Vectorial Astigmatic Changes after Corneal Collagen Crosslinking in Keratoconic Corneas Previously Treated with Intracorneal Ring Segments: A Preliminary Study

Piñero, David P.; Alió, Jorge L.; Klonowski, Pawel; Toffaha, Bader T

doi:10.5301/ejo.5000063

Cited by 20 publications

(14 citation statements)

References 37 publications

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“…In addition to halting the ectatic process [22][23][24], CXL results in decrease of corneal curvature irregularity, manifested as central anterior corneal flattening [25,26]. In other words, the overall increase in corneal biomechanics (the stiffening effect over the entire cornea) is invariably accompanied by corneal curvature reduction [27][28][29][30][31].…”

Section: Corneal Collagen Cross-linking For Presbyopia: a Novel Approachmentioning

confidence: 99%

Presbyopic PiXL Cross-Linking

Kanellopoulos

Asimellis

2015

Curr Ophthalmol Rep

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We describe principles and initial clinical findings regarding a novel application of topographically customized collagen cross-linking (CXL) aiming to achieve a modest, nevertheless predictable hyperopic and presbyopic refractive changes. CXL is implemented in a specific, annular section mid-peripherally, employing differential response and biomechanical change, inducing central corneal steepening and asphericity changes. Efficacy, safety, and predictability of this procedure are also presented. This non-laser, minimally invasive technique may be applied either with epithelial removal, offering a more stable result or with a purely non-ablative and non-incisional approach, offering a minimally invasive alternative.

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Section: Corneal Collagen Cross-linking For Presbyopia: a Novel Approachmentioning

confidence: 99%

Presbyopic PiXL Cross-Linking

Kanellopoulos

Asimellis

2015

Curr Ophthalmol Rep

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“…[24][25][26][27][28][29][30][31][32] In a retrospective nonrandomized comparative case series by Chan and Sharma, 25 12 eyes (9 patients) underwent inferior-segment Intacs placement without CXL and 13 eyes (12 patients) underwent inferior-segment Intacs placement followed by CXL with UV light and riboflavin. Previous studies reported that combining these two complementary interventions has been shown to be safe and effective.…”

Section: Combination Treatment Of Corneal Crosslinking and Intracornementioning

confidence: 99%

Cross-Linking and Intracorneal Ring Segments—Review of the Literature

Avni-Zauberman

Rootman

2014

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“…Collagen cross-linking has been used for many years as a means of stabilizing cornea ectasia 1–5. Although a multitude of treatments and techniques are available, it has been well documented that the procedure almost invariably results in some central anterior corneal flattening,1–5 which has often been interpreted as “disease regression.” As our understanding and the technology available for collagen cross-linking has progressed, it has been theorized that differential application of collagen cross-linking in specific areas of the cornea may produce predictable refractive changes.…”

Section: Introductionmentioning

confidence: 99%

Novel myopic refractive correction with transepithelial very high-fluence collagen cross-linking applied in a customized pattern: early clinical results of a feasibility study

Kanellopoulos¹

2014

OPTH

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BackgroundThe purpose of this study is to report the safety and efficacy of a new application of collagen cross-linking using a novel device to achieve predictable refractive myopic changes in virgin corneas.MethodsFour cases were treated with a novel device employing very high-fluence collagen cross-linking applied in a myopic pattern. Prior to treatment, riboflavin solution was applied to the intact epithelium. The collagen cross-linking device was then engaged for a total of 12 J/cm2, to be applied transepithelially in a predetermined pattern. Cornea clarity, corneal keratometry, and corneal topography were evaluated by both Placido disc and Scheimpflug imaging, along with cornea anterior segment optical coherence tomography and endothelial cell counts.ResultsAn average of 2.3 diopters was achieved in the first week in all four cases treated with the very high-fluence myopic collagen cross-linking intervention. There was a slight regression to 1.44 diopters at 1 month, which remained stable at 6-month follow-up. The mean keratometry change was from 44.90 diopters to 43.46 diopters. There was no significant change in endothelial cell counts or corneal clarity. There was some mild change in epithelial thickness distribution, with the treated area showing a slight but homogeneous reduction in mean thickness from 52 μm to 44 μm.ConclusionThis report describes the novel application of very high-fluence collagen cross-linking with a predictable well defined myopic refractive (flattening) corneal effect. This technique has the advantages of essentially no postoperative morbidity, immediate visual rehabilitation, and the potential for tapering until the desired result is achieved.

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Vectorial Astigmatic Changes after Corneal Collagen Crosslinking in Keratoconic Corneas Previously Treated with Intracorneal Ring Segments: A Preliminary Study

Abstract: Crosslinking is able to induce a corneal astigmatic change, but it is variable, not predictable, and insufficient to provide an effective astigmatic correction.

Cited by 20 publications

References 37 publications

Presbyopic PiXL Cross-Linking

Presbyopic PiXL Cross-Linking

Cross-Linking and Intracorneal Ring Segments—Review of the Literature

Novel myopic refractive correction with transepithelial very high-fluence collagen cross-linking applied in a customized pattern: early clinical results of a feasibility study

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