Combined Corneal Cross Linking and Other Procedures: Indications and Application Models

Cummings, Arthur; Sinjab, Mazen; Hatch, Kathryn M; Talamo, Jonathan H.; Randleman, Bradley; Kanellopoulos, Anastasios John; Asimellis, George; Sakla, Hani F.; Altroudi, Wassim; Rabinowitz, Yaron S.; Kılıç, Aylin; Rubinfeld, Roy S.; Ambrósio, Renato; El-Kateb, Mohamed; DeVore, Dale P.; Ross, Michael A.; Woolfson, Bruce H. De; Dryjski, Olivia; Stulting, R. Doyle

doi:10.1007/978-3-319-39775-7_4

Cited by 4 publications

(4 citation statements)

References 280 publications

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“…During our CK pilot trials for this study, it appeared that when CK and CXL were applied sequentially in the same session, considerable regression was observed. 26 A similar effect has been reported by Cummings et al in combining another thermokeratoplasty technique (microwave) with CXL. 32 , 33 Empirically, we had determined that a 1-day delay between CK and CXL provided the most consistent VA results over time.…”

Section: Discussionsupporting

confidence: 72%

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Outcomes of Conductive Keratoplasty Combined with Corneal Crosslinking in Advanced Ectatic Corneal Disease

Sinjab¹,

Rubinfeld²,

Wagner³

et al. 2021

OPTH

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Purpose: To assess the effectiveness of a novel treatment for patients with advanced corneal ectasia and loss of visual acuity (VA). Conductive keratoplasty (CK) is performed to improve VA followed by epithelium-on (epi-on) corneal crosslinking (CXL) to stabilize the cornea after CK. Methods: Retrospective, exploratory cohort study. Patients with keratoconus or postsurgical ectasia and best spectacle-corrected distance VA (CDVA) ≤ 20/40 were included. Conductive keratoplasty was performed (ViewPoint CK System, Refractec, Inc., Bloomington, MN); followed a day later by epi-on CXL (CXLUSA/CXLO, Bethesda, MD/CXLO Encinitas, CA). Measures included uncorrected distance visual acuity (UDVA) and CDVA, as well as refractive and tomographic measures and tomographic indices. Results: Data from 50 eyes of 45 patients were analyzed. Mean follow-up was 15.1 ± 12.2 months (range: 2 to 51). Overall, UDVA and CDVA improved postoperatively. Subjective refraction and tomographic metrics did not show consistent changes, but changes in tomographic indices were associated with treatment follow-up time. At the 1-year visit, mean UDVA significantly improved over baseline (P = 0.009) by approximately 3 lines; mean CDVA improved significantly (P = 10 −5 ) by approximately 2 lines. No eye lost lines of CDVA. Change in the Index of Surface Variance (ISV) was associated with treatment, and the D-Index trended over follow-up time. Conclusion:Conductive keratoplasty with a proprietary epi-on CXL treatment improved vision in patients with advanced ectasia This CK/epi-on CXL treatment offers the possibility of improved VA for patients with compromised vision due to ectasia.

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Section: Discussionsupporting

confidence: 72%

“…Epi-on CXL was scheduled for the next day using the CXLUSA epi-on protocol. 7,23,26,27 All patients used generic polymyxin b sulfate and trimethoprim ophthalmic solution qid and generic prednisolone acetate 1% suspension qid for 3 days postoperatively as well as artificial tears as needed.…”

Section: Surgerymentioning

confidence: 99%

Outcomes of Conductive Keratoplasty Combined with Corneal Crosslinking in Advanced Ectatic Corneal Disease

Sinjab¹,

Rubinfeld²,

Wagner³

et al. 2021

OPTH

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show abstract

“…Patients may usually return to contact lens wear in 7–10 days after TE CXL compared to 1 month after epi-off CXL. [ 64 ] However, an intact epithelium poses a few challenges. Riboflavin is a hydrophilic macromolecule and has less permeability into the cornea through an intact epithelium.…”

Section: Newer Modalities and Associated Problemsmentioning

confidence: 99%

“…[ 77 ] Since risk factors for progression were found in studies using epi-off protocol, primary use of epi-on protocol in patients with thin and steep corneas was suggested. [ 64 ] Protocol modifications mentioned previously may prevent progression in thin corneas. However, progression in a patient with a very thin cornea using hypoosmolar riboflavin was reported.…”

Section: Failure/progression After CXLmentioning

confidence: 99%

Complications of corneal collagen cross-linking

Agarwal

Jain

Arora

2022

Indian Journal of Ophthalmology

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Corneal collagen cross-linking (CXL) is an effective treatment for arresting progression in patients with keratoconus. CXL was approved by United States Food and Drug Administration for the treatment of progressive keratoconus in 2016. It is a relatively safe procedure with a low complication rate. As this approach becomes more popular, it is paramount to be familiar with the potential complications associated with the procedure and its management. This article aims to report and review the complications of CXL for the treatment of keratoconus and post-LASIK ectasia.

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Corneal Collagen Cross-Linking Complications

Evangelista

Hatch

2017

Seminars in Ophthalmology

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Corneal cross-linking was approved by United States Food and Drug Administration for the treatment of progressive keratoconus in April 2016. As this approach becomes more widely used for the treatment of keratoconus and post-laser in situ keratomileusis (LASIK) ectasia, the medical community is becoming more familiar with potential complications associated with this procedure. This article aims to review the reported complications of collagen cross-linking for the treatment of keratoconus and post-LASIK ectasia.

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Combined Corneal Cross Linking and Other Procedures: Indications and Application Models

Cited by 4 publications

References 280 publications

Outcomes of Conductive Keratoplasty Combined with Corneal Crosslinking in Advanced Ectatic Corneal Disease

Outcomes of Conductive Keratoplasty Combined with Corneal Crosslinking in Advanced Ectatic Corneal Disease

Complications of corneal collagen cross-linking

Corneal Collagen Cross-Linking Complications

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