Additive Effect of Repeated Corneal Collagen Cross-linking in Keratoconus

Hafezi, Farhad; Tabibian, David; Richoz, Olivier

doi:10.3928/1081597x-20140903-03

Cited by 19 publications

(11 citation statements)

References 10 publications

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“…In an adult patient, retreatment resulted in further 4 D of flattening in Kmax over a period of 2 years. 105 In a recently published series of 62 eyes of pediatric patients, two children showed progression up to 3.2 D in Kmax by the 36-month follow up visit, requiring retreatment. Both patients experienced stabilization of Kmax values 12 months after retreatment.…”

Section: Outcomes Of Pediatric Cross-linkingmentioning

confidence: 97%

Corneal Cross-Linking for Pediatric Keratcoconus Review

Perez-Straziota

Gaster

Rabinowitz

2018

Cornea

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Studies of cross-linking in pediatric patients are sparse, with relatively short follow-up times, and mostly on small groups of patients. Treatment with cross-linking halts progression of keratoconus in the pediatric population, and early treatment seems to be cost-effective compared with later penetrating keratoplasty. Long-term effects and regression rates remain unclear, and further studies are needed in this population.

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Section: Outcomes Of Pediatric Cross-linkingmentioning

confidence: 97%

Corneal Cross-Linking for Pediatric Keratcoconus Review

Perez-Straziota

Gaster

Rabinowitz

2018

Cornea

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“…The results obtained are further encouraging in light of the evidence that inadequate cross-linking effect can be augmented by further treatment. 24 Thus, it becomes increasingly important to produce a cross-linking treatment characterized by minimal risk and maximal compliance.…”

Section: Discussionmentioning

confidence: 99%

Transepithelial Corneal Cross-Linking With Vitamin E-Enhanced Riboflavin Solution and Abbreviated, Low-Dose UV-A

Caruso

Ostacolo

Epstein

et al. 2016

Cornea

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Purpose:To report the clinical outcomes with 24-month follow-up of transepithelial cross-linking using a combination of a d-alpha-tocopheryl polyethylene-glycol 1000 succinate (vitamin E-TPGS)-enhanced riboflavin solution and abbreviated low fluence UV-A treatment.Methods:In a nonrandomized clinical trial, 25 corneas of 19 patients with topographically proven, progressive, mild to moderate keratoconus over the previous 6 months were cross-linked, and all patients were examined at 1, 3, 6, 12, and 24 months. The treatments were performed using a patented solution of riboflavin and vitamin E-TPGS, topically applied for 15 minutes, followed by two 5-minute UV-A treatments with separate doses both at fluence below 3 mW/cm2 that were based on preoperative central pachymetry.Results:During the 6-month pretreatment observation, the average Kmax increased by +1.99 ± 0.29 D (diopter). Postoperatively, the average Kmax decreased, changing by −0.55 ± 0.94 D, by −0.88 ± 1.02 D and by −1.01 ± 1.22 D at 6, 12, and 24 months. Postoperatively, Kmax decreased in 19, 20, and 20 of the 25 eyes at 6 months, 12 months, and 24 months, respectively. Refractive cylinder was decreased by 3 months postoperatively and afterward, changing by −1.35 ± 0.69 D at 24 months. Best spectacle-corrected visual acuity (BSCVA) improved at 6, 12, and 24 months, including an improvement of −0.19 ± 0.13 logarithm of the minimum angle of resolution units at 24 months. There was no reduction in endothelial cell count. No corneal abrasions occurred, and no bandage contact lenses or prescription analgesics were used during postoperative recovery.Conclusions:Transepithelial cross-linking using the riboflavin-vitamin E solution and brief, low-dose, pachymetry-dependent UV-A treatment safely stopped keratoconus progression.

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“…On the other hand, failure and progression of keratectasia after primary CXL have also been reported [7,8]. Although the definition and criteria of progression after CXL has been reported [9], a series of studies [10][11][12][13] revealed diverse signs of deterioration after CXL, including tomographic progression, worse ocular refractive status, and even morphological alteration observed by anterior segment optical coherence tomography or in vivo confocal microscopy. Whether repeated CXL should be performed to manage keratoconus progression needs more elucidation.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of repeated crosslinking assisted by transepithelial double-cycle iontophoresis in keratoconus progression after primary corneal crosslinking

Luo

et al. 2021

Eye

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Objectives To evaluate the safety and efficacy of repeated corneal collagen crosslinking assisted by transepithelial double-cycle iontophoresis (DI-CXL) in the management of keratoconus progression after primary CXL. Methods A retrospective analysis was conducted in the patients who underwent repeated CXL between 2016 and 2018. These patients were treated with DI-CXL if keratoconus progression was confirmed after primary CXL. Scoring of ocular pain and corneal epithelial damage, visual acuity, corneal tomography, in vivo corneal confocal microscopy (IVCM) was performed before and at 3, 6, 12, and 24 months after DI-CXL. Results Overall, 21 eyes of 12 patients (mean age 17.3 ± 1.9 years) were included in this study. Before DI-CXL, an average increase of 4.26 D in Kmax was detected in these patients with a mean follow-up interval of (23.0 ± 13.7) months. After DI-CXL, corneal epithelial damage rapidly recovered within days. Visual acuity remained unchanged with follow-up of 24 months. When compared to baseline, significant decreases were observed in Kmax (at 3 months) and K2 (at 3 and 6 months) after DI-CXL. Corneal thickness of thinnest point significantly decreased at 3 months postoperatively. When compared to baseline, no significant differences were found in any of the refractive or tomographic parameters at 12 and 24 months. IVCM revealed trabecular patterned hyperdense tissues after DI-CXL in the anterior stroma at the depth of 200 μm or more. No corneal infiltration or persistent epithelial defect was recorded after DI-CXL. Conclusion DI-CXL is safe and effective as a good alternative in stabilizing keratoconus progression after primary CXL.

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Additive Effect of Repeated Corneal Collagen Cross-linking in Keratoconus

Cited by 19 publications

References 10 publications

Corneal Cross-Linking for Pediatric Keratcoconus Review

Corneal Cross-Linking for Pediatric Keratcoconus Review

Transepithelial Corneal Cross-Linking With Vitamin E-Enhanced Riboflavin Solution and Abbreviated, Low-Dose UV-A

Safety and efficacy of repeated crosslinking assisted by transepithelial double-cycle iontophoresis in keratoconus progression after primary corneal crosslinking

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