45
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      Are you tired of sifting through news that doesn't interest you?
      Personalize your Karger newsletter today and get only the news that matters to you!

      Sign up

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Toric Topographically Customized Transepithelial, Pulsed, Very High-Fluence, Higher Energy and Higher Riboflavin Concentration Collagen Cross-Linking in Keratoconus

      case-report

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Purpose: To report a novel application of toric topographically customized transepithelial collagen cross-linking (CXL) aiming to achieve refractive astigmatic changes in a keratoconic cornea. Methods: Specially formulated riboflavin transepithelial administration and delivery of high-fluence UVA in a topographically customized pattern was applied in an eye with progressive keratoconus. Visual acuity, cornea clarity, keratometry, topography, and pachymetry with a multitude of modalities, as well as endothelial cell counts were evaluated for >6 months. Results: Uncorrected distance visual acuity changed from preoperative 20/40 to 20/25 at 6 months. A mean astigmatic reduction of 0.8 D, and significant cornea surface normalization was achieved 6 months postoperatively. There was some mild change in the epithelial distribution, with the treated area having a slight normalization in the average epithelial thickness. Conclusions: We introduce herein the novel application of a topographically customizable transepithelial CXL in progressive keratoconus in order to achieve an astigmatic refractive effect and ectasia stabilization. This novel technique offers a nonablative and nonincisional approach to treat irregular astigmatism in ectatic cornea with rapid visual rehabilitation.

          Related collections

          Most cited references20

          • Record: found
          • Abstract: found
          • Article: not found

          Corneal collagen crosslinking with riboflavin and ultraviolet A to treat induced keratectasia after laser in situ keratomileusis.

          To determine whether riboflavin and ultraviolet-A (UVA) corneal crosslinking can be used as an alternative therapy to prevent the progression of keratectasia. Institute for Refractive and Ophthalmic Surgery, Zurich, Switzerland, and a private clinic, Athens, Greece. Corneal crosslinking was performed in 10 patients with formerly undiagnosed forme fruste keratoconus or pellucid marginal corneal degeneration who had laser in situ keratomileusis (LASIK) for myopic astigmatism and subsequently developed iatrogenic keratectasia. Surgery was performed in 1 eye per patient. Crosslinking induced by riboflavin and UVA arrested and/or partially reversed keratectasia over a postoperative follow-up of up to 25 months as demonstrated by preoperative and postoperative corneal topography and a reduction in maximum keratometric readings. Riboflavin-UVA corneal crosslinking increased the biomechanical stability of the cornea and may thus be a therapeutic means to arrest and partially reverse the progression of LASIK-induced iatrogenic keratectasia.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Corneal topography indices after corneal collagen crosslinking for keratoconus and corneal ectasia: one-year results.

            To evaluate changes in corneal topography indices after corneal collagen crosslinking (CXL) in patients with keratoconus and corneal ectasia and analyze associations of these changes with visual acuity. Cornea and refractive surgery subspecialty practice. Prospective randomized controlled clinical trial. Corneal collagen crosslinking was performed in eyes with keratoconus or ectasia. Quantitative descriptors of corneal topography were measured with the Pentacam topographer and included 7 indices: index of surface variance, index of vertical asymmetry, keratoconus index, central keratoconus index, minimum radius of curvature, index of height asymmetry, and index of height decentration. Follow-up was 1 year. The study comprised 71 eyes, 49 with keratoconus and 22 with post-LASIK ectasia. In the entire patient cohort, there were significant improvements in the index of surface variance, index of vertical asymmetry, keratoconus index, and minimum radius of curvature at 1 year compared with baseline (all P < .001). There were no significant differences between the keratoconus and ectasia subgroups. Improvements in postoperative indices were not correlated with changes in corrected or uncorrected distance visual acuity. There were improvements in 4 of 7 topography indices 1 year after CXL, suggesting an overall improvement in corneal shape. However, no significant correlation was found between the changes in individual topography indices and changes in visual acuity after CXL. Copyright © 2011. Published by Elsevier Inc.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              In vivo three-dimensional corneal epithelium imaging in normal eyes by anterior-segment optical coherence tomography: a clinical reference study.

              To evaluate the safety and efficacy of real-time measurement of corneal epithelial thickness and investigate the distribution characteristics in a large normal-eye population using a clinically available spectral-domain anterior-segment optical coherence tomography (AS OCT) system.
                Bookmark

                Author and article information

                Journal
                COP
                COP
                10.1159/issn.1663-2699
                Case Reports in Ophthalmology
                S. Karger AG
                1663-2699
                2014
                May – August 2014
                18 June 2014
                : 5
                : 2
                : 172-180
                Affiliations
                aLaservision.gr Eye Institute, Athens, Greece; bDepartment of Ophthalmology, NYU Medical School, New York, N.Y., Departments of cOphthalmology and dBiomedical Engineering, Cleveland Clinic, eCole Eye Institute, Cleveland Clinic, and fDepartment of Chemical and Biomedical Engineering, Cleveland State University, Cleveland, Ohio, USA
                Author notes
                *A. John Kanellopoulos, MD, Laservision.gr Eye Institute, 17 Tsocha Street, GR-115 21 Athens (Greece), E-Mail ajk@brilliantvision.com
                Article
                363371 PMC4105951 Case Rep Ophthalmol 2014;5:172-180
                10.1159/000363371
                PMC4105951
                25076897
                8225a14e-05c4-40ba-a850-8626eb9f376a
                © 2014 S. Karger AG, Basel

                Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) ( http://www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Page count
                Figures: 4, Tables: 1, Pages: 9
                Categories
                Published: June 2014

                Vision sciences,Ophthalmology & Optometry,Pathology
                Toric cross-linking,KXL II,High-fluence cross-linking,Topography customizable cross-linking,Keratoconus,Transepithelial cross-linking,Photorefractive intrastromal cross-linking

                Comments

                Comment on this article