Corneal cross-linking

Randleman, J. Bradley; Khandelwal, Sumitra; Hafezi, Farhad

doi:10.1016/j.survophthal.2015.04.002

Cited by 164 publications

(129 citation statements)

References 161 publications

(127 reference statements)

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…Diseases such as keratoconus can pathologically degenerate the cornea, and its shape causing degraded vision or even complete vision loss (Gore et al, 2014; Ortiz-Toquero et al, 2015; Sahebjada et al, 2014). Therapeutic interventions such as LASIK surgeries or UV-A/riboflavin corneal collagen crosslinking (CXL) can also alter corneal biomechanical properties (Randleman et al, 2015; Richoz et al, 2013; Wollensak et al, 2003a). Therefore, assessing corneal biomechanical properties can provide crucial information for assessing corneal health and integrity as well as evaluating the efficacy of therapeutic interventions, particularly those aimed at altering corneal biomechanical properties such as CXL.…”

Section: Introductionmentioning

confidence: 99%

Optical coherence elastography assessment of corneal viscoelasticity with a modified Rayleigh-Lamb wave model

Han

Singh

et al. 2017

Journal of the Mechanical Behavior of Biomedical Materials

107

View full text Add to dashboard Cite

The biomechanical properties of the cornea play a critical role in forming vision. Diseases such as keratoconus can structurally degenerate the cornea causing a pathological loss in visual acuity. UV-A/riboflavin corneal collagen crosslinking (CXL) is a clinically available treatment to stiffen the cornea and restore its healthy shape and function. However, current CXL techniques do not account for pre-existing biomechanical properties of the cornea nor the effects of the CXL treatment itself. In addition to the inherent corneal structure, the intraocular pressure (IOP) can also dramatically affect the measured biomechanical properties of the cornea. In this work, we present the details and development of a modified Rayleigh-Lamb frequency equation model for quantifying corneal biomechanical properties. After comparison with finite element modeling, the model was utilized to quantify the viscoelasticity of in situ porcine corneas in the whole eye-globe configuration before and after CXL based on noncontact optical coherence elastography measurements. Moreover, the viscoelasticity of the untreated and CXL-treated eyes was quantified at various IOPs. The results showed that the stiffness of the cornea increased after CXL and that corneal stiffness is close to linear as a function of IOP. These results show that the modified Rayleigh-Lamb wave model can provide an accurate assessment of corneal viscoelasticity, which could be used for customized CXL therapies.

show abstract

Section: Introductionmentioning

confidence: 99%

Optical coherence elastography assessment of corneal viscoelasticity with a modified Rayleigh-Lamb wave model

Han

Singh

et al. 2017

Journal of the Mechanical Behavior of Biomedical Materials

107

View full text Add to dashboard Cite

show abstract

“…(3) Since then, various prospective studies have echoed the same results in patients with keratoconus (4)(5)(6) and corneal ectasia after refractive surgery (from now on referred to as "ectasia"). (7) The objective of this review is to determine the indications of the surgery which promotes new covalent bonds among corneal collagen fibers, known as Cross-Linking (CXL), and to clarify its aims.…”

mentioning

confidence: 81%

“…Other noncomparative studies corroborate the findings of interrupted progression and apparent safety of the treatment. (3)(4)(5)(6)(7)12,(21)(22)(23)(24)(25)(26)(27) Considering that keratoconus generally begins in the second decade of life and has a progressive nature, pediatric patients may benefit from treatment with CXL. (28) Recent studies confirm the treatment's effectiveness, as well as the significant improvement of topographic features and visual acuity.…”

Section: Scientific Evidence Of Treatment Effectivenessmentioning

confidence: 99%

Corneal Crosslinking: The Standard Protocol

Santhiago¹

2017

Revista Brasileira De Oftalmologia

View full text Add to dashboard Cite

RESUMOO objetivo desta revisão é de determinar as indicações e eficácia da cirurgia que promove novas ligações covalentes entre as fibras de colágeno da córnea, conhecida como Cross-Linking (CXL), assim como esclarecer seus objetivos. O ceratocone é uma doença ectasica da córnea, bilateral, assimétrica, que, principalmente, cursa com encurvamento e afinamentos progressivo, e se inicia em geral na segunda década de vida. O uso primário do CXL tem sido na interrupção da progressão do Ceratocone. Apesar do conhecido encurvamento no estroma da córnea ocorrer nesses pacientes, a fisiopatologia por trás do ceratocone ainda é desconhecida e parece ser multifatorial. Pela evidencia literária disponível até o momento, o CXL da córnea esta, portanto indicado nos pacientes com doença em progressão. Concluímos que existe evidencia suficiente para afirmar que o CXL da córnea é eficaz na estabilização da doença ectásica da cornea.Descritores: Córnea/fisiologia; Córnea/metabolismo; Cross-linking reagentes; Ceratocone/terapia; Riblflavina/administração & dosagem; Protocolos ABSTRACT The purpose of this review is to determine the indications and efficacy of the surgery that promotes new covalent bonds between the collagen fibers of the cornea, known as Cross-Linking (CXL), as well as to clarify its objectives. Keratoconus is a bilateral, asymmetric ectasic disease of the cornea that mainly courses with steepening and progressive thinning, and usually begins in the second decade of life.The primary use of CXL has been in discontinuing the progression of keratoconus. Although known corneal stromal remodeling occurs in these patients, the pathophysiology behind keratoconus is still unknown and appears to be multifactorial. By the literary evidence available to date, the CXL of the cornea is safely indicated in patients with progressing disease. We conclude that there is sufficient evidence to affirm that cornea CXL is effective in stabilizing corneal ectasic disease.

show abstract

“…Corneal cross-linking (CXL) has been the treatment of choice in preventing the progression of keratoconus over the last decade [24]. In children, the progression pattern of keratoconus is more aggressive than in adults, and hence this procedure is now strongly indicated for pediatric keratoconus [25].…”

Section: Keratoconusmentioning

confidence: 99%