Same-Day Intrastromal Corneal Ring Segment and Collagen Cross-Linking for Ectasia after Laser In Situ Keratomileusis: Long-Term Results

2014 ◽  
Vol 157 (5) ◽  
pp. 1070-1076.e2 ◽  
Author(s):  
Aydin Yildirim ◽  
Hasim Uslu ◽  
Necip Kara ◽  
Hanefi Cakir ◽  
Bulent Gurler ◽  
...  
2020 ◽  
pp. 112067212092892 ◽  
Author(s):  
Ahmed Elmassry ◽  
Osama Ibrahim Said Ahmed ◽  
Moones F Abdalla ◽  
Karim Gaballah

Purpose To study the effect of corneal collagen cross-linking (CXL) using riboflavin and ultraviolet rays on cases of corneal ectasia in keratoconus cases, post-laser–assisted in situ keratomileusis ectasia, and pellucid marginal degeneration and to present its long-term results over many years. Methods This study was conducted throughout 10 “years” experience in corneal collagen CXL, including 6120 cases. The study consists of two parts: a retrospective and a prospective part. All patients in the retrospective part were operated by epi-off, while in the prospective part, the epi-on procedure was used. Also, other machines were used as Peschke Vario, Peschke Phoenix, and different types of riboflavin. The results were analyzed using SPSS. Results The study showed stabilization ectasia in 95% of cases using our standard protocol, and this was proved by topography, pachymetry, refraction, and visual acuity. The effect of CXL was continued in 20% of cases, over a period of 3–5 years, some cases needed to repeat CXL due to the progression of corneal ectasia after cross-linking, in six eyes, that were rubbing their eyes and/or hormonal disturbance. Conclusion Corneal collagen cross-linking CXL is an effective method to prevent the progression of corneal ectasia, whether primary or post-laser–assisted in situ keratomileusis, and the effect was stable over the years of study.


2021 ◽  
pp. 112067212110183
Author(s):  
Yasin Cinar ◽  
Cagla Cilem Han ◽  
Alparslan Sahin ◽  
Zeba A Syed

Purpose: To evaluate the long term visual, refractive, and corneal tomographic outcomes of epithelium-off accelerated corneal collagen cross-linking (ACXL) in the management of pediatric keratoconus (KC). Methods: This retrospective study included patients under 18 years old with progressive KC who underwent ACXL between 2012 and 2019 at Dicle University Hospital. Complete ophthalmic examination was performed including uncorrected distance visual acuity (UDVA), best spectacle-corrected distance visual acuity (CDVA), manifest refraction, and corneal tomography. Evaluations were performed preoperatively and at 6 months intervals postoperatively. Results: Forty-nine eyes of 49 patients were included in the study. The mean age of patients at the time of ACXL was 14.2 ± 1.8 (range: 9.5–17.3) years. Mean follow up was 4.61 ± 1.90 (range: 2.0–8.1) years. The mean LogMAR UDVA improved from 0.94 ± 0.41 to 0.81 ± 0.43, 0.69 ± 0.41, and 0.67 ± 0.33 after 1, 3, and 5 years respectively ( p = 0.001). The mean LogMAR CDVA improved from 0.58 ± 0.36 to 0.46 ± 0.31, 0.34 ± 0.23, and 0.39 ± 0.27 after 1, 3, and 5 years respectively ( p = 0.015). The mean refractive cylinder improved significantly from 6.01 ± 2.07 diopters (D) to 5.46 ± 1.87, 5.38 ± 2.18, and 5.02 ± 2.31 D after 1, 3, and 5 years respectively ( p = 0.005). As compared to preoperative values, steep keratometry and maximum keratometry were not significantly different ( p = 0.805 and 0.448, respectively) following ACXL, while flat keratometry significantly improved after ACXL ( p = 0.012). Although central corneal thicknesses decreased significantly ( p = 0.029), the decrease in thinnest corneal thickness was not statistically significant ( p = 0.205). Conclusion: Epithelium-off ACXL seems to be effective for halting KC progression with long term clinical benefits in pediatric patients.


2018 ◽  
Vol 11 (2) ◽  
pp. 6-12 ◽  
Author(s):  
Oleg A. Frolov ◽  
Sergey Yu. Astakhov ◽  
Pavel A. Danilov ◽  
Sergey A. Novikov

Corneal collagen cross-linking became a permanent part of complex treatment for patients with different forms of corneal ectasia. In periodical literature, there are anecdotal reports concerning long-term results of this corneal disease therapy method, which is an isolated variant of photodynamic therapy. Purpose. To carry out a retrospective study of corneal collagen cross-linking long-term results in various ectatic corneal diseases. Materials and methods. Results of corneal collagen cross-linking in patients with ectatic forms of corneal dystrophy 6 years after surgery were analyzed. The nosological structure of the study included a group of patients with primary keratoconus, pellucid marginal corneal degeneration, secondary ectasias. The group with primary keratoconus includes 30 patients (31 eyes), that with pellucid marginal degeneration 10 patients (10 eyes), that with secondary ectasias – 10 patients (10 eyes). Data of the diagnostic examination before surgery, intermediate data of the dynamic follow-up during 6 years of observation were used for the analysis. Corneal collagen cross-linking was performed in the first or second year of follow-up, followed by monitoring of changes in the state of the cornea after corneal collagen cross-linking for 4-5 years. Results. A statistically significant increase in visual acuity was observed after the corneal collagen cross-linking in patients with primary and secondary ectasias. In patients diagnosed with pellucid marginal degeneration, there was no statistically significant increase of visual function. A decrease in the corneal asymmetry index was revealed in all groups and confirmed by statistical analysis.


Sign in / Sign up

Export Citation Format

Share Document