Journal ArticleDOI
Characteristics influencing outcomes of corneal collagen crosslinking for keratoconus and ectasia: implications for patient selection.
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TLDR
Patients with worse preoperative CDVA and higher K values, particularly with a CDVA of 20/40 or worse or a maximum K of 55.0 D or more, were most likely to have improvement after CXL, but no preoperative characteristics were predictive of CXL failure.Abstract:
PURPOSE: To determine preoperative patient characteristics that may predict topography and visual acuity outcomes of corneal collagen crosslinking (CXL). SETTING: Cornea and refractive surgery practice. DESIGN: Cohort study. METHODS: Crosslinking was performed in eyes with keratoconus or corneal ectasia. Multiple regressionandoddsratioanalyseswereperformedtodetermineindependentpredictors ofchanges in topography-derived maximum keratometry (K) and corrected distance visual acuity (CDVA) 1 year postoperatively. Preoperative characteristics included sex, age, uncorrected distance visual acuity (UDVA), CDVA, maximum keratometry (K), corneal thickness, corneal haze, disease group, and cone location. Postoperative improvement in maximum K was defined as flattening of 2.0 diopters (D) or more and worsening as steepening of 1.0 D or more. Improvement in CDVA was defined as a gain of 2 lines or more and worsening as a loss of 1 line or more. RESULTS: The study comprised 104 eyes (66 keratoconus; 38 corneal ectasia). Eyes with a preoperative CDVA of 20/40 or worse were 5.9 times (95% confidence interval [CI], 2.2-6.4) more likely to improve 2 Snellen lines or more. Eyes with a maximum K of 55.0 D or more were 5.4 times (95% CI, 2.1-14.0) more likely to have topographic flattening of 2.0 D or more. No preoperative characteristics significantly predicted worsening of visual acuity or corneal topography. CONCLUSIONS: Patients with worse preoperative CDVA and higher K values, particularly with a CDVA of 20/40 or worse or a maximum K of 55.0 D or more, were most likely to have improvement after CXL. No preoperative characteristics were predictive of CXL failure.read more
Citations
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Journal ArticleDOI
United States Multicenter Clinical Trial of Corneal Collagen Crosslinking for Keratoconus Treatment
Peter Hersh,R. Doyle Stulting,David Muller,Daniel S. Durrie,Rajesh K. Rajpal,Perry S. Binder,Eric D. Donnenfeld,Daniel Durrie,David R. Hardten,Peter S. Hersh,Francis W. Price,David J. Schanzlin,Walter J. Stark,William Trattler,Steven Trokel +14 more
TL;DR: Corneal collagen crosslinking was effective in improving the maximum keratometry value, CDVA, and UCVA in eyes with progressive keratoconus 1 year after treatment, with an excellent safety profile.
Journal ArticleDOI
Treatment options for advanced keratoconus: A review.
TL;DR: A summary of the current and emerging treatment options for advanced KC is offered, aiming to provide the corneal specialist useful information in selecting the optimal therapy for individual patients.
Book
Corneal Cross-Linking
TL;DR: The history of corneal cross-link, the scientific underpinnings of current techniques, evolving clinical treatment parameters, and the use of cross-linking in combination with refractive surgery and for the treatment of infectious keratitis are highlighted.
Journal ArticleDOI
Customized Corneal Cross-linking: One-Year Results.
TL;DR: Customized CXL seems to be as safe as standard CXL with stronger flattening in Kmax and RI, and a faster epithelial healing period.
Journal ArticleDOI
Corneal collagen cross-linking for treating keratoconus
Evripidis Sykakis,Rushmia Karim,Jennifer R Evans,Catey Bunce,Kwesi N Amissah-Arthur,Showrob N. Patwary,Peter J. McDonnell,Samer Hamada +7 more
TL;DR: This review assessed whether there is evidence that CXL is an effective and safe treatment for halting the progression of keratoconus compared to no treatment and identified three unpublished trials that potentially had enrolled a total of 195 participants.
References
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Journal ArticleDOI
Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus.
TL;DR: Collagen crosslinking may be a new way for stopping the progression of keratectasia in patients with keratoconus and the need for penetrating keratoplasty might then be significantly reduced in keratconus.
Journal ArticleDOI
Collagen crosslinking with riboflavin and ultraviolet-A light in keratoconus: long-term results.
TL;DR: Results indicate long‐term stabilization and improvement after collagen crosslinking is an effective therapeutical option for progressive keratoconus, and thus, collagenCrosslinking was an effective therapeutic option forgressive keratconus.
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Long-term results of riboflavin ultraviolet a corneal collagen cross-linking for keratoconus in Italy: the Siena eye cross study.
TL;DR: The results of the Siena Eye Cross Study showed a long-term stability of keratoconus after cross-linking without relevant side effects, supported by clinical, topographic, and wavefront modifications induced by the treatment.
Journal ArticleDOI
Complication and failure rates after corneal crosslinking
TL;DR: Results indicate that changing the inclusion criteria may significantly reduce the complications and failures of CXL and restricting patient age to younger than 35 years may reduce the complication rate to 1%.
Journal ArticleDOI
Parasurgical therapy for keratoconus by riboflavin-ultraviolet type A rays induced cross-linking of corneal collagen: preliminary refractive results in an Italian study
TL;DR: Topo‐aberrometric analysis findings of corneal symmetry showed a trend toward increasing cornean symmetry with a major reduction in asymmetry between vertical hemimeridians, which was confirmed by the reduction in mean K.