In Vivo Thermographic Analysis of the Corneal Surface in Keratoconic Patients Undergoing Riboflavin–UV-A Accelerated Cross-Linking

Mencucci, Rita; Mazzotta, Cosimo; Corvi, Andrea; Terracciano, Luca; Rechichi, Miguel; Matteoli, Sara

doi:10.1097/ico.0000000000000324

Cited by 20 publications

(13 citation statements)

References 28 publications

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“…Equally effective and accelerated protocols were introduced to shorten the duration of treatment based on Bunsen and Roscoe law of reciprocity that states, photochemical biological effect is proportional to the total energy dose delivered regardless of the applied irradiance and time. High intensity accelerated protocols such as 9mW/cm 2 for 10 minutes,18 mW/cm 2 for 5 mintes,30 mW/cm 2 for 3minutes, with a total dose of 5.4j/cm 2 and 30 mW/cm 2 for 4minuters and 45 mW/cm 2 for 2 min 40 sec with a total energy dose of 7.2j/cm 2 gave comparable results to conventional method in treatment of progressive keratoconus 18,19. We used accelerated protocol of 9mW/cm 2 for 10 minutes, total dose of 30 mW/cm 2 , 5.4j/cm 2 for UVA irradiance, unlike manufacturer guidelines of 45mwatt/cm 2 owing to max 30 mW/cm 2 limitation of our CCL-VARIO corneal cross linking device.…”

Section: Discussionmentioning

confidence: 93%

Transepithelial corneal crosslinking in treatment of progressive keratoconus: 12 months’ clinical results

Akbar¹,

Intisar-Ul-Haq²,

Ishaq³

et al. 2017

Pak J Med Sci

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Objective:The purpose of this study was to evaluate the safety and efficacy of transepithelial corneal collagen cross linking (TE-CXL) with modified riboflavin and accelerated UVA irradiance in thin corneas with pachymetry less than 400 microns at thinnest point, untreatable by epithelium off corneal collagen cross linking (CXL) in adult Pakistani population with progressive keratoconus.Methods:This quasi experimental study included twenty six eyes of 26 patients with progressive keratoconus who underwent accelerated transepithelial CXL in Armed forced institute of ophthalmology with 12 months follow up. Modified riboflavin, ParaCel ((riboflavin 0.25%, Benzalkonium chloride, EDTA, Trometamol, hydroxypropyl methylcellulose) and vibeX Xtra (riboflavin 0.25%) (Avedro, USA)) were applied to cornea in two stages. Uncorrected and Corrected Distant Visual Acuities (UDVA, CDVA), spherical equivalent (SE), astigmatism, pachymetry at thinnest point (Pachy thin), apex keratometry (Kmax), simulated and steep keratometry (Sim K, steep K) were measured at baseline and at 3, 6 and 12 months post operatively. The cornea was then exposed to accelerated UVA irradiance of 9mW/cm2 for 10 min (total dose 30 mW/cm2).Results:The mean age of the patient was 24.54±5.16 years. UDVA, CDVA, SE, astigmatism significantly improved at all postoperative test points (p=0.000, 0.004, 0.000, 0.004 respectively). Kmax and pachy thin were significantly reduced over baseline at 1 year (p=0.000, 0.004 respectively). Topographic indices Sim K and steep K did not show significant changes. No intra or post-operative complications were reported.Conclusion:Transepithelial accelerated CXL with modified riboflavin is a safe and effective procedure which halt disease progression in thin corneas with progressive keratoconus.

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Section: Discussionmentioning

confidence: 93%

Transepithelial corneal crosslinking in treatment of progressive keratoconus: 12 months’ clinical results

Akbar¹,

Intisar-Ul-Haq²,

Ishaq³

et al. 2017

Pak J Med Sci

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“…The analysis included 49 eyes from 43 patients (25 males, 18 females) with a mean age of 21.2 6 7.1 (range: [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Before the surgery, the mean corneal thickness was 404 6 18 mm, and the thickness was reduced to 360 6 24 mm after removing the epithelium.…”

Section: Resultsmentioning

confidence: 99%

“…4,7,11,12,17 Increasing the UVA intensity to 30 mW/cm 2 does not lead to any serious heat increases in the corneal surface and thermal damage to collagen fibers. 18 In this study, we performed accelerated CXL with hypoosmolar riboflavin solution throughout the entire procedure on thin keratoconic corneas. This is the first study in which a hypoosmolar riboflavin solution was used throughout the procedure.…”

Section: Discussionmentioning

confidence: 99%

Accelerated Corneal Cross-Linking With a Hypoosmolar Riboflavin Solution in Keratoconic Thin Corneas

Koç

Uzel

Koban

et al. 2016

Cornea

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“… 22 – 25 Thermography was also performed in patients with glaucoma, 26 particularly normal tension glaucoma. Furthermore, it was used to record the temperature course after glaucoma surgery 27 or other ocular surgeries, 28 , 29 for example in patients undergoing refractive surgery 25 , 30 or in patients with corneal transplant. 31 Ocular surface thermography also seems to be helpful in patients with corneal ulcer, 32 patients wearing contact lens, 33 or in patients with keratoconus wearing scleral lens.…”

Section: Discussionmentioning

confidence: 99%

Cornea Thermography: Optimal Evaluation of the Outcome and the Resulting Reproducibility

Konieczka

Schoetzau

Koch

et al. 2018

Trans. Vis. Sci. Tech.

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PurposeThe aim of the study was to establish a standardized quantitative evaluation of corneal temperature (CT) that includes anchoring reference points in the topography and minimization of artifacts. We further investigated the distribution and the short- and long-term reproducibility of the CT values, as well as the influence of the core temperatures.MethodsThe CT values in both eyes of 40 healthy subjects were measured through thermography. These examinations took place over the course of four visits within 2 consecutive weeks. At each visit, the CTs were measured twice in both eyes with intervals of 15 minutes between measurements.ResultsCT values were not significantly different between the right and left eyes and their distribution was nearly normal. The CTs increased slightly when measured twice over the 15-minute intervals (short-term reproducibility) but remained stable over a period of 2 weeks (long-term reproducibility). In addition, the CT values depended on the core temperatures.ConclusionsOcular surface thermography is a fast and noninvasive examination. The methods of optimized and standardized evaluation of the CT values facilitate comparisons and follow-ups.Translational RelevanceThermography can be used clinically and scientifically only if both the measurement and its evaluation are efficient and standardized and if the outcomes are highly reproducible.

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In Vivo Thermographic Analysis of the Corneal Surface in Keratoconic Patients Undergoing Riboflavin–UV-A Accelerated Cross-Linking

Abstract: Accelerated corneal collagen cross-linking did not cause thermal rise over the threshold of thermal injury to the corneal surface, demonstrating a safe thermal profile both at 30 mW/cm with 7.2 J and 18 mW/cm with 5.4 J energy dose.

Cited by 20 publications

References 28 publications

Transepithelial corneal crosslinking in treatment of progressive keratoconus: 12 months’ clinical results

Transepithelial corneal crosslinking in treatment of progressive keratoconus: 12 months’ clinical results

Accelerated Corneal Cross-Linking With a Hypoosmolar Riboflavin Solution in Keratoconic Thin Corneas

Cornea Thermography: Optimal Evaluation of the Outcome and the Resulting Reproducibility

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