.81 +/- 307.25 (cells/ mm2) and 2708.5 +/- 263.27 (cells/ mm2) (p=0.05); KMax values 55.31 +/- 4.12 D and 53.9 +/- 3.77 D (p=0.0001). 16 eyes underwent hypotonic CXL treatment. Pre-treatment and post-treatment BCVA were 0.15 +/- 0.13 log MAR and 0.14 +/- 0.14; specular count 2701.19 +/- 243.25 (cells/ mm2) and 2713.5 +/- 369 (cells/ mm2) (p= 1) and KMax values 54.74 +/- 7.44 D and 52.74 +/- 6.76 D (p = 0.002). 15 eyes underwent accelerated CXL treatment. Pre-treatment and post-treatment BCVA were 0.16 +/- 0.15 and 0.10 +/- 0.12 log MAR; specular counts 2967.53 +/- 356.48 and 2893.07 +/- 336.55 (cells/ mm2) (p = 0.78) and KMax values 55.19 +/- 5.46 D and 54.24 +/- 5.33 D (p = 0.337). Conclusion: All three protocols appeared safe and efficacious as therapeutic regimen for progressive keratoconus.

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“…Sarac et al17 compared the 2-year results of accelerated and standard cross-linking in children with keratoconus and concluded that the 2 procedures have similar efficacy and safety and recommended the accelerated technique, being rapid, for this group of patients.…”

Section: Discussionmentioning

confidence: 99%

Intrastromal Corneal Ring Segments Implantation And Corneal Cross-Linking For Keratoconus In Children With Vernal Keratoconjunctivitis – Three-Year Results

Abozaid

Hassan

Abdalla

2019

OPTH

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PurposeTo assess the 3-year safety and efficacy of femtosecond laser-assisted intrastromal corneal ring segments' (ICRS) implantation followed or accompanied by transepithelial accelerated corneal collagen cross-linking (TE-ACXL) as a treatment of keratoconus in children with vernal keratoconjunctivitis (VKC).Patients and methodsFifty two eyes of 28 children with keratoconus and vernal VKC were included in this study. Cases were divided into 2 groups; the first group had been treated with femtosecond laser-assisted ICRS (Keraring) implantation accompanied or followed by TE-ACXL, while the second group had been treated by TE-ACXL only and all cases completed a follow-up period of 3 years.ResultsIn group 1: the mean uncorrected (UCVA) and best-corrected (BCVA) visual acuity, spherical equivalent, K-max and Q-value improved markedly from 0.97 ± 0.19, 0.67 ± 0.18, −8.75 ± 4.55, 60.41 ± 4.98, and −1.18 ± 0.54 preoperatively to 0.61 ± 0.27, 0.39±0.21, −3.25 ± 3.56, 55.22 ± 5.72, and −0.44 ± 0.68 postoperatively respectively. While in group 2: the preoperative mean UCVA, BCVA, spherical equivalent, K-max and Q-values were 0.68 ± 0.28, 0.38 ± 0.24, −2.84 ± 2.59, 50.29 ± 4.04, and-0.58 ± 0.23 respectively while their corresponding postoperative values were 0.58 ± 0.34, 0.19 ± 0.17, −2.35 ± 2.07, 49.58 ± 3.26, and −0.57 ± 0.25. Only one case in group 1 required repeat cross-linking.ConclusionAlthough the long-term safety and efficacy of femtosecond laser-assisted ICRS implantation accompanied or followed by TE-ACXL in children with keratoconus and VKC is high, some cases still may need repeat cross-linking.

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Accelerated versus standard corneal collagen cross-linking in pediatric keratoconus patients: 24 months follow-up results

Cited by 45 publications

References 33 publications

<p>Long-Term Visual, Refractive and Topographic Outcomes of “Epi-off” Corneal Collagen Cross-Linking in Pediatric Keratoconus: Standard versus Accelerated Protocol</p>

<p>Long-Term Visual, Refractive and Topographic Outcomes of “Epi-off” Corneal Collagen Cross-Linking in Pediatric Keratoconus: Standard versus Accelerated Protocol</p>

Evaluation of safety and efficacy of different protocols of collagen cross linking for keratoconus

<p>Intrastromal Corneal Ring Segments Implantation And Corneal Cross-Linking For Keratoconus In Children With Vernal Keratoconjunctivitis – Three-Year Results</p>

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