Corneal Collagen Cross-Linking for Ectasia After Excimer Laser Refractive Surgery: 1-Year Results

Vinciguerra, Paolo; Camesasca, Fabrizio I.; Albè, Elena; Trazza, Silvia

doi:10.3928/1081597x-20090910-02

Cited by 109 publications

(78 citation statements)

References 35 publications

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“…Several small, prospective clinical studies have evaluated CXL for PLE and found that visual acuity and keratometric measures either significantly stabilized or improved. All those studies had only 1 year of follow-up [144,145,146,147]. A retrospective study evaluated 26 eyes with PLE (23 eyes) and with ectasia after PRK (3 eyes) during a 2-year follow-up period.…”

Section: Resultsmentioning

confidence: 99%

Corneal Collagen Crosslinking: A Systematic Review

Sorkin

Varssano²

2014

Ophthalmologica

166

122

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Keratoconus (KCN) is an ectatic disorder with progressive corneal thinning and a clinical picture of corneal protrusion, progressive irregular astigmatism, corneal fibrosis and visual deterioration. Other ectatic corneal disorders include: post-LASIK ectasia (PLE) and pellucid marginal degeneration (PMD). Corneal crosslinking (CXL) is a procedure whereby riboflavin sensitization with ultraviolet A radiation induces stromal crosslinks. This alters corneal biomechanics, causing an increase in corneal stiffness. In recent years, CXL has been an established treatment for the arrest of KCN, PLE and PMD progression. CXL has also been shown to be effective in the treatment of corneal infections, chemical burns, bullous keratopathy and other forms of corneal edema. This is a current review of CXL - its biomechanical principles, the evolution of CXL protocols in the past, present and future, indications for treatment, treatment efficacy and safety.

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Section: Resultsmentioning

confidence: 99%

Corneal Collagen Crosslinking: A Systematic Review

Sorkin

Varssano²

2014

Ophthalmologica

166

122

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“…In the entire study group, the improvements in CDVA and maximum keratometry after CXL treatment were in agreement with the previous studies. 9,10,[18][19][20] In the current literature, a small number of studies investigated the effects of preoperative patient characteristics on outcomes of CXL treatment. Koller et al 21 evaluated the effects of maximum K, preoperative CDVA, and age on complication and failure rates of CXL treatment for primary keratectasia.…”

Section: Eyementioning

confidence: 99%

Factors affecting outcomes of corneal collagen crosslinking treatment

Toprak

Yaylalı

Yıldırım

2013

Eye

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Purpose To assess the effects of preoperative patient characteristics on clinical outcomes of corneal crosslinking (CXL) treatment in patients with progressive keratoconus. Methods This retrospective study comprised 96 eyes of 96 patients who had unilateral CXL treatment for progressive keratoconus. All patients underwent a complete ophthalmological examination and corneal topography at baseline and 1 year. Subgroup analyses were performed according to the age (o30 andZ30 years), gender, preoperative corrected distance visual acuity (CDVA, o0.3 and Z0.3 logMAR (log of the minimum angle of resolution)), preoperative maximum keratometry (K, o54 and Z54 D), baseline topographic cone location (central, paracentral, and peripheral), and preoperative thinnest pachymetry (o450 and Z450 mm) to determine the associations between preoperative patient characteristics and outcomes (changes in visual acuity and maximum keratometry) of CXL treatment. Results In the entire study population, mean CDVA and maximum K significantly improved after CXL treatment (Po0.001). Patients with a preoperative CDVA of 20/40 Snellen equivalent or worse (Z0.3 logMAR) experienced more visual improvement after CXL treatment (Po0.001). However, an age Z30 years and a baseline thinnest pachymetry less than 450 mm were found significantly associated with more flattening in maximum keratometry (P ¼ 0.024, P ¼ 0.005 respectively). Gender, preoperative maximum K, and baseline topographic cone location did not show significant effect on postoperative visual acuity and maximum keratometry (P40.05). Conclusions In patients with progressive keratoconus, age, baseline visual acuity, and baseline thinnest pachymetry seem to affect the success of the CXL treatment.

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“…As for the treatment of ectasia after LASIK, Hafezi et al [3 ]reported a series of 10 eyes with 25 months of follow-up in which there was a reduction in Kmax at 12 months in all cases and an improvement of CDVA in 40% of the cases. Good results were also observed by Vinciguerra et al [14]. However, the role of CXL alone in improving the visual function was limited while the effectiveness of halting the progression process has been demonstrated.…”

Section: Discussionmentioning

confidence: 73%

Corneal Collagen Crosslinking Combined with Phototherapeutic Keratectomy and Photorefractive Keratectomy for Corneal Ectasia after Laser in situ Keratomileusis

Zhu

Han²,

Cui³

et al. 2018

Ophthalmic Res

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Purpose: The aim of this study was to analyze the effects of corneal crosslinking (CXL) combined with phototherapeutic keratectomy (PTK) and photorefractive keratectomy (PRK) in halting the progression and improving the visual function of corneal ectasia after laser in situ keratomileusis (LASIK). Methods: PTK-PRK-CXL was performed on 14 eyes of 14 patients who developed corneal ectasia after LASIK. The visual acuity, spherical refraction and cylinder, corneal topography indices, thinnest corneal thickness (TCT), and endothelial cell count were evaluated at baseline and at 1, 3, 6, and 12 months postoperatively. Results: The mean uncorrected visual acuity improved significantly from 0.64 ± 0.36 logMAR preoperatively to 0.19 ± 0.12 logMAR at 12 months of follow-up (p < 0.001), while the mean best corrected visual acuity improved from 0.21 ± 0.14 logMAR at baseline to 0.04 ± 0.10 logMAR at 12 months postoperatively (p < 0.001). A significant decrease was observed in Kmax and Kmean values from 52.51 ± 6.74 and 43.55 ± 3.37 D at baseline to 45.72 ± 5.18 (p < 0.001) and 40.60 ± 3.05 D (p < 0.001) at the 1-year follow-up. The mean TCT decreased significantly from 419.07 ± 36.56 µm before treatment to 320.93 ± 39.78 µm at 12 months of follow-up (p < 0.001), and there was no significant endothelial cell loss (p > 0.05) beyond 6 months after treatment. Conclusion: PTK-PRK-CXL is a promising procedure to halt the progression of post-LASIK keratectasia with significant visual quality improvement.

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Corneal Collagen Cross-Linking for Ectasia After Excimer Laser Refractive Surgery: 1-Year Results

Abstract: One year after surgery, CXL appears to stabilize eyes with ectasia consequent to excimer laser refractive surgery and improve BSCVA.

Cited by 109 publications

References 35 publications

Corneal Collagen Crosslinking: A Systematic Review

Corneal Collagen Crosslinking: A Systematic Review

Factors affecting outcomes of corneal collagen crosslinking treatment

Corneal Collagen Crosslinking Combined with Phototherapeutic Keratectomy and Photorefractive Keratectomy for Corneal Ectasia after Laser in situ Keratomileusis

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